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Postoperative Nausea And Vomiting (postoperative + nausea_and_vomiting)
Selected AbstractsPreoperative ropivacaine infiltration in breast surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2000A. Johansson Purpose: The aim of the study was to investigate whether preoperative infiltration with ropivacaine in conjunction with breast surgery improves postoperative pain management and attenuates postoperative nausea and vomiting. Method: Prospective, randomised, double-blind study, including 60 healthy women (ASA 1,2) allocated to one of two groups. Thirty patients were given 0.3 ml/kg saline in the operating field before surgery. Another 30 patients received a similar volume of ropivacaine 3.75 mg/ml. A visual analogue scale (0,100 mm) was used for evaluation of postoperative pain, nausea and vomiting. If the score was more than 30 mm at rest, the patients were given ketobemidone i.v. as treatment for postoperative pain, and dixyrazine i.v. against nausea and vomiting. The intra- and postoperative analgesic requirements and postoperative nausea and vomiting were registered. Results: The intraoperative fentanyl consumption was similar in the saline group 81±22 ,g vs 76±28 ,g; (ns) in the ropivacaine group. The postoperative 24-h ketobemidone consumption was also similar to those treated with ropivacaine (4.2±2.6 mg vs 4.2±4.3 mg; ns). Postoperative nausea and vomiting (PONV) occurred with similar frequencies in both groups. The 24-h dixyrazine consumption was the same in the two groups (2.1±2.7 mg in the saline group compared to 2.4±2.8 mg in the ropivacaine group; ns). After 6 h recovery, 41% of all patients had experienced nausea and 20% vomiting. Conclusion: We found no differences in postoperative pain management between 3.75 mg/ml ropivacaine and saline wound infiltration before breast surgery. The data show similar postoperative needs of analgesics and antiemetics with a similar frequency of PONV. [source] Sevoflurane: an ideal agent for adult day-case anesthesia?ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2003S. Ghatge Sevoflurane has several properties which make it potentially useful as a day case anaesthetic. Following induction of anaesthesia with propofol, awakening from sevoflurane is faster compared to isoflurane, faster or similar compared to propofol and comparable (in the majority of studies) to desflurane. Subsequent recovery and discharge is generally similar following all agents. Sevoflurane may also be used to induce anaesthesia, which is generally well-received and causes less hypotension and apnoea compared to propofol. When used as a maintenance anaesthetic, the incidence of postoperative nausea and vomiting after sevoflurane is comparable to other inhaled anaesthetics, but this complication appears more common after inhaled inductions. The tolerability and low solubility of sevoflurane facilitate titration of anaesthesia and may reduce the need for opioid analgesia, which in turn may limit the occurrence of nausea and vomiting. [source] How to study postoperative nausea and vomitingACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2002C. C. Apfel Anesthesiological journals are flooded by innumerable studies of postoperative nausea and vomiting (PONV). Nevertheless, PONV remains a continuing problem with an average incidence of 20,30%. This paper should provide essential information for the design, conduct, and presentation of these studies. It should also increase comparability among future studies and help clinicians in assessing and reading the literature on PONV. First, future studies should address new and relevant questions instead of repeatedly investigating prophylactically given antiemetics whose main results are predictable (e.g. already proven by meta-analysis). Second, group comparability should be based on well-proven risk factors and a simplified risk score for predicting PONV. Endless listings of doubtful risk factors should be avoided. Third, a realistic sample size estimation should be performed, i.e. in most cases at least 100 patients per group are necessary. Fourth, nausea, vomiting and rescue medication should be recorded and reported separately with the corresponding incidences (and number of patients with these separate symptoms), and the main end-point should be PONV. The entire observation period should cover 24 h. Additional reporting of the early (0,2 h) and delayed (2,24 h) postoperative period is desirable and should consider single and cumulative incidences. Lastly, interpretation of results should take into account the study hypothesis, sources of potential bias or imprecision, and the difficulties