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Postoperative Nausea (postoperative + nausea)

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Medical Sciences100%

Terms modified by Postoperative Nausea

  • postoperative nausea and vomiting
    		•

    Selected Abstracts

    Assessment of postoperative nausea using a visual analogue scale

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2000
    J. G. Boogaerts
    Background: Assessment of postoperative nausea intensity is difficult because nausea is a subjective and unpleasant sensation. We propose using the Visual Analogue Scale (VAS) device to increase the efficiency and precision in the assessment of nausea. We carried out a pilot study on postoperative patients suffering from nausea to measure the degree of agreement between the VAS scores and those given on a 4-point verbal descriptive scale (VDS). Methods: Postoperative nausea was evaluated by means of a classical VAS (0,10 cm) device and a 4-point VDS (0=no nausea, 1=mild, 2=moderate, 3=severe) in 128 surgical spontaneously complaining patients. Evaluation was repeated 45 min after rescue medication given if nausea was intractable, lasted more than 10 min or at the request of the patient. Ordinal logistic regression was used to measure the association between VAS and VDS and to determine cut-off points on the VAS. Results: The VAS device was easily understood and used by patients. VAS scores decreased significantly from 5.5±2.3 to 1.4±1.8 after rescue medication (P=0.002). Application of ordinal logistic regression to pre- and post-medication data combined yielded an agreement of 86% between VAS and VDS and the cut-off points on the VAS were estimated as follows: 0,1 (no nausea), 1+,4 (mild), 4+,7 (moderate) and 7+,10 (severe). Conclusion: The VAS method proved to be useful for assessing quantitative nausea intensity and for testing the efficacy of rescue medication. It was found that a cut-off value of 4 on the VAS may be considered as a critical threshold triggering anaesthesiologists or nurses to administer rescue medication. [source]

    Intramuscular ephedrine reduces emesis during the first three hours after abdominal hysterectomy

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2000
    E. Hagemann
    Background: We tested the hypothesis that intramuscularly administered ephedrine prevents postoperative nausea and vomiting. Ephedrine is cheap, and for this indication poorly documented. Methods: One hundred and nine patients undergoing elective abdominal hysterectomy under general anaesthesia were studied in a randomized, double-blind placebo-controlled study. Ten minutes before the end of the procedure patients received either ephedrine 0.5 mg/kg i.m. or placebo. The patients were closely observed for 24 h for postoperative nausea or vomiting (PONV) and received a standardized two-step antiemetic treatment of i.v. metoclopramide 10 mg, supplemented with ondansetron 4 mg i.v. if needed. Results: The ephedrine treated patients had significantly less nausea, retching and vomiting, and need of antiemetic rescue during the first 3 h postoperatively compared with the placebo patients. No difference between the groups was evident in the 3,24 h postoperative observation period. All the patients with PONV during 0,3 h experienced PONV in the 3,24 h period. Treatment or prophylaxis with one drug was less efficient than two or more drugs combined. No significant differences in hypotension, tachycardia or other side-effects between the groups were noted. Conclusion: Ephedrine 0.5 mg/kg i.m. administered at the end of abdominal hysterectomy has a significant antiemetic effect during the first 3 h after administration with no evident side-effects. [source]

    The anaesthetic management of patients with congenital insensitivity to pain with anhidrosis

    PEDIATRIC ANESTHESIA, Issue 4 2004
    V. Rozentsveig MD
    Summary Background :,Congenital insensitivity to pain with anhidrosis (CIPA, or hereditary sensory and autonomic neuropathy type IV) is a rare, autosomal recessive disease, related to a mutation in the TrkA gene, characterized by inability to sweat, insensitivity to pain and recurrent episodes of hyperpyrexia. There are two Bedouin tribes in Israel with different mutations of the TrkA gene: one in the southern region and the other in the northern region. The Soroka University Medical Center is the referral centre for the entire southern region of Israel. One in 4500 anaesthesia cases involves a patient with CIPA. Methods :,We reviewed 40 anaesthesia records of 20 patients with CIPA for anaesthetic technique and incidence of side-effects. Results :,Sixteen patients developed complications in the immediate perioperative period: mild hypothermia in one patient and cardiovascular events in 15 others with one case of cardiac arrest. These complications were unrelated to the anaesthetic drug administered. There were no events of hyperthermia or postoperative nausea. Conclusions :,Cardiovascular complications following anaesthesia are common in patients with the southern Israel variant of CIPA. Hyperthermia, previously recognized as a major concern in patients with congenital insensitivity to pain with anhydrous, was not seen in our patients. We conclude that cardiovascular involvement is frequently encountered in CIPA patients following anaesthesia and is the major concern in their anaesthetic management. [source]

