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)

Epidural administration of an opioid analgesic by means of a patient-controlled analgesia (PCA) system was compared with conventional intravenous PCA for pain relief after cesarean delivery. One hundred seventeen healthy women were randomly assigned to receive hydromorphone either intravenously (IV-PCA) or epidurally (EPI-PCA) after cesarean delivery with epidural bupivacaine for operative anesthesia. The hydromorphone requirements were 3.4 and 4.2 times more in the IV-PCA group on the first (P less than 0.01) and second (P less than 0.01) postoperative days, respectively. The mean number (+/- SD) of PCA demands during the first 24 h after the operation was 105 (+/- 88) for the IV-PCA group and 33 (+/- 48) for the EPI-PCA group (P less than 0.01). This difference was also significant 24-48 h after surgery. Although the EPI-PCA group utilized significantly less opioid medication, pain and sedation scores were similar in the two treatment groups; however, a significantly larger percentage of patients in the IV-PCA group (46% vs 22%) stated that they felt drowsy during the first postoperative day. Pruritus was reported more frequently in the EPI-PCA (67%) than in the IV-PCA (33%) group. Nausea was experienced by only 10% of patients in the IV-PCA and 6% in the EPI-PCA group. There was no evidence of postoperative respiratory depression, with minimal oxygen saturation values of 93% (+/- 3%) and 94% (+/- 1%) in the IV-PCA and EPI-PCA groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery. 137 7

The efficacy of ondansetron, a selective 5-HT3 receptor antagonist, in preventing postoperative nausea and vomiting in surgical patients was studied. Fifty women were randomized in a double-blind manner to receive either two 8 mg doses of intravenous ondansetron or two doses of placebo vehicle: the first given just before general anesthesia induction and the second 8 hours later. During the first 24 postoperative hours, the number of emetic episodes was recorded and the subjects rated their nausea on a scale from 0 to 10. Ondansetron-treated subjects had fewer emetic episodes (p less than 0.001) and lower subjective nausea scores (p less than 0.001). The number of complete responders (no emetic episodes and no rescue therapy) was 1 of 24 (4%) and 15 of 26 (58%) in the placebo and ondansetron groups, respectively (p less than 0.001). Ondansetron is clearly more effective than placebo in the prophylaxis of postoperative nausea and vomiting. The adverse event profile for ondansetron was similar to that of placebo.
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PMID:Ondansetron is effective in decreasing postoperative nausea and vomiting. 138 67

In a placebo-controlled, double-blind study, we have compared the efficacy of ondansetron 16 mg, 8 mg and 1 mg administered 8-hourly for prevention of postoperative nausea and vomiting. We studied 995 patients undergoing major gynaecological surgery; 982 were included in the analysis. Study medication was administered 1 h before induction of anaesthesia and second and third doses were given 8 and 16 h after the first. The treatment groups were similar for patient characteristics, surgical procedures, anaesthetics administered and opioids given. The frequency of nausea was 75%, 70%, 56% and 55% after placebo and ondansetron 1 mg, 8 mg and 16 mg, respectively; the corresponding frequencies of vomiting were 60%, 55%, 37% and 37%. Ondansetron 8 mg was as effective as 16 mg and both resulted in significant reductions in nausea and vomiting compared with placebo and ondansetron 1 mg (P less than 0.001).
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PMID:Efficacy of orally administered ondansetron in the prevention of postoperative nausea and vomiting: a dose ranging study. 138 23