associated with multiplicity of analysis and outcomes. [source] A small dose of droperidol decreases postoperative nausea and vomiting in adults but cannot improve an already excellent patient satisfactionACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2001A. Hechler Background: We evaluated whether or not 1) a routine prophylaxis with 20 ,g ,· ,kg,1 body weight of droperidol would efficiently prevent postoperative nausea and vomiting (PONV) after elective surgery in adults and 2) an efficient prophylaxis would improve patient satisfaction. Methods: With approval of the local ethics committe and after having obtained informed written consent, 1334 patients in a randomised, single-blinded fashion either received droperidol (group 1, n=665) or saline intravenously (group 2, n=669) 20 min before the end of a standard O2/N2O/fentanyl/isoflurane anaesthesia of at least 30 min duration. End points: incidence of PONV during the first 24 h; individual episodes of nausea or vomiting, overall patient satisfaction with the procedure. Results: Compared to saline, intravenous injection of droperidol substantially and significantly reduced the incidence of PONV from 30% to 20% (P<0.0001). Women suffered three times more frequently from PONV (10.5% vs. 30%, P<0.0001). Droperidol significantly reduced the incidence of PONV from 35.4% to 24.4% in women (relative risk reduction: 31%, P=0.0002), but not in men (13.1% vs. 8.2%, relative risk reduction: 37%, P=0.159) , without impact on overall patient satisfaction (98.8% vs. 97.1%, P=0.439). Distribution of surgical procedures, sex, age, height, weight and anaesthetic duration were not different between groups. To prevent one woman from suffering PONV, nine had to be treated prophylactically at an individual drug cost (German prices) of about 0.80 per woman. Conclusion: Routine PONV prophylaxis with 20 ,g ,· ,kg,1 body weight of droperidol is cost-efficient and appropriate in women but not in men. [source] Myopexy (Faden) results in more postoperative vomiting after strabismus surgery in childrenACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2001M. Saiah Background: Strabismus correction in children is associated with a high incidence of postoperative nausea and vomiting. The purpose of this prospective, double-blind study was to examine the influence of the surgical method for correction of squint on the incidence of postoperative vomiting. Methods: One hundred and twenty consecutive children aged 2,12 years, scheduled for elective strabismus surgery, were enrolled in this prospective, double-blind study. A standardised total intravenous anaesthesia was given to all children. The development of perioperative oculocardiac reflex was noted and the number of episodes of vomiting during the first 48 h postoperatively was recorded. At the completion of the study, the children who were operated with myopexy according to Faden, were allocated to a Faden group, those without a myopexy to the non-Faden group. All the patients included in this study were operated on by the same surgeon with standardised techniques. Results: The Faden group was younger, lighter and the operation time was longer (P<0.05). The incidence of vomiting was greater in the Faden group; 53% versus 12% (P<0.05). The incidence of oculocardiac reflex was similar in both groups; 40% in the Faden versus 28% in the non-Faden group, respectively. The total dose of propofol and alfentanil was similar between the groups. Requirement of analgesics for postoperative pain was similar in both groups. The only independent risk factor for postoperative vomiting was the Faden operation. Conclusion: The surgical method used for strabismus correction in children has a great influence on the incidence of postoperative vomiting. The Faden operation is associated with a very high incidence of postoperative vomiting; this particular group of patients has to be considered as a high risk group for postoperative vomiting and deserves an antiemetic prophylaxis. [source] Preoperative ropivacaine infiltration in breast surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2000A. Johansson Purpose: The aim of the study was to investigate whether preoperative infiltration with ropivacaine in conjunction with breast surgery improves postoperative pain management and attenuates postoperative nausea and vomiting. Method: Prospective, randomised, double-blind study, including 60 healthy women (ASA 1,2) allocated to one of two groups. Thirty patients were given 0.3 ml/kg saline in the operating field before surgery. Another 30 patients received a similar volume of ropivacaine 3.75 mg/ml. A visual analogue scale (0,100 mm) was used for evaluation of