Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective, double-blind, randomized study, we have compared i.v. ketorolac and morphine in paediatric outpatients undergoing strabismus surgery. Forty-two ASA I or II children, aged 2-12 yr, were allocated randomly to receive either ketorolac 0.75 mg kg-1 i.v. or morphine 0.1 mg kg-1 i.v. and metoclopramide 0.15 mg kg-1. Anaesthesia was induced with propofol and maintained with propofol and nitrous oxide. Pain was assessed at 15-min intervals until discharge, and the incidence of nausea and vomiting was recorded for the first 24 h. There was no difference in pain behaviour scores or recovery times. The incidence of nausea and vomiting during the first 24 h was 19% in the ketorolac group and 71% in the morphine group (P < 0.001). We concluded that ketorolac was an effective analgesic for this type of surgery and that it was associated with less postoperative emesis than morphine and metoclopramide.
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PMID:Comparison of the analgesic and emetic properties of ketorolac and morphine for paediatric outpatient strabismus surgery. 802 8

Although the aetiology of postoperative nausea and vomiting is not completely clear, a number of key contributing factors increase the risk for an individual patient. The inhalational agents are variably associated with postoperative nausea and vomiting, and nitrous oxide is particularly emetogenic. Older inhalational anaesthetics, such as cyclopropane, are associated with a high incidence, while the currently used agents, isoflurane, enflurane and halothane, cause less, but still significant postoperative nausea and vomiting. Intravenous anaesthetics are also associated with differing degrees of emesis, though the newer agent, propofol, may be less emetogenic than the older anaesthetics. Opioids, used extensively throughout surgery, are further strong emetogens. Patient factors are also important--postoperative nausea and vomiting is three times more prevalent in adult females than in males, and children are around twice as susceptible as adults. Furthermore, a previous history of postoperative nausea and vomiting or motion sickness is a known risk factor. Superimposed on this is the type of surgery--abdominal and gynaecological surgery are particularly emetogenic, and the incidence of postoperative nausea and vomiting following strabismus surgery is high. Increased quality of healthcare, and a growing awareness of the importance of patient satisfaction, are providing new incentives to ensure that postoperative nausea and vomiting is dealt with adequately.
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PMID:Risk factors for postoperative nausea and vomiting. 812 61

Strabismus surgery in children is associated with a high incidence of postoperative nausea and vomiting (PONV). METHODS. Ninety ASA class I and II children aged 6 to 16 years and scheduled for strabismus surgery were randomly assigned to one of the following groups: Group 1 (n=30):thiopentone 4-6 mg/kg i.v., halothane 0.8-1.5%, N2O--O2 2:1, no opioids, droperidol 75 micrograms/kg i.v.; Group 2 (n=30):propofol 2-3 mg/kg i.v., propofol 6-9 mg/kg.h, alfentanil 30 micrgrams/kg.h, N2O-O2 2:1, no antiemetics; Group 3 (n=30):similar to group 2, but ventilation with air and O2 2:1. All patients were mechanically ventilated during anaesthesia and gastric contents were aspirated. Recovery scores were calculated for 2 h, emetic scores for 24 h postoperatively.
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PMID:[The effect of propofol on vomiting after strabismus surgery in children]. 877 7

The occurrence of postoperative nausea and vomiting in children after strabismus surgery has historically been a challenging aspect of anesthetic management. This article provides an overview of the cause, physiology, and mechanisms of post surgical vomiting in this patient population. Current pharmacological treatment modalities and implications for future practice are examined.
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PMID:Postoperative nausea and vomiting after strabismus surgery: mechanisms, treatment, and implications for practice. 885 Sep 92

Forty children undergoing strabismus surgery as day patients were randomly allocated to receive oxybuprocaine 0.4% eyedrops or 0.1% diclofenac eyedrops for perioperative analgesia. A non-invasive anaesthetic technique using the reinforced laryngeal mask airway was used. The study demonstrated that both topical analgesics provided good to excellent analgesia and the anaesthetic technique was associated with a relatively low incidence of nausea and vomiting. Complications were limited to two children who were admitted with persistent postoperative nausea and vomiting.
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PMID:Diclofenac vs oxybuprocaine eyedrops for analgesia in paediatric strabismus surgery. 918 68

Day case surgery has become a widely accepted practice for many ophthalmological procedures including strabismus surgery. Prompt recovery from anesthesia and minimal postoperative morbidity are especially requested to the anesthesiologists to deal with the high day case surgery burden. The purpose of this study was to compare two anesthesia techniques, halothane/thiopental anesthesia and propofol anesthesia, for patients undergoing monocular strabismus surgery. We studied the level of postoperative consciousness, nausea and vomiting, ocular pain, starting oral intake and activity in 43 patients, ranging from 7 to 41 years of age. A scoring system was used to assess these parameters in the first postoperative 48 h. Although there was not a significant difference in the level of ocular pain, the propofol group had less morbidity in terms of having a better level of consciousness and appetite, less nausea and vomiting and enhanced activity than the halothane/thiopental group. We conclude that propofol anesthesia has significant advantages over halothane/thiopental anesthesia on an outpatient basis for strabismus surgery.
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PMID:Comparison of halothane/thiopental and propofol anesthesia for strabismus surgery. 1042 Jan 5

