Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although reported in the aerospace literature and anecdotally by anesthesiologists, the putative antiemetic effect of ephedrine remains unquantitated. We therefore prospectively studied ephedrine as an antiemetic agent in the perioperative setting in 97 patients undergoing general anesthesia for outpatient gynecologic laparoscopy. Patients were assigned in a double-blind randomized fashion to receive a standardized general anesthetic followed by an intramuscular dose of either ephedrine (0.5 mg/kg), droperidol (0.04 mg/kg), or saline before the conclusion of surgery. Nausea, retching, or vomiting, as well as the degree of sedation and discharge times, were assessed in the recovery room and for 24 h postoperatively. Ephedrine was found to have a significantly antiemetic effect (P less than 0.05) when compared with placebo and an antiemetic effect similar to that of droperidol. Sedation scores were also significantly less in the ephedrine group than in both placebo and droperidol groups. Finally, variations in mean arterial blood pressure among the three groups were not statistically significant. We conclude that ephedrine is an effective antiemetic agent with minimal sedative side effects in patients undergoing outpatient laparoscopy.
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PMID:Efficacy of ephedrine in the prevention of postoperative nausea and vomiting. 182 85

Postoperative nausea and vomiting were compared in 68 women with regular menstrual periods undergoing gynaecological laparoscopy. The patients were divided into four group on the basis of the phase of the menstrual cycle as follows: premenstrum-menstrum (pre + menstrum) (Pd 25-6), early follicular phase (Pd 8-12), ovulatory phase (Pd 13-15) and luteal phase (Pd 20-24). The overall incidence of nausea and vomiting was 46%. Statistically significant differences in the incidence of nausea and retching were found among the groups by regression analysis. The incidence of nausea and vomiting was highest in women undergoing laparoscopy during the luteal phase (77%), which was greater than during the follicular phase (32%) or during pre + menstruation (18%). The need for antimetic was highest in women undergoing laparoscopy during the luteal phase (69%) and this was different from the follicular (18%, P less than 0.01) and pre + menstrum (19%, P less than 0.01) phases. It is concluded that the highest incidence of postoperative nausea and vomiting after gynaecological laparoscopy occurs during the luteal phase.
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PMID:Nausea and vomiting after gynaecological laparoscopy depends upon the phase of the menstrual cycle. 183 5

There have been claims that the postoperative course of patients may be improved by presentation during general anesthesia of therapeutic suggestions which predict a rapid and comfortable postoperative recovery. This study evaluated the effectiveness of such therapeutic suggestions under double-blind and randomized conditions. A tape recording predicting a smooth recovery during a short postoperative stay without pain, nausea, or vomiting was played during anesthesia to about half the patients (N = 109), while the remaining, control patients were played a blank tape instead (N = 100). The patients were primarily undergoing operations on the fallopian tubes, total abdominal hysterectomy, vertical banding gastroplasty, cholecystectomy, and ovarian cystectomy or myomectomy. The anesthesia methods consisted of either isoflurane with 70% nitrous oxide in oxygen to produce end-tidal concentrations of 1.0, 1.3, or 1.5 MAC; or 70% nitrous oxide in oxygen combined with high or low doses of opioids. Assessments of the efficacy of the therapeutic suggestions in the recovery room and throughout the postoperative hospital stay included: the frequency of administration of analgesic and antiemetic drugs; opioid doses; the incidence of fever; nausea, retching, and vomiting; other gastrointestinal and urinary symptoms; ratings of pain; ratings of anxiety; global ratings of the patients' physical and psychological recoveries by the patients and their nurses; and length of postoperative hospital stay. There were no meaningful, significant differences in postoperative recovery of patients receiving therapeutic suggestions and controls. These negative results were not likely to be due to insensitivity of the assessments of recovery, as they showed meaningful interrelations among themselves and numerous differences in recovery following different types of surgery. Widespread utilization of therapeutic suggestions as a routine operating room procedure seems premature in the absence of adequate replication of previously published positive studies.
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PMID:Efficacy of therapeutic suggestions for improved postoperative recovery presented during general anesthesia. 195 99

Drug-induced purposeless chewing movements in rodents are often considered to represent movement disorders or dyskinesias. We have compared the ability of drugs to induce chewing and retching or emesis in squirrel monkeys; such studies are not possible in rodents, which do not vomit. Acute administration of oxotremorine (3.3-33 micrograms/kg IM), SKF38393 (1-30 mg/kg SC) or ipecacuanha (0.5-0.75 mg/kg PO) caused dose-related increases in purposeless chewing which was frequently associated with retching and emesis. Treatment with haloperidol (0.015-0.06 mg/kg IM) did not induce chewing. Rather, haloperidol decreased spontaneous chewing at doses of 0.03 and 0.06 mg/kg. Our findings indicate that at least some drug-induced oral behaviours in rodents may reflect nausea rather than dyskinesia.
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PMID:Drug-induced purposeless chewing: animal model of dyskinesia or nausea? 197 78