postoperative pain, nausea and vomiting. If the score was more than 30 mm at rest, the patients were given ketobemidone i.v. as treatment for postoperative pain, and dixyrazine i.v. against nausea and vomiting. The intra- and postoperative analgesic requirements and postoperative nausea and vomiting were registered. Results: The intraoperative fentanyl consumption was similar in the saline group 81±22 ,g vs 76±28 ,g; (ns) in the ropivacaine group. The postoperative 24-h ketobemidone consumption was also similar to those treated with ropivacaine (4.2±2.6 mg vs 4.2±4.3 mg; ns). Postoperative nausea and vomiting (PONV) occurred with similar frequencies in both groups. The 24-h dixyrazine consumption was the same in the two groups (2.1±2.7 mg in the saline group compared to 2.4±2.8 mg in the ropivacaine group; ns). After 6 h recovery, 41% of all patients had experienced nausea and 20% vomiting. Conclusion: We found no differences in postoperative pain management between 3.75 mg/ml ropivacaine and saline wound infiltration before breast surgery. The data show similar postoperative needs of analgesics and antiemetics with a similar frequency of PONV. [source] Electrical stimulation of the vestibular system prevents postoperative nausea and vomitingACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2000F. Pusch Background: Electrical stimulation of the vestibular system may prevent nausea and vomiting. We studied the influence of transcutaneous impulse stimulation in prevention of postoperative nausea and vomiting (PONV) following gynaecological surgery. Methods: In this randomised study 70 women undergoing elective gynaecological surgery under general anaesthesia were assigned to receive either the activated (stimulation group) or the inactivated (non-stimulation group) impulse stimulator. The stimulator comprises the stimulator itself, two negative electrodes on a headset applied over both mastoid processes and a nuchal positive electrode. The device yielded a pulse frequency of 5 Hz direct current, individually adjustable between 0.5 and 4 mA. A trapezoid stimulation of 50 ms was applied. Nausea, vomiting, dizziness and the amount of antiemetic drugs used were assessed during the first 4 h postoperatively. Results: Lower postoperative nausea scores with a lower incidence of vomiting and postoperative dizziness were found in the stimulation group. A lower amount of antiemetic drugs was needed in the stimulation group when compared to the non-stimulation group (P<0.01 between groups). Conclusion: This study suggests that electrical stimulation of the vestibular system may be useful in prevention of PONV. [source] Intramuscular ephedrine reduces emesis during the first three hours after abdominal hysterectomyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2000E. 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] Effects of therapeutic suggestion in children undergoing general anesthesia: a randomized controlled trialPEDIATRIC ANESTHESIA, Issue 1 2010MICHELLE A. FORTIER PhD Summary Objectives and aim:, The goal of this randomized controlled trial was to examine the effect of intraoperative positive therapeutic suggestion on postoperative nausea and vomiting (PONV) in children undergoing general anesthesia and otolaryngological surgery. Background:, Because of the high incidence of PONV following otolaryngological surgery and its negative impact on recovery, researchers have examined various nonpharmacological interventions to target this phenomenon. To date, the effectiveness of therapeutic suggestion has not been studied in children. Methods:, Participants were 67 children undergoing tonsillectomy and adenoidectomy and their mothers. Children received a standardized anesthetic procedure and were randomly assigned to one of three interventions administered under general anesthesia: therapeutic suggestion, story (prosody control), or standard operating room noise. Children, parents, and healthcare personnel were blinded to group assignment. Nausea and vomiting were recorded in the postanesthesia care unit (PACU) and for the first 3 days at home. Results:, Results demonstrated a decrease in nausea severity across the first 3 days, F2,49 = 10.37, P < 0.001, but no group differences in nausea severity in the PACU (F2,49 = 0.87, P = 0.43) or at home (F2,49 = 0.80, P = 0.46). There were also no group differences in vomiting episodes in the PACU (,2 (2) = 1.25, P > 0.05) or at home (F2,49 = 1.59, P = 0.21). Conclusions:, In this blinded controlled trial, therapeutic suggestion delivered intraoperatively did not impact children's PONV. However, because this is the first study of this kind, replication may be needed. [source] Postoperative