A total of 56 women 18-45 years of age weighing 40-100 kg schedules for elective laparoscopic sterilization with or without uterine curettage were randomized into 2 groups, and 25 were subsequently analyzed in each data set. They received either 2 suppositories of 100 mg indomethacin each (Indocid) (Group 1), or 2 identical placebo suppositories (Group 2). At the same time, all patients received a premedication of temazepam 10 mg orally 2 hours preoperatively. General anaesthesia consisted of droperidol 1.25 mg IV, fentanyl 1.5 mcg/kg IV. Filshie clips were used exclusively. Analgesia consisted of 25 mg aliquots of pethidine iv in the recovery room and on the ward by using 1.0 mg.kg of in pethidine, 2-hourly if requested. There was no difference between groups with respect to patient characteristics. In the recovery room, the rating of no pain was lower with 28% in the indomethacin group (group 1) versus 18% in group 2, but the difference was not significant (p = .29). At 30 minutes postoperatively, 54% of those receiving indomethacin compared to 47% of the placebo groups had a pain score less than 30 (p = .09); and 96% compared to 72% had a score less than 70 (p = .07), but these differences were not significant. 48% in group 1 and 32% in group 2 did not require any postoperative pethidine (p = .39). The mean dosage of pethidine used was 24 mg +or- 27 mg in the indomethacin group and 42 mg +or- 44 mg in the placebo group. The Wilcoxon Rank Sum test also showed a nonsignificant trend for lower pethidine dose requirements in the indomethacin group, and in the Log Rank test this difference almost reached statistical significance. The incidence of preoperative (postmedication) nausea, headache and abdominal pain did not differ between the groups. There was a consistently lower incidence of postoperative symptoms or side-effects in the indomethacin group, but this was not statistically significant.
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PMID:Preoperative rectal indomethacin for analgesia after laparoscopic sterilisation. 138 3

The prophylactic antiemetic efficacy of ondansetron was evaluated in a randomized, double-blind comparison with droperidol and metoclopramide in 66 patients undergoing general anesthesia for dilatation and curettage. Ten minutes before induction of anesthesia, 22 patients received a single intravenous dose of 8 mg of ondansetron, 22 others received 1.25 mg of droperidol, and the remaining 22 received 10 mg of metoclopramide. Anesthesia was induced with 3.3-5 mg/kg of intravenous thiopental and maintained with 65% nitrous oxide in oxygen and 2%-3% enflurane. Postoperatively, the incidence of vomiting was 13% with ondansetron, 45% with droperidol, and 54% with metoclopramide (P less than 0.05; overall chi 2 test). There was no statistically significant difference in the incidence of nausea among the groups. Postoperative sedation and well-being scores were not significantly different among the groups. We conclude that preoperative prophylactic administration of ondansetron is superior to droperidol or metoclopramide in the prevention of emetic sequelae after general anesthesia for dilatation and curettage.
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PMID:Ondansetron in the treatment of postoperative vomiting: a randomized, double-blind comparison with droperidol and metoclopramide. 825 26

The comparative effects of ketorolac, dezocine, and fentanyl were evaluated in 136 healthy female patients undergoing outpatient laparoscopic procedures according to a randomized, double-blind protocol. Patients received ketorolac (60 mg) or dezocine (6 mg) or fentanyl (100 micrograms, control group) before the start of the operation. A standardized general anesthetic technique consisting of midazolam (2 mg), fentanyl (50 micrograms), and propofol (2 mg/kg) for induction of anesthesia followed by propofol (120 micrograms.kg-1.min-1), vecuronium (1-2 mg), and 67% nitrous oxide in oxygen for maintenance of anesthesia, was used. In the postanesthesia care unit, 61% of patients in the fentanyl group received analgesic drugs for persistent pain, compared with 34% and 25% in the ketorolac and dezocine groups, respectively. Similarly, less postoperative fentanyl (mean +/- SD) was required in the ketorolac (22 +/- 33 micrograms) and dezocine (18 +/- 35 micrograms) groups, compared with the fentanyl (58 +/- 71 micrograms) group. However, 52% of the patients receiving dezocine required antinausea therapy in the postanesthesia care unit, compared with 20% and 18% in the fentanyl and ketorolac groups, respectively. Finally, recovery times were significantly shorter in the ketorolac (vs dezocine) group. Although both ketorolac and dezocine were effective alternatives to fentanyl when administered during outpatient laparoscopy, dezocine was associated with an increased incidence of postoperative nausea and a delayed discharge time compared with ketorolac.
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PMID:Comparative effects of ketorolac, dezocine, and fentanyl as adjuvants during outpatient anesthesia. 832 67

Patients with primary hyperparathyroidism are often elderly with cardiovascular disease and in some an operation might be hazardous owing to anaesthetic complications. A technique for operation for primary hyperparathyroidism under local anaesthesia is described. The method uses a unilateral approach. Seventeen consecutive patients operated on under local anaesthesia were compared with a group of 15 patients undergoing surgery under general anaesthesia. Normocalcaemia was achieved in 14 patients in each group. There was no difference in the extent of pain or the overall well-being between the two groups as determined by a visual analogue scale. Patients receiving local anaesthesia, however, experienced significantly less nausea after operation (P < 0.01). There was more fluctuation in blood pressure and heart rate in the general anaesthesia group compared with the other group. Surgery for primary hyperparathyroidism can be performed safely under local anaesthesia, and could be offered to patients if general anaesthesia were not suitable or involved an increased perioperative risk. It should not be recommended for routine use in patients who are fit for general anaesthesia.
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PMID:Surgery for primary hyperparathyroidism performed under local anaesthesia. 142 61

