Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-two adult female ASA I patients (American Society of Anesthesiologists' grading) undergoing voluntary termination of pregnancy (VTP) under general anaesthesia were randomly divided into three groups. Patients received 0.6 mg/kg pentazocine intravenously five minutes prior to induction of anaesthesia along with either isotonic saline, or promethazine 0.5 mg/kg or metoclopramide 0.2 mg/kg. Anaesthesia was induced with intravenous thiopentone and maintained with nitrous oxide in oxygen and boluses of thiopentone. Vomiting and sedation were scored at the end of anaesthesia, one hour later and at the time of discharge. The mean vomiting score was comparable in the three groups. Though the mean dose of thiopentone used was significantly less in the promethazine group, the sedation scores and the duration of stay in the clinic were comparable in all the groups. It is concluded that promethazine and metoclopramide in the doses used are ineffective as antiemetic agents in outpatient gynaecological patients.
 ...
PMID:Evaluation of two antiemetic agents during outpatient gynaecological surgery. 799 2

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.
 ...
PMID:Comparison of the analgesic and emetic properties of ketorolac and morphine for paediatric outpatient strabismus surgery. 802 8

A randomized, prospective study was performed to evaluate the hemodynamic changes and recovery characteristics in 60 ASA physical status class I-II unpremedicated patients undergoing gynecological laparotomies with either isoflurane anesthesia only (ISO group) or isoflurane anesthesia followed by propofol infusion (ISO-PRO group). All patients received isoflurane 0.5-1.5% and nitrous oxide (N2O) 66% in oxygen after tracheal intubation. ISO-PRO group (n = 30) received 6 mg kg-1 hr-1 propofol infusion in substitution for isoflurane 25 minutes before the end of surgery. Propofol in ISO-PRO group and isoflurane in ISO group (n = 30) were discontinued 5 minutes before the end of surgery. In both groups, N2O was administered throughout the operation until skin was closed. Hemodynamic measurements were similar between the two groups except at extubation when heart rate and blood pressure were lower in ISO-PRO group. The maximal blood pressure was also lower in ISO-PRO group. In ISO-PRO group, the time required to responsiveness to verbal commands and to orientation were significantly shorter. ISO-PRO group had better Steward's score on arrival at the recovery room and was earlier to get a full score of six. The two groups experienced similar rates of emesis and excitement either two hours or 24 hours postoperatively. We conclude that in relatively long intra-abdominal operations, replacement of isoflurane by propofol infusion 25 minutes before the end of surgery may provide stable maintenance of anesthesia and a faster recovery.
 ...
PMID:Propofol modifies recovery from isoflurane-nitrous oxide anesthesia. 803 80

This prospective, randomized, placebo-controlled, double-blinded study evaluated the antiemetic efficacy of ondansetron and metoclopramide in 90 ASA physical status I or II children, 2-17 yr of age, undergoing strabismus repair. After anesthetic induction and prior to eye muscle manipulation, subjects received normal saline 0.3 mL/kg (Group 1), metoclopramide 0.25 mg/kg (Group 2), or ondansetron 0.15 mg/kg (Group 3), intravenously. There were no differences between groups with respect to age, weight, gender, fluids received, number of eye muscles repaired, anesthetic technique, or time in the operating room. The incidence of vomiting in Groups 1, 2, and 3 was 50%, 27%, and 10% prior to discharge, and 67%, 53%, and 30% during the 24 h after surgery, respectively. The number of children vomiting prior to discharge and within 24 h of surgery was significantly reduced in Group 3 compared with Group 1 (P < 0.003 and P < 0.015, respectively). The number of vomiting episodes per patient in Groups 1, 2, and 3 was 1.1, 0.5, and 0.1 prior to discharge, and 4.5, 2.6, and 1.2 during the 24 h after surgery (P < 0.0005 and P < 0.004, respectively). Ondansetron 0.15 mg/kg intravenously after the induction of anesthesia reduces the incidence and severity of vomiting after strabismus repair both prior to discharge from the hospital and during the 24 h after surgery.
 ...
PMID:Ondansetron reduces the incidence and severity of poststrabismus repair vomiting in children. 806 52

