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)

The hypothesis that the lipid emulsion of the emulsion formulation of propofol is responsible for the low frequency of nausea, retching, and vomiting after propofol anesthesia was tested. A randomized, prospective, and comparative study was performed to evaluate the antiemetic effect of 10% lipid solution in 60 women, ASA physical status I and II, scheduled for ambulatory laparoscopic procedures. Two groups of patients were studied. Induction of anesthesia (thiopental) and maintenance of anesthesia (enflurane, nitrous oxide) were similar in both groups. At induction the study group received 10% Intralipid (3 mL/min for 20 min). The control group received 5% dextrose in lactated Ringer's solution at the same rate. Other drugs administered during or after anesthesia were similar among the groups. The groups were similar with respect to duration of anesthesia, characteristics of early and intermediate recovery, as well as pain scores in the postanesthesia care unit. There were no differences in the amount of antiemetic medications administered or postoperative nausea, retching, or vomiting when the patients were evaluated objectively by a blinded observer or subjectively by patient self-evaluation. It is concluded that 10% Intralipid, the lipid in the emulsion formulation of propofol, does not possess significant antiemetic effects.
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PMID:Is the antiemetic effect of the emulsion formulation of propofol due to the lipid emulsion? 222 15

Fluorouracil (5-FU) and cisplatin display marked therapeutic synergy in preclinical models and are effective in the treatment of a number of solid tumors when combined and administered intravenously (IV). Each drug has also been administered intraperitoneally (IP) and displays a favorable pharmacologic profile and acceptable clinical toxicity. We therefore undertook a phase I study to determine the feasibility and toxicity of combination IP chemotherapy with these agents. Thirty-one patients with histologically documented malignancy confined to the peritoneal space were treated with cisplatin 90 mg/m2 mixed with 5-FU in 2 L of lactated Ringer's solution and given IP for 4 hours every 28 days. Cohorts of at least three patients received starting 5-FU concentrations ranging from 5 mmol/L (1,300 mg in 2 L) to 20 mmol/L. The dose-limiting toxicity was neutropenia with a median granulocyte nadir of 156 cells per microliter occurring at a 5-FU dose of 20 mmol/L. Intrapatient escalation of the 5-FU dose was permitted and 15 cycles of chemotherapy were delivered at 5-FU concentrations greater than 20 mmol/L, the highest concentration being 30.7 mmol/L (8 g of 5-FU in 2L). Other toxicities included mild to moderate nausea during all cycles of therapy, vomiting in 54% of cycles, and diarrhea in 15% of cycles. Abdominal pain, renal dysfunction, peripheral neuropathy, and oral mucositis occurred infrequently and were not related to the 5-FU dose. Peritoneal fluid and plasma 5-FU concentrations were measured by high-performance liquid chromatography (HPLC) in selected patients. Mean peak plasma 5-FU concentrations ranged from 6.19 mumol/L to greater than 60 mumol/L, and peritoneal fluid to plasma 5-FU area under the curve (AUC) ratios ranged from 85 to 1,150. Nine of 15 patients with nonbulky disease had resolution of malignant ascites or at least a 50% reduction of peritoneal studding by tumor at repeat laparotomy. We conclude that combination IP chemotherapy with cisplatin and 5-FU is technically feasible and has acceptable clinical toxicity and a favorable pharmacologic profile. The recommended starting 5-FU dose for phase II trials is 3,900 mg mixed with 90 mg/m2 of cisplatin in 2 L of isotonic fluid.
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PMID:Phase I clinical and pharmacologic study of intraperitoneal cisplatin and fluorouracil in patients with advanced intraabdominal cancer. 223 Aug 97

The authors evaluated the antiemetic properties of transdermal scopolamine (TDS) in healthy patients undergoing elective cesarean section and receiving epidural morphine for postoperative analgesia. Prior to administration of anesthesia, 203 patients had either TDS or a placebo study patch applied behind one ear. All patients were hydrated with lactated Ringer's solution iv and given 2.0% lidocaine with 1:200,000 epinephrine epidurally for surgical anesthesia. Following delivery of the infant, 4 mg of morphine sulphate was injected through the epidural catheter. After the operation patients were evaluated by "blinded" observers at 2, 4, 6, 8, 10, 24, and 48 h for nausea, vomiting, retching, pain relief, itching, and adverse effects. In addition, medications received were noted. No differences were found between the groups in terms of severity or incidence of pain, or requests for analgesic or antipruritic medication. Although there was no difference between the groups in the first 2 h, patients with TDS had significantly less nausea, vomiting, and retching than patients in the placebo group in each time interval between 2 and 10 h. Additionally, the TDS group required less antiemetic medication. There was no difference in the frequency of retching or vomiting between groups. Side effects were minimal and equal in both groups. The authors conclude that TDS results in a decreased incidence of nausea and vomiting in patients who have delivered by cesarean section and received epidural morphine. TDS appears safe for continuous antiemetic administration.
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PMID:Transdermal scopolamine decreases nausea and vomiting following cesarean section in patients receiving epidural morphine. 281 61

