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)

During a 2 year period nitrous oxide was used as a sole or supplementary analgesic during 173 vascular or interventional procedures including peripheral angiography and endourologic and endobiliary procedures. The decision to administer nitrous oxide to a given patient was a matter of physician preference. Patients with bowel obstruction, pneumothorax, or chronic obstructive pulmonary disease were excluded from this method of analgesia. The nitrous oxide was administered by a radiology nurse under the supervision of an attending radiologist. Nitrous oxide was used without premedication for 39 procedures and with premedication (usually meperidine 1 mg/kg, promethazine 0.3 mg/kg, or atropine 0.01 mg/kg) in 134 procedures. In 74% of nonpremedicated individuals analgesia was adequate with nitrous oxide alone; 26% required supplemental intravenous medication. In 61% of premedicated individuals pain relief was adequate with nitrous oxide; 39% required supplemental intravenous medication. Complications, including nausea, vomiting, and agitation, occurred in eight patients, but were minor and easily reversed by decreasing the concentration of nitrous oxide. Nasally administered nitrous oxide is a safe, easily used, and effective analgesic.
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PMID:Nitrous oxide: effective analgesic for vascular and interventional procedures. 387 37

The synthetic opioid tramadol was given to 40 patients during surgery according to a fixed, calculated infusion scheme. Anesthesia was started with thiopental and the patients were given different nitrous oxide concentrations via a semi-open system (group 1: 60%, group 2: 75%). The aim of this study was to clarify whether this anaesthetic procedure is practicable or whether it has grave disadvantages in comparison with the anesthesia models used so far. Furthermore we wanted to clarify whether under this infusion scheme the proportion of N2O in the inspiratory mixture is sufficient or whether higher concentrations are required. In 24 of 40 patients analgesia or the depth of anaesthesia was insufficient so that additional enflurane application was necessary. Postoperative respiratory depression in three patients had to be treated with naloxone. The advantages of this procedure are the safe and easy practicability, absence of significant changes in the haemodynamic parameters, good postoperative response of the patients and postoperative pain relief as well as the low incidence of postoperative side effects such as nausea, vomiting and CO2-retention.
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PMID:[Tramadol infusion anesthesia with the substitution of enflurane and various nitrous oxide concentrations]. 391 7

The antiemetic effect of clebopride, a new derivative of the orthopramide group, was compared with that of placebo in 298 women undergoing elective surgery. A group of 150 patients received premedication of 1 mg/kg of meperidine, administered intramuscularly (IM), and a group of 148 patients received premedication of 10 mg of diazepam IM. All patients received 0.5 mg of atropine IM. Anesthesia was induced with thiopental and maintained with halogenated N2O/O2. In a double-blind procedure, clebopride (2 mg) or placebo was injected IM at the end of anesthesia and whenever a patient had a second episode of vomiting. Clebopride appeared to be better than placebo in the prevention of nausea (P less than or equal to 0.05) and vomiting (P less than or equal to 0.001) during the 12-hour observation period. The frequency of side effects was virtually the same in patients given clebopride and patients given placebo.
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PMID:Effect of intramuscular clebopride on postoperative nausea and vomiting. 399 31

Sevoflurane, a new volatile anesthetic agent, is of great potential interest in pediatric anesthesia. Its use for ENT surgery in children was compared with halothane in this study. Altogether 40 children participated in the investigation. In 18 (median age 4.2 years), halothane was used. The remainder (median age 4.0 years) were anesthetized with sevoflurane. After rectal premedication with midazolam and atropine, anesthesia was induced by mask (the agent in O2/N2O, 40/60) using a Mapleson D system. The trachea was intubated without the use of muscle relaxants and the children were then allowed to breathe spontaneously at fresh gas flows set high enough to avoid rebreathing. Hemoglobine oxygen saturation (SpO2), inspired and expired gas concentrations, respiratory rate (RR), heart rate (HR), ECG and blood pressure were followed. Equianesthetic concentrations of the agents were used and induction characteristics were comparable between the two agents. RR and end-tidal CO2 tensions were similar in the two groups. HR and systolic blood pressures were, however, higher with sevoflurane. Cardiac arrhythmias were seen more frequently with halothane (61%) than with sevoflurane (5%). During emergence, postoperative nausea/vomiting was more frequent after halothane anesthesia. Initially, postoperative excitement occurred more often after sevoflurane, when paracetamol was given during anesthesia, which was reduced (P < 0.01) when paracetamol was given at the time for premedication. It is concluded that sevoflurane is an excellent induction agent, and maintains heart rate and systolic blood pressure better than when halothane is used. The incidence of cardiac arrhythmia is lower with sevoflurane than with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sevoflurane for ENT-surgery in children. A comparison with halothane. 767 95