continuous intrathecal pain treatment in children after selective dorsal rhizotomy with bupivacaine and two different morphine dosesPEDIATRIC ANESTHESIA, Issue 4 2006KARIN HESSELGARD RN Summary Background:, Children undergoing selective dorsal rhizotomy (SDR) experience severe pain postoperatively; a pain related to both the extensive surgical exposure with multilevel laminectomy and nerve root manipulation. We sought to define an optimal dose of continuous intrathecal (IT) morphine and bupivacaine to treat this severe pain. The aim of this study was to compare two different concentrations of morphine in a fixed dose of bupivacaine with regard to the analgesic effect and survey if they differed in side effects. Methods:, Twenty-six children, aged 2.7,7.4 years undergoing SDR were included in this study. Postoperatively 11 children received a continuous infusion of morphine 0.4 ,g.kg,1.h,1 and bupivacaine 40 ,g.kg,1.h,1 (low-dose group) and 15, a continuous infusion of morphine 0.6 ,g.kg,1.h,1 and bupivacaine 40 ,g.kg,1.h,1 (high-dose group). The Behavioral Observational Pain Scale (BOPS) was used to evaluate pain. Results:, Better pain relief was obtained in the high-dose group seen in lower BOPS score compared with the low-dose group [P = 0.03, Fisher's permutation test and P = 0.06 Wilcoxon,Mann,Whitney (WMW) test]. The low-dose group received seven times as much ketobemidone 0.43 ± 0.54 mg.kg,1 48 h,1 compared with 0.06 ± 0.09 mg.kg,1 48 h,1 in the high-dose group (P = 0.0005 Fisher's permutation test, P = 0.0017 WMW test). There was no statistical difference in pruritus and postoperative nausea and vomiting between the groups. Respiratory and hemodynamic depression was not found. Conclusion:, This study shows that, compared with low-dose, the higher dose of continuous IT morphine combined with bupivacaine, significantly reduce pain score and postoperative intravenous analgesic requirements without increasing adverse effects. [source] Incidence of postoperative nausea and vomitingin paediatric ambulatory surgeryPEDIATRIC ANESTHESIA, Issue 8 2002I. 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] Comparison of spontaneous with controlled mode of ventilation in tonsillectomyPEDIATRIC ANESTHESIA, Issue 2 2001FRCA(UK), Fauzia A. Khan MB Methods:,This randomized study compares spontaneous versus controlled ventilation in 60 ASA I and II patients undergoing tonsillectomy as regards haemodynamic stability, recovery characteristics, intra- and immediate postoperative complications and surgical impressions. Results:,The patients in the balanced anaesthesia (B) group showed less haemodynamic variability compared to baseline after tracheal intubation, mouth gag application and removal and incision. Two patients had dysrhythmias in the B group compared to six in the spontaneous breathing (S) group. Six patients in the S group had a rise in endtidal carbon dioxide concentration above 7.8 kPa (60 mmHg). Recovery scores were higher in the B group at 10 and 20 min into recovery. The surgical impression of bleeding and jaw relaxation was similar with both groups. The incidence of postoperative nausea and vomiting and agitation was higher in the S group but did not achieve statistical significance. Conclusions:,Use of balanced anaesthesia offered more haemodynamic stability and a rapid recovery. [source] Use of Dexamethasone on the Prophylaxis of Nausea and Vomiting After Tympanomastoid Surgery,THE LARYNGOSCOPE, Issue 7 2001Yun-Hou Liu MD Abstract Objective The aim of this study was to evaluate the prophylactic effect of dexamethasone on postoperative nausea and vomiting (PONV) in patients undergoing tympanomastoid surgery. Study Design Eighty patients (n = 40 in each of two groups) undergoing tympanomastoid surgery under general anesthesia were enrolled in this randomized, double-blind, placebo-controlled study. Methods After tracheal intubation, group 1 received 10 mg dexamethasone intravenously, whereas group 2 received saline intravenously. Several parameters concerning with the occurrence of PONV were evaluated. Results We found that dexamethasone reduced the total incidence of nausea and vomiting by 45%, with a 95% confidence interval of 26% to 64% (P <.001). Furthermore, dexamethasone reduced the incidence of vomiting episodes >4 times and the incidence of patients requiring rescue antiemetics (P <.05). Conclusion Dexamethasone at a dosage of 10 mg administered intravenously is effective in preventing PONV in patients undergoing tympanomastoid surgery. [source] Association of ABCB1 polymorphisms with the efficacy of ondansetron for postoperative nausea and vomitingANAESTHESIA, Issue 10 2010E. M. Choi Summary We