We studied the preventive effect on postoperative nausea and vomiting (PONV) of ondansetron, metoclopramide and placebo associated with epidural anaesthesia. Sixty children, ASA I or II, 4 to 12 yr old underwent surgery for inguinal hernia repair (n = 30) or orchidopexy (n = 30). Children were randomly assigned to a postinduction intravenous medication group, ondansetron (5 mg.m-2), metoclopramide (0,12 mg.kg-1) or a saline solution placebo. After a general anaesthesia was obtained with halothane, nitrous oxide and oxygen delivered by mask, caudal or lumbar epidural anaesthesia was performed with plain mepivacaine. General performed with plain mepivacaine. General anaesthesia was interrupted and light narcosis maintained with diazepam during surgery. There were no significant differences in age and weight between the three groups. There were no adverse reactions to either ondansetron or metoclopramide. vomiting was not present in ondansetron group. The incidence of postoperative emesis in the metoclopramide group was 25%, whereas that of placebo group was 10%. The administration of ondansetron was associated with a lower (P = 0.017) incidence of postoperative vomiting if compared to the metoclopramide group. In conclusion ondansetron given preoperatively had proven to be an effective treatment for PONV after epidural block for lower abdominal surgery.
 ...
PMID:[Effects of ondansetron and metoclopramide on postoperative nausea and vomiting after epidural anesthesia in children]. 807 28

The role of nitrous oxide in postoperative emesis is controversial. This prospective randomized study was performed to compare the emetic sequelae and quality of recovery between a group of patients anesthetized with propofol alone and a group anesthetized with propofol plus nitrous oxide. Seventy patients, ASA grade I or II, scheduled for ambulatory gynecologic laparoscopy under general anesthesia were included. Most factors which could influence the incidence of postoperative emesis were controlled. The overall incidence of emetic sequelae during the first 24 h postoperatively was 25% in the group anesthetized with propofol alone versus 29% for the group anesthetized with propofol and nitrous oxide. The incidence of emetic sequelae requiring therapeutic intervention was 13% and 6%, respectively. This difference was not statistically significant. The group of patients who received propofol alone required an average propofol dose of 221.5 +/- 71.9 micrograms.kg-1.min-1 to maintain anesthesia compared with 162.5 +/- 43.9 micrograms.kg-1.min-1 for the group receiving propofol plus nitrous oxide (P < 0.001). The time from discontinuation of propofol to eye-opening and orientation was significantly longer in patients anesthetized with propofol alone. Otherwise, the recovery variables were comparable between the two groups. We conclude that supplementing propofol with nitrous oxide in patients undergoing ambulatory laparoscopy reduces the requirements of propofol, expedites immediate recovery (emergence), and does not increase the incidence of postoperative emesis. This tends to confirm that there is no clinical advantage to omitting nitrous oxide.
 ...
PMID:Propofol for ambulatory gynecologic laparoscopy: does omission of nitrous oxide alter postoperative emetic sequelae and recovery? 816 Sep 78

We have compared the efficacy of ondansetron with droperidol and saline in the prevention of postoperative nausea and vomiting (PONV) in 120 ASA I and II patients undergoing hip and knee replacements and femoral resections. They received a standardized combined extradural and general anaesthetic and at the end of surgery were allocated randomly to receive droperidol 1.25 mg, ondansetron 4 mg or 0.9% saline in a 25-ml bag. An extradural mixture containing 0.5% plain bupivacaine 10 ml, fentanyl 500 micrograms and saline 30 ml was infused and PONV assessed for 24 h. Both ondansetron and droperidol were superior to saline in preventing vomiting (P < 0.01) although there was no significant difference between them. The incidence of vomiting was 17% for ondansetron, 18% for droperidol and 45% for saline. There was no significant difference in the incidence of nausea between the groups. Metoclopramide, the rescue antiemetric, was demanded by 38%, 34% and 17% of patients receiving saline, droperidol and ondansetron, respectively (ondansetron vs droperidol P < 0.05).
 ...
PMID:Double-blind comparison of ondansetron, droperidol and saline in the prevention of postoperative nausea and vomiting. 819 6