Total intravenous anaesthesia (TIVA) with propofol and alfentanil was compared with balanced anaesthesia (BA) in 30 uraemic patients undergoing renal transplantation. TIVA (n = 15) was induced with propofol and alfentanil and maintained with propofol and alfentanil infusions, which were started immediately after induction. Thereafter the infusion rates were adjusted as needed. Ventilation was with oxygen in air. BA (n = 15) was induced with thiopentone and fentanyl and maintained with isoflurane/N2O/fentanyl. Vecuronium was used for muscle relaxation in both groups. Mean infusion rates for propofol and alfentanil were 10 +/- 1.8 mg kg-1 h-1 and 70 +/- 9 micrograms kg-1 h-1, respectively. To control hypertension during TIVA, larger amounts of propofol and alfentanil were needed and slower recovery was observed than in previous studies in ASA 1-2 patients. Also, significantly more vecuronium was needed during TIVA than during BA (P < 0.05). The recovery parameters were similar in both groups, except for the occurrence of nausea, which was less after TIVA. In conclusion, TIVA had no clinical advantages over BA.
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PMID:Comparison of propofol/alfentanil anaesthesia with isoflurane/N2O/fentanyl anaesthesia for renal transplantation. 783 74

The efficacy and safety of prophylactic intravenous ondansetron on prevention of postoperative nausea and vomiting were investigated in 65 ASA grades I-III patients undergoing elective abdominal surgery and receiving general anesthesia. Patients received ondansetron 4mg i.v. prior to a standardized technique for induction and intubation. Anesthesia was maintained with N2O-O2 and enflurane. The results showed that, by ondansetron 4mg, nausea and emesis could be significantly decreased. The effect lasted around 24h postoperatively without sedation. No one developed vomiting and only 9 patients developed nausea. No changes on laboratory parameters as well as vital signs were observed. No side-effects related to ondansetron were found. In prophylaxis of postoperative nausea and vomiting, ondansetron is effective and safe.
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PMID:[Ondansetron on postoperative nausea and vomiting]. 784 86

We examined the response to the laryngeal mask (LM) compared to the endotracheal tube (ETT) in patients undergoing ambulatory anesthesia. The differences in management by the anesthesiologists for these two airways were also examined. Peripheral orthopedic procedures were studied in 44 outpatients randomized to receive a LM or ETT, and either spontaneous or controlled ventilation. Anesthesia was induced with propofol and succinylcholine intravenously (i.v.) and maintained with N2O and isoflurane. Anesthesiologists were allowed to determine ventilatory variables and anesthetic concentration. Hemodynamic and ventilatory measurements were made during the anesthesia. Barium sulfate was poured into the oropharynx after the airway was secure. Fiberoptic examination through the LM was performed at the beginning and at the end of the administration of each anesthetic. Radiographs were taken at the end of the anesthetic administration before LM or ETT removal to look for barium in the trachea. After airway removal, presence of blood on the airway, sore throat, coughing, nausea, vomiting, shivering, and amount of morphine demanded during recovery were noted. No barium in the trachea or bronchial tree was seen in any of the radiographs. The ETT was associated with greater hemodynamic response not only to airway placement (P < 0.05), but also to surgical incision (P < 0.05) and airway removal (P < 0.05). Spontaneous or controlled ventilation favored neither airway, although the ETT was associated with increased work of inspiration with controlled ventilation (P < 0.05). Anesthesiologists tended to elect smaller tidal volumes, faster ventilation rates, and lower anesthetic concentrations for patients with the LM (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prospective comparison of use of the laryngeal mask and endotracheal tube for ambulatory surgery. 976 7