Fundoplication with gastrostomy has become a frequent treatment for patients with familial dysautonomia, so we evaluated the use of both procedures in 65 patients. Although patients differed widely in presenting signs and age, from 5 weeks to 40 years, gastroesophageal reflux was documented in 95% of patients by cineradiography or pH monitoring. Panendoscopy was a useful adjunct. Preoperative symptoms of gastroesophageal reflux included vomiting, respiratory infections, and exaggerated autonomic dysfunction. Severe oropharyngeal incoordination frequently coexisted and resulted in misdirected swallows with aspiration, dependence on gavage feedings, or poor weight gain and dehydration. Follow-up after surgical correction ranged from 3 months to 11 years; 55 patients (85%) were available for a 1-year postoperative assessment. We had no instances of surgical death. The long-term mortality rate was 14%, primarily related to severe preexisting respiratory disease. Beyond the first postoperative year, 30 patients had pneumonia attributed to continued aspiration, exacerbation of preexisting lung disease, or recurrence of gastroesophageal reflux. Of 11 patients who vomited postoperatively, six had recurrence of reflux. Recurrence of gastroesophageal reflux was documented in eight patients (12%), and we revised the fundoplication in three patients. The number of patients with cyclic crises was reduced from 18 to 7; retching replaced overt vomiting in all but two of these seven patients, neither of whom had recurrence of reflux. Because oropharyngeal incoordination was prominent, concomitant use of gastrostomy and an antireflux procedure was especially effective in the treatment of younger patients with familial dysautonomia, before the development of severe respiratory disease. Despite the development of severe morning nausea in 15 patients, the combination procedure resulted in significantly improved nutritional status, decreased vomiting, and decreased respiratory problems. Appropriate use of gastrostomy feedings also contributed to success of the operation. The generally good outcome of fundoplication with gastrostomy confirms the benefit of this procedure in familial dysautonomia.
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PMID:Fundoplication and gastrostomy in familial dysautonomia. 199 77

This double-blind randomized cross-over study was conducted to compare the safety and efficacy of high-dose prochlorperazine infusion and dexamethasone (HDPD) with an effective and safe combination of high-dose metoclopramide and dexamethasone (HDMD) in controlling cisplatin-induced emesis. None of the patients entering the study had received any prior chemotherapy. High-dose cisplatin was administered on an inpatient basis. Twenty eligible patients were analyzed based on the assessment made 24 h after the chemotherapy. The parameters compared were severity and duration of nausea and vomiting, severity of retching and side effects. Significantly less vomiting and retching episodes were recorded with HDPD combination. The severity of nausea was also less with this combination. There was no significant difference in the incidence of side effects.
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PMID:A double-blind randomized cross-over comparison of high-dose prochlorperazine with high-dose metoclopramide for cisplatin-induced emesis. 202 2

Children recovering from anaesthesia for strabismus surgery are particularly prone to nausea and vomiting as a result of intraoperative vagus irritation. Besides being disturbing to the patient, vomiting can be dangerous during emergence from anesthesia and can result in delayed discharge. Droperidol is a powerful antiemetic drug that has been shown to reduce the incidence and severity of postoperative nausea and vomiting in pediatric strabismus patients, although the best timing for administration is not clear. MATERIAL AND METHODS. We compared three randomized groups totalling 61 patients. Droperidol 0.075 mg/kg i.v. was given either at induction of anesthesia after intubation (n = 20) or during the last muscle suture (n = 21). The third group received no antiemetic treatment. The patients' ages ranged from 3 to 14 years (mean 5.9 +/- 2.84 years). There was no difference in age or sex between the three groups. Anesthesia was standardized with rectal midazolam premedication, atropine, thiopental, succinylcholine, O2/N2O = 1:2, enflurane, intubation, and a gastric tube. RESULTS. Nausea, retching, or vomiting occurred in 2/20 children (10%) given droperidol preoperatively, 4/21 children (19%) with droperidol during the operation, and 9/20 children (45%) with no antiemetic treatment. The difference between groups I and III was significant (p less than 0.05). Comparison of groups II and III and groups I and II showed no statistical significance. Operation time was similar in each group and there was no delay in time of extubation. In each group 1 case of hypotension occurred. No child showed extrapyramidal symptoms. The lower incidence of vomiting in all study groups compared to the literature is thought to be due to three factors: (1) emptying the stomach at the end of the operation by a gastric tube, which is removed before extubation; (2) avoidance of opioids; (3) surgical procedure being done by a very experienced surgeon in 57/61 children (12 vomiting versus 45 not vomiting) in contrast to 3/4 children vomiting postoperatively after surgery by a less experienced surgeon. CONCLUSIONS. We recommend preoperative droperidol 75 micrograms/kg i.v. as the best prophylaxis of postoperative emesis without severe side effects in pediatric strabismus surgery.
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PMID:[The prevention of postoperative vomiting following strabismus surgery in children]. 204 9