Phase II and III studies are tightly controlled trials investigating adverse effects before government approval of a new drug. However, because postapproval Phase IV studies involve a much larger and more complex population, the true nature of adverse effects can be seen. We analyzed Phase IV data for the new drug propofol with regard to the incidence of adverse events, and evaluations of such events by anesthesiologists versus postanesthesia care unit (PACU) nurses. Data pertained to 25,981 patients, 1722 institutions, and 1819 anesthesiologists giving propofol in three anesthetic regimens. Inclusion criteria were liberal: age, 18-80 yr; ASA physical status I-III; no continuing pregnancy; and no prior adverse anesthetic experience. Anesthesiologists and PACU nurses used data collection forms to record demographic, perioperative, and outcome variables; to evaluate recovery (excellent, good, or poor); and to describe adverse events. Adverse events were reported for 2813 patients (10.8%); the most common events were pain on injection (5.2%), hypotension (1.1%), nausea/vomiting (1.9%), and excitement (1.3%). The incidences of pain on injection and nausea/vomiting were approximately one-half and one-fifth, respectively, the values reported in earlier studies. Six hundred thirty-three patients (2.4%) had a "poor" recovery according to one or both of the evaluators (the anesthesiologist or PACU nurse). The PACU nurse was more influenced by nausea, vomiting, or postoperative pain; and the anesthesiologist was more influenced by postoperative confusion or delayed emergence from anesthesia. For only 0.6% of patients did both evaluators rate recovery as poor. Anesthesiologists gave more weight to intraoperative adverse events, and nurses to postoperative events.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Adverse events in a multicenter phase IV study of propofol: evaluation by anesthesiologists and postanesthesia care unit nurses. 821 94

Propofol anaesthesia may reduce postoperative emesis. The purpose of this study was to compare the incidence of emesis after propofol anaesthesia with and without nitrous oxide, compared with thiopentone and halothane anaesthesia, in hospital and up to 24 hr postoperatively, in outpatient paediatric patients after strabismus surgery. Seventy-five ASA class I or II, unpremedicated patients, aged 2-12 yr were randomly assigned to one of three groups: Thiopentone, 6.0 mg.kg-1 i.v. induction followed by halothane and N2O/O2 for maintenance (T/H); propofol for induction, followed by propofol and oxygen for maintenance (P/O2); and propofol for i.v. induction, followed by propofol infusion and N2O/O2 for maintenance (P/N2O). All received vecuronium, controlled ventilation, and acetaminophen pr. Morphine was given as needed for postoperative analgesia. There were no differences in age, weight, number of eye muscles operated upon, duration of anaesthesia or surgery. The P/N2O group (255 +/- 80 micrograms.kg-1 x min-1) received less propofol than the P/O2 group (344 +/- 60 micrograms.kg-1 x min-1) (P < or = 0.0001) and had shorter extubation (P < 0.001) and recovery (P < 0.01) times. Emesis in the hospital, in both the P/N2O (4.0%) and P/O2 group (4.0%) was less than in the T/H group (32%) (P < 0.01). Antiemetics were required in four patients in the T/H group (16.0%). Overall emesis after surgery was not different among the groups: T/H (48%), P/O2 (28%) and P/N2O (42%). The use of propofol anaesthesia with and without N2O decreased only early emesis. This supports the concept of a short-acting, specific antiemetic effect of propofol.
 ...
PMID:Propofol anaesthesia reduces early postoperative emesis after paediatric strabismus surgery. 822 31

Patient-controlled analgesia (PCA) is rarely used on surgical wards despite described advantages of this method as compared to conventional techniques. Uncertainties in patient selection and insufficient evaluation of this technique may explain these circumstances. The aim of our study was to evaluate PCA on general surgery and traumatology wards by means of standardized criteria for technology assessment (i.e. safety, practicability, benefit for patients and medical staff) and the efficacy of pain relief. In a prospective study we investigated 120 patients. In phase I, we performed analgesic therapy with tramadol/metamizol (50 ASA status I-IV patients). In phase II, piritramid had been applied to 70 ASA status I-II patients after an intermediate analysis of phase I. In 7% of the patients technical problems led to an early interruption even at the end of the study period. There were, however, no incidents which caused vital problems for the patients. A mean postoperative pain level of 55 visual analogue scale points (0-100 point scale) was achieved with tramadol/metamizol. PCA was stopped in 16% of the patients due to the occurrence of nausea or vomiting and in two patients due to insufficient pain relief. The use of piritramid in phase II led to lower pain levels and no interruptions of PCA because of ineffectivity or nausea/vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Patient-controlled analgesia (PCA) for postoperative pain relief. A prospective observational study for evaluating the technology in a ward routine]. 826 45


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>