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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patient-controlled analgesia (PCA, intravenous self-application of narcotics) has been studied during the early postoperative period in 40 ASA I-III patients recovering from elective major and minor surgery (20 abdominal and 20 orthopaedic operations). Doses of 3.7 mg of the new agonist-antagonist opioid analgesic nalbuphine were available on demand, whenever the patients felt that pain relief was necessary, delivered by a microprocessor-controlled injection pump (On-Demand Analgesia Computer, ODAC) in response to use of a patient-controlled manual switch. The maximum dose/h was set at 28.2 mg, with a refractory time of 1 minute between successful demands. A continuous nalbuphine infusion (0.44 mg X h-1) was administered in addition in order to prevent obstruction of the catheter. The duration of the PCA period was 17.9 (0.4-28.0) h (median, range). During that time, 13.3 (1-45) demands per patient were recorded, resulting in median individual nalbuphine consumptions of 51.3 (8.1-1050.5) micrograms X kg-1 X h-1. Self-administration was characterized by considerable intra- and inter-individual variability. Following abdominal surgery significantly more nalbuphine was needed compared to orthopaedic patients, but it resulted in poorer pain relief. There were no statistically significant differences in drug requirements or pain scores between the sexes. Overall efficacy and patient acceptance proved to be good. When compared with previous conventional postoperative analgesia, the effectiveness of PCA was judged superior by about 57% of patients. Side effects (nausea, sweating) occurred in about 10% of patients but were usually of minor intensity. No serious circulatory or respiratory problems were observed during the period of PCA. Patient-controlled analgesia is a promising technique for the treatment of acute pain and for clinical pain research.
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PMID:Patient-controlled analgesia with nalbuphine, a new narcotic agonist-antagonist, for the treatment of postoperative pain. 379 24

Patient-controlled analgesia (PCA, intravenous self-application of narcotics) was studied during the early postoperative period. Subjects were 40 ASA I-III patients recovering from elective major and minor surgery (each 20 having undergone abdominal or orthopaedic operations). Pentazocine bolusses of each 8 mg were available via a hand-button whenever the patients felt pain relief necessary, and delivered by a microprocessor-controlled injection pump (On-Demand Analgesia Computer, ODAC). Hourly maximum dose was set to 60 mg with a pump refractory time of 1 min between valid demands. A continuous low-dose pentazocine infusion (1 mg/h) was additionally administered in order to prevent catheter obstruction. Duration of the PCA period was 20.3 +/- 5.9 h (mean, standard deviation). During this time, 20.0 +/- 12.7 demands per patient were recorded resulting in mean pentazocine consumption of 135.6 +/- 81.4 micrograms/kg/h. Self-administration was characterized by considerable intra- and interindividual variability. There were no statistically significant differences with regard of pentazocine consumption or pain relief between abdominal and orthopaedic patients, nor could any be demonstrated between the sexes. Similarly, no clear differences were found after various anaesthetic techniques (neuroleptanalgesia, halothane or spinal anaesthesia). Over-all efficacy and patient acceptance proved to be excellent. Effectiveness of PCA was judged superior by about 68% of patients when compared with previously experienced conventional postoperative analgesia. Side effects (nausea, emesis, sweating) occurred in about 10-18% but were usually of minor intensity. Circulatory or respiratory problems were not observed during the PCA period. Patient-controlled analgesia is discussed as a promising concept for the treatment of acute pain and clinical pain research.
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PMID:[Postoperative on-demand analgesia with pentazocine (Fortral)]. 409 11

This discussion is based on the experience of the Phoenix Surgicenter, where over 60,000 patients have been anaesthetized since 1970. Patients accepted for out-patient surgery are ASA Status I or II, although status III patients may be included if their co-existing disability is under excellent control. Eighty-five per cent of adult patients receive general anaesthesia. A wide variety of local and regional anaesthetic techniques may be used. Efforts during recovery are directed towards preparing the patient for discharge in a "home ready" condition for safe handling by attending relatives. The common complications have been postoperative nausea or emesis and hypotension. The hospital transfer rate has been 0.2 per cent.
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PMID:Anaesthesia for day-care surgery: a symposium (III). Anaesthesia for adult surgical out-patients. 740 73