An international clinical trial programme has been established to assess the efficacy and safety of ondansetron in the prevention and treatment of postoperative nausea and vomiting. The programme included nine pilot studies and six key placebo-controlled studies. These studies have evaluated both oral and intravenous formulations of ondansetron in the prevention of postoperative nausea and vomiting, and intravenously administered ondansetron in the treatment of established symptoms. Most patients included in the trials were adult women, less than 50 years of age, receiving anaesthesia for gynaecological surgery. The primary efficacy analysis for emesis was based on the assessment of complete response (i.e. absence of emetic episodes or nausea in the first 24 h postoperatively). These trials clearly demonstrated the anti-emetic efficacy of ondansetron in the prevention and treatment of postoperative nausea and vomiting.
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PMID:The clinical development of ondansetron for use in the prevention and treatment of postoperative nausea and vomiting. 142 24

The efficacy and safety of prophylactic intravenous ondansetron in preventing postoperative nausea and vomiting was investigated in a randomized, stratified, double-blind, placebo-controlled, dose-comparison study of 580 ASA physical class I and II female outpatients undergoing gynaecological surgery and receiving general anaesthesia. Patients received either ondansetron 1, 4 or 8 mg, or placebo i.v. immediately prior to a standardized technique for induction and maintenance of anaesthesia. All patients were intubated and received nitrous oxide and a narcotic. All doses of ondansetron were significantly more effective than placebo in preventing emesis over the 24 h postoperative period. Ondansetron significantly decreased nausea and emesis scores over 24 h postoperatively without causing sedation. No changes in laboratory parameters (haematology, blood chemistry, and liver enzymes) or vital signs (heart rate, blood pressure, and respiratory rate) were observed. Headache and dizziness were the most common side-effects; however, their incidence was the same as with placebo. Ondansetron was generally well tolerated, as evidenced by an adverse event, laboratory safety, and vital sign profile similar to placebo. Ondansetron 4 mg was found to be the optimal prophylactic i.v. dose for female outpatients over the entire 24 h postoperative period. Higher doses may offer an added benefit in some patients, such as those with a history of nausea and vomiting following general anaesthesia.
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PMID:Prophylactic intravenous ondansetron in female outpatients undergoing gynaecological surgery: a multicentre dose-comparison study. 142 25

The safety and efficacy of ondansetron were evaluated in the treatment of postoperative nausea and vomiting. Five hundred patients who experienced nausea or vomiting in the Post-Anaesthesia Care Unit within the first 2 h of recovery were randomized to receive either 1, 4, or 8 mg of ondansetron, or placebo. All patients had undergone ambulatory surgery with general endotracheal anaesthesia. Episodes of emesis, nausea scores, adverse events, vital signs, and laboratory values were assessed before and during the 24 h after study drug administration. Patients were evaluated for the first 2 h in the Post-Anaesthesia Care Unit then followed up for the next 22 h. Complete response was defined as no emetic episodes, no nausea or no rescue anti-emetic medication. For the 0-24 h study period, complete response occurred in only 15% of the placebo group compared to 41%, 47%, and 47% in the 1, 4, and 8 mg ondansetron groups, respectively. Mean nausea scores (scale of 0-10) during the initial observation period (0-2 h) were significantly lower for all doses of ondansetron [2.2 (1 mg), 1.7 (4 mg), and 2.1 (8 mg)] compared to placebo (3.0). The optimal dose of ondansetron for the treatment of postoperative nausea and vomiting was found to be 4 mg. All doses of ondansetron were well tolerated. No clinically significant increases in laboratory parameters or alterations in haemodynamic stability occurred in the ondansetron groups compared to placebo.
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PMID:Ondansetron in the treatment of postoperative nausea and vomiting in ambulatory outpatients: a dose-comparative, stratified, multicentre study. 142 26


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