We report an autopsy case of duodenal bulb obstruction caused by a shiitake mushroom. A 74-year-old woman with depression was admitted to the hospital after suffering nausea and abdominal fullness for 3 days. Because the physical findings and laboratory data on admission revealed marked dehydration, lactated Ringer's solution was administered. Twelve hours later, the patient suddenly died. Autopsy showed an enlarged stomach filled with 850 ml of partially digested food. In the anal side of the pylorus, a 9-cm-diameter shiitake mushroom had become impacted, causing complete obstruction. We conclude that the patient suffered from duodenal bulb obstruction caused by the impacted mushroom and subsequently died of ileus. This case illustrates a rare cause of duodenal obstruction and emphasizes that ingested food can cause obstructive ileus and death.
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PMID:Autopsy case of duodenal obstruction from impacted mushroom. 1021 37

Ninety elderly (>65 y) patients were studied to assess the influence of patient position during induction of spinal anaesthesia on the incidence of perioperative hypotension and haemodynamic stability. Prior to induction of anaesthesia, Lactated Ringer's solution (8-10 ml/kg) was administered. In the Sitting Group, intrathecal anaesthesia was performed with the patient in the sitting position. In the Lateral Group, patients assumed the lateral decubitus position. In all cases hyperbaric bupivacaine (10 mg) was administered using a 25 gauge Quincke spinal needle. Patients were placed in the supine (and thereafter lithotomy) position immediately after withdrawing the spinal needle. Incremental doses of ephedrine (5 mg, i.v.) were administered in response to hypotension (>20% of baseline), nausea, vomiting, sweating, skin pallor or impaired consciousness. The mean arterial blood pressure, heart rate and the number of hypotensive episodes requiring ephedrine administration were unaffected by group affiliation. In the Sitting Group, nine patients received 24 doses of ephedrine 5 mg i.v. In the Lateral Group, 21 incremental doses of ephedrine were administered to nine patients. The incidence of nausea, vomiting, sweating and pallor were similar between the groups. Patient comfort was similar. In summary, the incidence of hypotension and hypotension-related adverse effects was similar when intrathecal anaesthesia was induced in the sitting or lateral position. Furthermore, subjective perception of the induction process or anaesthetic experience was not affected by patient position.
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PMID:Intrathecal anaesthesia for the elderly patient: the influence of the induction position on perioperative haemodynamic stability and patient comfort. 1151 48

Preload with crystalloid or colloid solution is widely recommended for the prevention of maternal hypotension during spinal anaesthesia. A combination of simultaneous rapid crystalloid infusion with vasopressor has also been suggested. This study tested the hypothesis that ephedrine infusion with crystalloid loading at spinal anaesthesia would reduce hypotension and alter neonatal outcome compared with fluid preloading. One hundred and twenty women undergoing elective caesarean delivery were randomly allocated to one of three groups to receive rapid infusion of lactated Ringer's solution (20 ml.kg(-1), n=40) or 4% succinylated gelatin solution (500 ml, n =40) before spinal anaesthesia or an ephedrine infusion (1.25 mg.minute(-1)) plus lactated Ringer's solution (1000 ml, n=40) after spinal anaesthesia. The incidence of hypotension (moderate and severe) and the ephedrine dose used to treat hypotension were compared. Neonatal outcome was assessed using Apgar scores and umblical venous and arterial blood gas analysis. The frequency of moderate or severe hypotension was lower in the ephedrine group than in the crystalloid or colloid preload group (10% vs. 51% and 38%; 5% vs. 21% and 23% respectively, P < 0.05). The incidence of nausea was significantly different between the crystalloid preload and ephedrine group. Umbilical blood gas analysis and Apgar scores were similar in all groups. A combination of an ephedrine infusion at 1.25 mg.minute(-1) with a crystalloid co-load was more effective than fluid preloading with crystalloid or colloid in the prevention of moderate and severe hypotension.
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PMID:Effects of fluid preload (crystalloid or colloid) compared with crystalloid co-load plus ephedrine infusion on hypotension and neonatal outcome during spinal anaesthesia for caesarean delivery. 2071 26