investigated whether the 2677G>T/A and 3435C>T polymorphisms of adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1) affect the efficacy of ondansetron to prevent postoperative nausea and vomiting. One hundred and ninety-eight patients undergoing general anaesthesia were enrolled. Thirty minutes before the end of surgery, 0.1 mg.kg,1 ondansetron was administered intravenously. The incidence of postoperative nausea and vomiting was compared between genotypes in the 2677G>T/A and 3435C>T polymorphisms of ABCB1. The incidence of postoperative nausea and vomiting was lower in patients with the 2677TT genotype (TT vs Non-TT = 25.9% vs 53.0%, p = 0.01) and 3435TT genotype (CC + CT vs TT = 52.6% vs 21.7%, p = 0.01) during the first 2 h after surgery. There were no significant differences in the incidence of postoperative nausea and vomiting between the different genotype groupings during period between 2 and 24 h after surgery. In conclusion, ABCB1 genotypes may be a clinical predictor of responsiveness for ondansetron. [source] Improving the accuracy of risk assessment in postoperative nausea and vomitingANAESTHESIA, Issue 8 2010A. Roberts No abstract is available for this article. [source] Comparison of the prophylactic anti-emetic efficacy of ramosetron and ondansetron in patients at high-risk for postoperative nausea and vomiting after total knee replacementANAESTHESIA, Issue 5 2010T. S. Hahm Summary We compared the prophylactic anti-emetic efficacy of ramosetron, a newly developed 5-HT3 antagonist, and ondansetron in patients at high-risk for postoperative nausea and vomiting after total knee replacement. Eighty-four patients with three risk factors for postoperative nausea and vomiting (female, non-smoking and use of postoperative opioid use (ropivacaine and hydromorphone patient controlled epidural analgesia)) undergoing unilateral total knee replacement were randomly allocated to ramosetron 0.3 mg (n = 42) or ondansetron 4 mg (n = 42) groups. A complete response (no postoperative nausea and vomiting and no rescue anti-emetic) and the incidence of postoperative nausea and vomiting were assessed for 48 h after surgery at 0,2 h, 2,6 h, 6,24 h, and 24,48 h. More patients in the ramosetron group had a complete response between 2 and 48 h. The incidence of nausea between 2 and 24 h and the severity of nausea between 2 and 48 h were also less in the ramosetron group. Ramosetron was more effective than ondansetron in preventing postoperative nausea and vomiting in patients at high risk undergoing unilateral total knee replacement. [source] Association between nitrous oxide and the incidence of postoperative nausea and vomiting in adults: a systematic review and meta-analysisANAESTHESIA, Issue 4 2010J. Fernández-Guisasola Summary Some, but not all studies have suggested intra-operative use of nitrous oxide is correlated with postoperative nausea and vomiting. We performed a meta-analysis of randomised controlled trials to compare the incidence of nausea and vomiting in adults following general anaesthesia with or without nitrous oxide. We retrieved 30 studies (incorporating 33 separate trials) that investigated a ,nitrous oxide group' (total 2297 patients) vs a ,no-nitrous oxide group' (2301 patients). Omitting nitrous oxide significantly reduced postoperative nausea and vomiting (pooled relative risk 0.80, 95% CI 0.71,0.90, p = 0.0003). However, the absolute incidence of nausea and vomiting was high in both the nitrous oxide and no-nitrous oxide groups (33% vs 27%, respectively). In subgroup analysis, the maximal risk reduction was obtained in female patients (pooled relative risk 0.76, 95% CI 0.60,0.96). When nitrous oxide was used in combination with propofol, the antiemetic effect of the latter appeared to compensate the emetogenic effect of nitrous oxide (pooled relative risk 0.94, 95% CI 0.77,1.15). We conclude that avoiding nitrous oxide does reduce the risk of postoperative nausea and vomiting, especially in women, but the overall impact is modest. [source] The effect on outcome of peribulbar anaesthesia in conjunction with general anesthesia for vitreoretinal surgeryANAESTHESIA, Issue 3 2010A. M. Ghali Summary The purpose of this study was to evaluate peri-operative outcome after vitreoretinal surgery when peribulbar anaesthesia is combined with general anaesthesia. Sixty adult patients undergoing elective primary retinal detachment surgery with scleral buckling or an encircling procedure received either peribulbar anaesthesia in conjunction with general anaesthesia or general anaesthesia alone. For peribulbar anaesthesia a single percutaneous injection of 5,7 ml of local anaesthetic solution (0.75% ropivacaine with hyaluronidase 