Vomiting is a common problem following strabismus surgery. We compared the effects of propofol-N2O and sevoflurane-N2O on the incidence of oculocardiac reflex and postoperative nausea and vomiting. Forty unpremedicated children, aged 3-15 years were randomly assigned to two groups of 20 patients. In group 1, anaesthesia was induced and maintained with propofol infusion (173 +/- 41 micrograms.kg-1.min-1). In group 2, anaesthesia was induced with N2O (66%) in O2 and incremental sevoflurane via face mask and maintained with sevoflurane. Both groups received 66% N2O in O2 throughout surgery. The overall incidence of vomiting and antiemetic requirement in the first 24 h was significantly higher in sevoflurane-N2O group than propofol-N2O group (P < 0.05). The propofol-N2O group had significantly more episodes of oculocardiac reflex than sevoflurane-N2O group (P < 0.05). Propofol-N2O anaesthesia results in a significantly lower incidence of postoperative vomiting, yet a significantly higher incidence of oculocardiac reflex.
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PMID:Propofol-nitrous oxide versus sevoflurane-nitrous oxide for strabismus surgery in children. 1059 52

In a prospective, randomized parallel study, 60 ASA I-III children aged 1-17 years, scheduled for elective strabismus surgery, were anaesthetized with desflurane without prophylactic antiemetic medication. The objective of the study was to determine the incidence of postoperative nausea and vomiting after general anaesthesia with desflurane. To decide whether nitrous oxide further influences these symptoms, the patients were randomly assigned to two groups of 30 patients each. One group received desflurane in oxygen/air and a second group received desflurane in oxygen/nitrous oxide. In all children, after intravenous induction and tracheal intubation, anaesthesia was administered as minimal flow anaesthesia with oxygen and nitrous oxide or air according to the random plan. The patients were observed for 48 postoperative hours until their discharge from the ward. The overall incidence of nausea was found to be 37%, and vomiting was seen in 32% of all patients. No statistical correlation was found between the incidence of postoperative emesis and the administration of nitrous oxide or the duration of general anaesthesia. Instead, the incidence of vomiting was 2.5-fold higher when surgery was performed on both eyes compared with one eye. The relatively low incidence of postoperative nausea and vomiting, as well as the quick recovery from anaesthesia, permitting an early discharge from the postoperative care unit to the ward, show desflurane to be a suitable volatile anaesthetic in strabismus surgery in children.
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PMID:Incidence of nausea and vomiting in children after strabismus surgery following desflurane anaesthesia. 1059 56

This prospective, randomized, double-blinded study evaluated the effect of the timing of ondansetron administration on its antiemetic efficacy in children undergoing elective strabismus surgery. One hundred and twenty children aged one to 15 years, ASA physical status 1 or 2, were randomly allocated to receive intravenous ondansetron 100 micrograms/kg either at induction (Group 1) or at the end of the surgery (Group 2). All patients had general anaesthesia induced and maintained with nitrous oxide and halothane, muscle relaxation with vecuronium, endotracheal intubation, reversal with neostigmine and glycopyrrolate, and pethidine 0.5 mg/kg analgesia. Episodes of nausea and vomiting were evaluated at 0 to 2, 2 to 6 and 6 to 24 hour intervals by a blinded observer. Demographic data, duration of anaesthesia, type of surgery, incidence of previous postoperative nausea or vomiting and motion sickness and number of patients who developed oculocardiac reflex requiring atropine treatment were similar in both groups. The incidence of emesis in the first 24 hours following surgery was similar in both groups (35% Group 1, 33.3% Group 2, P = 1.00). Severity of emesis (median number of emetic episodes, rescue antiemetic requirement and mean time to the onset of first episode of emesis) and mean time to discharge from the post anaesthesia care unit were also similar in the two groups. We conclude that the timing of ondansetron administration either before or after the surgical manipulation of extraocular muscles had similar antiemetic efficacy following strabismus surgery in children.
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PMID:Effect of timing of ondansetron administration on incidence of postoperative vomiting in paediatric strabismus surgery. 1070 Oct 32

This prospective, randomized and double-blinded study was designed to evaluate the anti-emetic efficacy of a combination of ondansetron and metoclopramide in 100 ASA physical status I and II children of either sex and 1-15 years of age undergoing elective surgery for strabismus. A standardized anaesthetic technique and post-operative analgesia were used for all the children. Children were divided into four groups. They received saline, metoclopromide 250 micrograms kg-1, ondansetron 150 micrograms kg-1 or a combination of metoclopramide 150 micrograms kg-1 and ondansetron 100 micrograms kg-1 intravenously immediately after the insertion of an intravenous cannulae. There were no differences between the groups in their age, gender, weight, duration of surgery, number of muscles subjected to surgery or intravenous fluids received. In the first 24 post-operative hours, 18 (72%) patients in the placebo group, 15 (60%) patients in the metoclopramide group, 10 (40%) patients in the ondansetron group and 11 (44%) patients in the combination group had nausea or vomiting. The overall incidence of post-operative nausea and vomiting was significantly (P < 0.05) lower in the combination group and in the ondansetron group compared with the placebo group. Nine (36%) patients in both the placebo and the metoclopramide groups and one (4%) patient in the ondansetron group required rescue anti-emetic treatment. None of the patients in the combination group required rescue anti-emetic and this was significantly less (P < 0.01) when compared with the placebo and the metoclopramide groups. Recovery and sedation scores were comparable in all the four groups. A combination of metoclopramide 150 micrograms kg-1 and ondansetron 100 micrograms kg-1 administered prior to surgery was not found to be more effective than ondansetron 150 micrograms kg-1 alone for the prophylaxis of nausea and vomiting following surgical repair of strabismus in paediatric patients.
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PMID:Comparison of anti-emetic effects of ondansetron, metoclopromide or a combination of both in children undergoing surgery for strabismus. 1071 69


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