    Incidence of postoperative nausea and vomitingin paediatric ambulatory surgery

    PEDIATRIC ANESTHESIA, Issue 8 2002
    I. Villeret
    SummaryBackground: We performed a prospective descriptive study over a 5-month period to determine the incidence of postoperative nausea and vomiting (PONV) during the first 24 h following elective ambulatory paediatric surgery, excluding head and neck procedures. Methods: Four hundred and seven patients, aged 15 days to 16 years, were analysed prospectively. Results: The incidence of PONV was 9.4%, occurring most frequently during the first 3 h after anaesthesia and in hospital but rarely during the journey home. It was associated with age, previous history of PONV, tracheal intubation or use of the laryngeal mask airway (LMAÔ), controlled or manual ventilation, opioids and absence of oral intake of liquids or solids. Conversely, type of surgery, premedication, induction mode, association of regional anaesthesia, inhaled nitrous oxide, duration of anaesthesia, stay in the postanaesthesia care unit and duration of journey after discharge were not significantly associated with PONV. Conclusions: PONV never induced complications or delayed patient discharge and curative treatment was rapidly effective. [source]

    Ondansetron has similar clinical efficacy against both nausea and vomiting

    ANAESTHESIA, Issue 2 2009
    R. M. Jokela
    Summary Ondansetron is widely believed to prevent postoperative vomiting more effectively than nausea. We analysed data from 5161 patients undergoing general anaesthesia who were randomly stratified to receive a combination of six interventions, one of which was 4 mg ondansetron vs placebo. For the purpose of this study a 20% difference in the relative risks for the two outcomes was considered clinically relevant. Nausea was reduced from 38% (969/2585) in the control to 28% (715/2576) in the ondansetron group, corresponding to a relative risk of 0.74, or a relative risk reduction of 26%. Vomiting was reduced from 17% (441/2585) to 11% (293/2576), corresponding to a relative risk of 0.67, or a relative risk reduction of 33%. The relative risks of 0.67 and 0.74 were clinically similar and the difference between them did not reach statistical significance. We thus conclude that ondansetron prevents postoperative nausea and postoperative vomiting equally well. [source]

    Health-related quality of life during neoadjuvant treatment and surgery for localized esophageal carcinoma

    CANCER, Issue 9 2005
    Jane M. Blazeby B.Sc., M.D.
    Abstract BACKGROUND Esophagectomy has a negative influence on health-related quality of life (HRQL) during the first postoperative year, but it is not known how chemotherapy or chemoradiotherapy treatment before surgery affects HRQL. The current study examined HRQL during preoperative chemotherapy/chemoradiotherapy treatment and compared postoperative recovery of HRQL in patients undergoing combined treatment with patients undergoing surgery alone. METHODS One hundred three patients completed standardized HRQL measures before and during neoadjuvant treatment and before and after surgery. Mean HRQL scores were calculated and preoperative scores were used to model postoperative ratings using linear regression. RESULTS Deterioration in most aspects of HRQL occurred during preoperative chemotherapy. Patients proceeding to concomitant radiotherapy further deteriorated with specific problems with reflux symptoms and role function (difference between means >15, P < 0.01). After neoadjuvant treatment, but before surgery, HRQL returned to baseline levels. Six weeks after surgery, patients reported marked reductions in physical, role, and social function (difference between means > 30, P < 0.01) and increase in fatigue, nausea and emesis, pain, dyspnea, appetite loss, and coughing (difference between means > 15, P < 0.01). Recovery of HRQL was not hampered by preoperative treatment, and fewer problems with postoperative nausea, emesis, and dysphagia were reported by patients who had undergone neoadjuvant treatment compared with patients who had undergone surgery alone. CONCLUSIONS Preoperative chemotherapy or chemoradiotherapy had a negative impact on HRQL that was restored in patients proceeding to surgery. Recovery of HRQL after esophagectomy was not impaired by neoadjuvant treatment. These results supported the use of neoadjuvant treatment before surgery. Cancer 2005. © 2005 American Cancer Society. [source]