15 iu.ml,1) was used. The incidence of intra-operative oculocardiac reflex and surgical bleeding interfering with the surgical field, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In the block group there was a lower incidence of oculocardiac reflex and surgical bleeding intra-operatively. Patients in the block group also had better postoperative analgesia and a lower incidence of postoperative nausea and vomiting compared with the group without a block. The use of peribulbar anaesthesia in conjunction with general anesthesia was superior to general anaesthesia alone for vitreoretinal surgery with scleral buckling. [source] Efficacy of orally disintegrating ondansetron in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy: a randomised, double-blind placebo controlled studyANAESTHESIA, Issue 6 2009V. K. Grover Summary Peri-operative prophylactic anti-emetics are commonly used parenterally. Orally disintegrating ondansetron is efficacious during chemotherapy. Therefore, we aimed to study the efficacy of orally disintegrating ondansetron for postoperative nausea and vomiting. In a randomised, double-blind, placebo controlled trial on 109 patients scheduled for laparoscopic cholecystectomy, oral ondansetron was compared to intravenous ondansetron and placebo. The anaesthetic technique was standardised. Mean time (SD) to tolerating oral intake was delayed in the placebo group to 366.1 (77.6) min compared to oral 322.9 (63.7) min and intravenous 322.4 (65.2) min groups. This is corroborated by a higher incidence of nausea and vomiting in the control group during the first 6 h postoperatively (control 44.4%, oral 17.7%, intravenous 18.2%). There was no significant difference between oral and intravenous groups. In conclusion, orally disintegrating ondansetron was as efficacious as intravenous ondansetron in the peri-operative phase and may be a viable option for prophylaxis of emesis in day care surgery. [source] Subacute pain and function after fast-track hip and knee arthroplastyANAESTHESIA, Issue 5 2009L. Ř. Andersen Summary In a well-defined fast-track setup for total hip and knee arthroplasty, with a multimodal analgesic regimen consisting of intra-operative local anaesthetic infiltration and oral celecoxib, gabapentin and paracetamol for 6 days postoperatively, we conducted a prospective, consecutive, observational study. The purpose was to describe the prevalence and intensity of subacute postoperative pain and opioid related side effects, use of analgesics and functional ability 1,10 and 30 days postoperatively. Fast-track total hip and knee arthroplasty with early discharge (< 3 days) resulted in acceptable levels of pain and postoperative nausea and vomiting with concomitant low use of opioids in > 95% of patients after discharge before day 10 after total hip arthroplasty. However, after total knee arthroplasty 52% patients reported moderate pain (VAS 30,59 mm), and 16% severe pain (VAS , 60 mm) when walking 1 month after surgery with a concomitant increase in the use of strong opioids. These results emphasise the need for improvement in analgesia after discharge following total knee arthroplasty, to facilitate rehabilitation. [source] The addition of dexamethasone to dolasetron or haloperidol for treatment of established postoperative nausea and vomiting,ANAESTHESIA, Issue 8 2007D. Rüsch Summary It is not known whether dexamethasone increases the effectiveness of anti-emetics when given to treat postoperative nausea and vomiting (PONV). In a randomised study, 242 patients who were experiencing PONV received dolasetron and placebo, haloperidol and placebo, dolasetron and dexamethasone, or haloperidol and dexamethasone. The results from 228 patients were suitable for analysis. PONV recurred significantly less frequently in patients treated with additional dexamethasone (33%) than in patients treated without additional dexamethasone (51%). The combination of dexamethasone with dolasetron or dexamethasone with haloperidol is superior to dolasetron or haloperidol alone for the treatment of PONV. [source] Midazolam vs ondansetron for preventing postoperative nausea and vomitingANAESTHESIA, Issue 6 2007G. Timms No abstract is available for this article. [source] Prophylaxis of postoperative nausea and vomiting: an audit of current practice and costANAESTHESIA, Issue 3 2007A. Kumar No abstract is available for this article. [source] Is postoperative nausea and vomiting following tonsillectomy really a problem?ANAESTHESIA, Issue 10 2002J. J. Church No abstract is available for this article. [source] The effect of smoking on postoperative nausea and vomitingANAESTHESIA, Issue 10 2000R. Thomas [source] | ||||||||||