Sevoflurane is a "new" volatile inhaled anaesthetic that is currently undergoing phase III clinical trial in Europe and the United States. Owing to the low blood solubility, rapid induction of anaesthesia and emergence from anaesthesia would be expected. In this study, we compared emergence times and haemodynamics in patients receiving either sevoflurane or isoflurane. Furthermore, all adverse effects were recorded and the relationship to the drug administered was rated. METHODS. Fifty ASA physical status I and II patients were studied in an open, prospective, randomised clinical trial. Anaesthesia was induced with fentanyl, thiopentone, and vecuronium for facilitating endotracheal intubation and maintained with sevoflurane or isoflurane, 60% nitrous oxide (N2O) in oxygen (O2), and additional doses of fentanyl (1-2 micrograms/kg.h). The electrocardiogram, blood pressure (non-invasive), O2 saturation, temperature, and end-tidal concentrations of sevoflurane or isoflurane, N2O, and carbon dioxide were monitored continuously. At the end of surgery, administration of sevoflurane or isoflurane and N2O was discontinued without tapering and emergence times were recorded. All adverse events that occurred until the 3rd postoperative day were recorded and the relationship to the inhaled anaesthetic was rated as "none", "unlikely", "possible", "probable", or "highly probable". RESULTS. With the exception of gender, the two patient groups were comparable (Tables 1 and 2). Due to the higher MAC value, mean end-tidal concentrations were higher for sevoflurane (0.82% vs. 0.59% for isoflurane). The duration of anaesthetic exposure was 1.3 MAC h (calculation with FIO2 = 1.0 MAC value) and 3.1 MAC h (calculation with FIO2 = 0.4 in N2O MAC value), respectively, for both inhaled anaesthetics. Pulmonary elimination was faster (Fig. 1) and emergence time shorter (7 min vs. 11.5 min, Table 3) with sevoflurane. There was no difference in the time courses of heart rate and mean arterial blood pressure (Figs. 2 and 3). No adverse effects with a "probable" or "highly probable" relationship to the inhaled anaesthetic were observed. Table 4 shows the adverse events with a possible relationship to the drug administered. Further evaluations of nausea, vomiting, and dizziness are shown in Table 5. DISCUSSION. Emergence time after inhalation anaesthesia depends on pulmonary elimination and MACawake, that is, the end-tidal concentration that would allow opening of the eyes on verbal command. Pulmonary elimination depends on dose applied (MAC h), alveolar ventilation, and blood-gas solubility coefficient. Due to the lower blood-gas solubility coefficient (0.6-0.7 for sevoflurane vs. 1.3-1.4 for isoflurane) and in accordance with the investigations of Frink et al. [4] and Smith et al. [16], emergence time was significantly shorter with sevoflurane. Gender, the only difference between the two patient groups, does not influence pulmonary elimination and MACawake [8]. Supplementing inhalation anaesthesia with fentanyl, there was no difference in the time courses of heart rate and mean arterial blood pressure between sevoflurane and isoflurane. Adverse events with a possible relationship to the inhaled anaesthetic occurred in both groups.
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PMID:[Emergence times, hemodynamics and adverse effects of sevoflurane and isoflurane: an open, randomized, comparative phase iii study]. 797 85

We studied the influence of mivacurium on the recovery profile following outpatient laparoscopic tubal ligation in 60 healthy, nonpregnant women. After administration of midazolam 2 mg intravenously (IV), anesthesia was induced with fentanyl, 2 micrograms/kg, and thiopental, 4 mg/kg, IV. When the patient became unresponsive (loss of eyelid reflex), either succinylcholine 1 mg/kg, IV (Group I), or mivacurium 0.2 mg/kg, IV (Groups II and III), was administered to facilitate tracheal intubation. Anesthesia was maintained with isoflurane (0.5%-2% inspired concentration) in combination with 67% N2O in oxygen. Muscle relaxation was maintained in all three groups with intermittent bolus doses of mivacurium, 2-4 mg, IV. In Group III, residual neuromuscular block was reversed with a combination of neostigmine, 2.5 mg, and glycopyrrolate, 0.5 mg, IV, at the end of the operation. In the postanesthesia care unit (PACU), patients in Group III had a significantly increased incidence of postoperative nausea and vomiting compared to Group II. The use of succinylcholine (versus mivacurium) was also associated with more frequent postoperative nausea and vomiting. However, these emetic sequelae did not delay postoperative recovery times. In addition, a comparable number of patients in each treatment group required analgesic medication for postoperative pain. Although patients who received succinylcholine complained of significantly more neck pain during the 24-h period after discharge, nausea, vomiting, and shoulder pain were similar in all three groups during this period. We conclude that neostigmine and glycopyrrolate may contribute to the development of postoperative emesis when used for reversal of residual neuromuscular block.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Use of mivacurium during laparoscopic surgery: effect of reversal drugs on postoperative recovery. 970 58

During propofol-nitrous oxide (N2O) anesthesia, volatile anesthetics are frequently administered to treat signs of inadequate anesthesia and to decrease the possibility of intraoperative awareness. Because the clinical effects of this combination have not been examined rigorously, we used data from the 1989-90 Phase IV clinical trial with propofol to evaluate recovery from propofol-N2O anesthesia with and without supplementation with isoflurane. In this study involving 15,806 patients at 1722 institutions, propofol was administered for induction and maintenance of anesthesia with N2O for procedures lasting less than 60 min. At the discretion of the anesthesiologist, volatile anesthetics were administered as needed during maintenance of anesthesia (the incidence of use of inhaled anesthetics was 14.7% for isoflurane, 2.2% for enflurane, and 0.2% for halothane). Other intraoperative medications included opioid analgesics, muscle relaxants, and anticholinergic drugs. The present study concerns the subset of 7796 patients given propofol-N2O maintenance anesthesia (intermittent bolus or continuous infusion) with or without isoflurane supplementation for procedures lasting less than 60 min. Isoflurane was used more frequently for procedures lasting 30-60 min than for those less than 30 min. Nevertheless, the maintenance dose of propofol was significantly (P < 0.05) less with isoflurane (178 vs 235 mg). Adjunctive use of isoflurane prolonged the time to awakening and to becoming oriented, but discharge times were similar for the two groups. The incidence of postoperative nausea, vomiting, recall, and excitement did not differ between the two groups. We conclude that the addition of isoflurane to a propofol-N2O anesthetic does not alter recovery from anesthesia.
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PMID:Effects on recovery when isoflurane is used to supplement propofol-nitrous oxide anesthesia. 821 92


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