The efficacy of ginger for the prevention of postoperative nausea and vomiting was studied in a double-blind, randomized, controlled trial in 108 ASA 1 or 2 patients undergoing gynaecological laparoscopic surgery under general anaesthesia. Patients received oral placebo, ginger BP 0.5g or ginger BP 1.0g, all with oral diazepam premedication, one hour prior to surgery. Patients were assessed at three hours postoperatively. The incidence of nausea and vomiting increased slightly but nonsignificantly with increasing dose of ginger. The incidence of moderate or severe nausea was 22, 33 and 36%, while the incidence of vomiting was 17, 14 and 31% in groups receiving 0, 0.5 and 1.0g ginger, respectively (odds ratio per 0.5g ginger 1.39 for nausea and 1.55 for vomiting). These results were essentially unchanged when adjustment was made for concomitant risk factors. We conclude that ginger BP in doses of 0.5 or 1.0 gram is ineffective in reducing the incidence of postoperative nausea and vomiting.
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PMID:A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. 748 35

The effect of preoperative sublingual buprenorphine (B) on postoperative pain (VAS), the need for postoperative opioid injections and on time to discharge, was evaluated in a prospective randomised double-blind study. Forty ASA I-II patients scheduled for arthroscopy of the knee received premedication with 0.4 mg buprenorphine (group B) and 42 patients were given placebo (group P). Postoperatively, pethidine was given to patients with pain. Three of the 40 patients in group B vs 11 of the 42 in group P received pethidine (P < 0.05). In group B, however, 13 of the 40 patients complained of nausea, prolonging median time to discharge from 155 to 255 minutes (P < 0.05). In group P, 3 of the 42 patients were nauseated, P < 0.01, compared with group B. Time to discharge did not differ between the groups in patients without nausea. The median respiratory rate was significantly lower in group B, but no patient required ventilatory support. In conclusion, premedication with sublingual buprenorphine cannot be recommended for this procedure. It reduces the need for postoperative injections of pethidine but increases the incidence of postoperative nausea which prolongs the recovery time. Careful monitoring is also mandatory because of the possibility of respiratory depression.
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PMID:Premedication with sublingual buprenorphine for out-patient arthroscopy: reduced need for postoperative pethidine but higher incidence of nausea. 757 13

The prophylactic antiemetic efficacy of intravenous (i.v.) ondansetron, droperidol, perphenazine, and metoclopramide was evaluated in a prospective, double-blind study of 360 ASA physical status I-III patients undergoing total abdominal hysterectomy (TAH). Subjects were randomized to receive i.v., one of ondansetron 4 mg, droperidol 1.25 mg, perphenazine 5 mg, metoclopramide 10 mg, or placebo prior to induction of anesthesia. Hypotension immediately after administration of metoclopramide was observed in two patients and four patients given ondansetron developed profound systolic hypotension at induction of anesthesia. Twenty-two percent of patients receiving droperidol became sedated. Postoperatively, patients developing severe nausea, retching, or vomiting, defined as severe emetic sequelae (SES), were deemed to have failed antiemetic prophylaxis and received antiemetic rescue. A significantly larger number of patients who received i.v. ondansetron (63%), droperidol (76%), and perphenazine (70%) were free of SES when compared to placebo (43%); P < 0.05. Metoclopramide was ineffective. Although ondansetron, droperidol, and perphenazine were effective in providing antiemetic prophylaxis, only i.v. perphenazine was free of side effects. Hence, we conclude that perphenazine is the best choice for antiemetic prophylaxis after TAH.
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PMID:The efficacy of prophylactic ondansetron, droperidol, perphenazine, and metoclopramide in the prevention of nausea and vomiting after major gynecologic surgery. 759 43