In a cross-over design of a study of prevention of emesis induced by cancer chemotherapy done in Saitama Cancer Center, the efficacy of oral lorazepam was superior to that of i.v. domperidone. And then, we proceeded a parallel study with use of oral lorazepam and oral domperidone. However, in this situation lorazepam was not superior to domperidone despite accrual of more than 60 patients. Recently, a multi-institutional study has been started in October of 1988 in an evaluation of the efficacy and safety of the new anti-emetic drug of a 5HT3 receptor antagonist, ondansetron. Two methods of its administration were designed. In one study ondansetron was given 2 hr prior to non-platinum chemotherapy as an 2 or 8 mg dose by oral administration, followed by receiving it 6 hr and 12 hr after chemotherapy. In another study, it was given 15 min prior to cisplatin including chemotherapy as an 2 or 8 mg loading dose by i.v. injection over 5 min, followed by continuous infusion at a rate of 0.25 mg/h or 1 mg/h for 24 h, respectively. Efficacy was assessed by measurement of the number of episodes of retching and vomiting occurring in the 24h after administration of chemotherapy and by an assessment of nausea during the same period. This time the major efficacy category was adopted, which is made up of the complete responder and major responder categories of both vomiting and nausea. 19 patients were evaluable for efficacy in the non-platinum group; the major efficacy rates showed 45% in 2 mg-given group and 88% in 8 mg-given group, respectively. 108 patients were evaluable for efficacy in the cisplatin group: the major efficacy rates showed more than 70% in both 2 mg and 8 mg-given group. However, in the patients given more than 75 mg/mg2 of cisplatin, the major efficacy rates were 55% in the 2 mg-given group, compared to 73% in the 8 mg-given group. Ondansetron was well tolerated, with no significant drug-related adverse events.
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PMID:[Gastrointestinal toxicity induced by anticancer drugs--including new antiemetic drugs]. 214 Apr 98

The authors evaluated the effect of transdermal scopolamine on the incidence of postoperative nausea, retching, and vomiting after outpatient laparoscopy in a double-blind, placebo-controlled study. A Band-Aid-like patch containing either scopolamine or placebo was placed behind the ear the night before surgery. Anesthesia was induced with fentanyl (0.5-2 micrograms/kg iv), thiopental (3-5 mg/kg iv), and succinylcholine (1-1.5 mg/kg iv) and maintained with isoflurane (0.2-2%) and nitrous oxide (60%) in oxygen. Scopolamine-treated patients had less nausea, retching, and vomiting compared with placebo-treated patients (P = 0.0029). Severe nausea and/or vomiting was present in 62% of the placebo group but only 37% of those getting the scopolamine patch. Repeated episodes of retching and vomiting were also less frequent in the scopolamine group compared with the placebo group (23% vs. 41%; P = 0.0213) as was the need for additional antiemetic therapy (13% vs. 32%; P = 0.0013). Patients in the scopolamine group were also discharged from the hospital sooner (4 +/- 1.3 vs. 4.5 +/- 1.5 h; P = 0.0487). Side effects were more frequent among those patients treated with the scopolamine patch (91% vs. 45%; P less than 0.05) but were not troublesome. The authors conclude that transdermal scopolamine is a safe and effective antiemetic for outpatients undergoing laparoscopy.
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PMID:Transdermal scopolamine reduces nausea and vomiting after outpatient laparoscopy. 198 53

Thirty children aged 2-16 years with malignant tumours who were receiving chemotherapy were treated with the 5-HT3 antagonist ondansetron. Each received a single intravenous dose (5 mg/m2) followed by oral doses (2-4 mg depending on surface area) every eight hours for five days. Chemotherapy regimens comprised: carboplatin alone, carboplatin plus etoposide, cisplatin plus etoposide; adriamycin (doxorubicin) plus cyclophosphamide, or ifosfamide. Twelve patients received ondansetron with their first course of chemotherapy and the other patients were poor responders to previous antiemetic treatment. Efficacy was assessed by a questionnaire documenting the incidence of vomiting and severity of nausea. In a 24 hour period after starting chemotherapy a complete or major response (less than two vomiting episodes) was achieved in 87% of children. Although ondansetron was effective for early antiemesis after cisplatin or ifosfamide, delayed vomiting, retching, or nausea reduced responses to 50% and 20%, respectively. We conclude that in children ondansetron is an effective, well tolerated, oral antiemetic enabling simple administration in the outpatient setting. In the present schedule it was of limited efficacy against cisplatin or ifosfamide induced emesis.
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PMID:5-HT3 antagonist ondansetron--an effective outpatient antiemetic in cancer treatment. 214 21


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