Opioid-related side effects, including nausea and vomiting, are common in patients using morphine in patient-controlled analgesia for postoperative pain relief. The purpose of this study was to determine if the addition of droperidol to a morphine sulfate delivery system could decrease the incidences of nausea and vomiting without increasing droperidol-related side effects. Forty ASA 1 and 2 patients scheduled to undergo peripheral orthopedic surgery were randomized to receive either morphine sulfate (2 mg/mL), or morphine sulfate (1.9 mg/mL) plus droperidol (0.125 mg/mL) for postoperative self-controlled analgesia. Visual analogue scores for pain, nausea, and sedation were obtained from each patient immediately after surgery and each morning and evening until patient-controlled analgesia was discontinued approximately 48 hours later. Total patient-controlled use of morphine sulfate was recorded at each visual analogue rating. The patients who used morphine sulfate plus droperidol had significantly less nausea and vomiting and used significantly less morphine. No patient experienced droperidol-related side effects. We conclude that the routine addition of droperidol to morphine sulfate in self-controlled analgesia improves the comfort of patients following peripheral orthopedic surgery.
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PMID:Improving patient-controlled analgesia: adding droperidol to morphine sulfate to reduce nausea and vomiting and potentiate analgesia. 761 78

In a double-blind, randomized study, we have compared the efficacy of transdermal hyoscine with placebo in the reduction of nausea and vomiting in 50 patients, ASA I-II, after surgical correction of prominent ears under general anaesthesia. In the placebo group, 28%, 4% and 48% of patients suffered nausea, retching and vomiting, respectively, during the first 24 h after anaesthesia. The corresponding values in the hyoscine group were 12%, 0% and 16% (P < 0.01). In the placebo group more patients (48%) needed droperidol as an antiemetic compared with the hyoscine group (16%; P < 0.05). There was significantly more sedation in the hyoscine group.
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PMID:Effect of transdermal hyoscine on nausea and vomiting after surgical correction of prominent ears under general anaesthesia. 764 Jan 17

Fifty ASA 1 or 2 patients scheduled to undergo major gynaecological surgery were allocated randomly to one of two groups. All patients received a standard anaesthetic regimen. Patients in group 1 received droperidol 1.25 mg given intravenously 20 min prior to the end of surgery and a patient-controlled analgesia infusion containing morphine 1 mg.ml-1 and droperidol 0.05 mg.ml-1. Patients in group 2 received cyclizine 50 mg by slow intravenous injection 20 min prior to the end of surgery and a patient-controlled analgesia infusion containing morphine 1 mg.ml-1 and cyclizine 2 mg.ml-1. Fifteen of 25 patients (60%) in group 1 and 18 (72%) of 25 in group 2 suffered no nausea or vomiting postoperatively. Two patients (8%) in group 1 and three (12%) in group 2 suffered severe postoperative nausea or vomiting. We conclude that cyclizine is as effective as droperidol in the prevention of postoperative nausea and vomiting when included in a patient-controlled analgesia infusion using morphine.
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PMID:A comparison of droperidol and cyclizine in the prevention of postoperative nausea and vomiting associated with patient-controlled analgesia. 867 32

Forty-five ASA physical status I volunteers, divided in three groups of 15 each, received intravenous regional anesthesia (IVRA) of the upper limb with 40 mL meperidine 0.25%, lidocaine 0.5%, or 0.9% sodium chloride (isolated ischemia) by random allocation. Using a double-blind method, the onset and recovery of sensory block was tested at six sites of the forearm and hand. The onset of complete motor block was also assessed. The symptoms after deflation of the tourniquet were recorded. The onset of block, as determined by pin-prick touch, and cold was significantly faster in the meperidine group (P < 0.001) than in the saline group, but also slower (P < 0.001) than in the lidocaine group. After the tourniquet was deflated, recovery occurred in reverse order. A complete motor block was noted in all volunteers from the meperidine and lidocaine groups, but in only 11 cases from the 0.9% sodium chloride group (P < 0.01). In the meperidine group, motor block developed concomitantly or prior to sensory block. There was a significant increase in the incidence of dizziness, nausea, and pain at the injection site in the meperidine group in comparison with the lidocaine group. We conclude that meperidine has local anesthetic action on the peripheral nerve in vivo, but that its single use for IVRA should be a second choice for patients allergic to local anesthetics.
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PMID:Intravenous regional anesthesia with meperidine. 953 32


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