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

The effect of introducing an Acute Pain Service into a District General Hospital was evaluated by conducting an audit of pain, emesis, sleep and satisfaction before and after inception. A total of 1518 questionnaires were collected; in which surgical patients had been asked to assess their experience pre- and postoperatively. The introduction of an Acute Pain Service significantly (p < 0.0001) improved in-patient perception of pain relief upon return of consciousness after anaesthesia and for 2 days postoperatively, when compared with the experience before its inception. The incidence of emetic sequelae did not increase and both patient satisfaction (p < 0.001) and sleep pattern (p < 0.05) in hospital were significantly improved. An estimate of the economic benefit suggests that the development of Acute Pain Services may be cost effective as well as providing an improved quality of service for patients undergoing surgery.
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PMID:The acute pain service: effective or expensive care? 1019 33

Lignocaine has been used successfully to treat burn pain and neuropathic pain. We have conducted a randomized, double-blind trial to assess the morphine-sparing effect of intravenous lignocaine in patients with acute pain. After major abdominal surgery, patients were treated with post-operative patient-controlled intravenous analgesia in two groups: group M (n = 25, morphine 0.2 mg mL-1) and group ML (n = 25, morphine 0.2 mg mL-1 plus lignocaine 3.2 mg mL-1). The patient-controlled analgesia system was programmed to deliver a 5 mL bolus with a 50 mL per 4 h limit; the lockout time was 10 min. Both groups closely resembled each other in terms of demographic data, pain intensity, cumulative morphine dose and the morphine-associated nausea, vomiting and pruritus. However, the sedation scores in group ML patients during the first post-operative day were significantly greater than those in group M. The incidence of lignocaine-related lightheadedness and dry mouth was also significantly greater in group ML than in group M. It was concluded that the addition of lignocaine 3.2 mg mL-1 to morphine 0.2 mg mL-1 given via patient-controlled analgesia system does not provide a post-operative morphine-sparing analgesic effect.
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PMID:Lignocaine plus morphine in bolus patient-controlled intravenous analgesia lacks post-operative morphine-sparing effect. 988 51

There is very little information in the medical literature regarding opioid-induced emesis and its relationship to patient outcomes. Two-hundred and six nonsurgical patients in a 400-bed teaching hospital with minimal known risks of disease-associated emesis were interviewed to examine emesis and associated outcomes following the administration of opioids for acute pain management. The mean age, weight, and height of the study group were 54.4 (+/- 19.6) years, 175.8 (+/- 45.7) pounds, and 67.1 (+/- 4.4) inches, respectively. Seventy-three (35.4%) patients experienced nausea; 28 (13.6%) patients vomited; and 15 (7.3%) patients retched following the opioid therapy. These symptoms were mild and discomforting for relatively short periods of time. The patients' ability to concentrate and eat was affected by the incidence of nausea/vomiting. The intensity, duration, and severity of nausea were positively associated with the magnitude of the functional limitations. The symptoms also influenced patients' ratings of various hospital satisfaction measures. In conclusion, emesis due to opioids represents a notable burden on nonsurgical patients. Successful therapies that prevent opioid-induced emesis are likely to positively influence patient outcomes by reducing adverse effects, improving functional outcomes, and enhancing quality of life.
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PMID:Opioid-induced emesis among hospitalized nonsurgical patients: effect on pain and quality of life. 1053 68

Helicobacter pylori infection is frequent in children. Its incidence in Europe, around 6% in children aged 6-16 years, varies with the socio-economic level and nutritional status. It may reach 46% in Africa and up to 75% in some institutions. Clinical manifestations debated. Vomiting, dyspepsia and acute pain related to ulcer disease may undisputedly be linked to H. pylori, whereas its role in chronic abdominal has yielded contradictory reports. Direct isolation of the bacterium is classically done through perendoscopic antral biopsies followed by culture and histology. Non-invasive diagnosis methods get a wider use in children. Serodiagnosis is reproducible and easy only in older children. The 13C-urea breath test is sensitive and specific, and seems perfectly suitable in pediatrics. The H. pylori stool antigen test for the detection of infection seems promising but not yet of current clinical use. Triple therapy using amoxicillin-clarithromycin (or metronidazole or tinidazole) and anti-secretory agents is recognised as the most efficient association.
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PMID:[Helicobacter pylori infection in children]. 1101 36

A case of intoxication in Southern Bulgaria after a bite from the venomous spider Latrodectus tredecimguttatus is reported. The development of both local (acute pain, itching erythema, paraesthesiae in the area of the bite) and general (weakness, headache, dizziness, fever, vomiting, myalgia, muscle cramps) symptoms, which passed relatively easily, is described. The clinical picture and treatment are briefly commented on.
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PMID:A case of intoxication after a bite by Latrodectus tredecimguttatus. 1134 25

Two double-blind, placebo-controlled, prospective randomized trials in the emergency department (ED) setting have examined the use of metoclopramide for the prevention of opiate-induced nausea and vomiting. Both showed a low incidence of vomiting in the control group. This prospective observational study in 205 unselected ED patients with acute pain syndromes measured nausea and vomiting before intravenous opiate administration and 30 and 60 minutes posttreatment. Cumulative incidence of vomiting was 1.5% at 30 minutes and 2.4% at 60 minutes. Corresponding figures for nausea were 4.9% at 30 minutes and 9.3% at 60 minutes, with more than 75% of patients rating their nausea as mild. Prevalence of both nausea and vomiting were higher at baseline than after analgesia. These data support the findings of previous randomized trials that the incidence of nausea and vomiting after intravenous opiate analgesia in the ED is low and argues against routine use of prophylactic antiemetic administration in combination with opiate analgesia.
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PMID:Low incidence of nausea and vomiting with intravenous opiate analgesia in the ED. 1244 38

Buprenorphine, a powerful opioid, is newly available for delivery in a transdermal formulation. The transdermal system's matrix patch provides rate-controlled administration of the drug. Three double-blind, placebo-controlled trials were conducted to evaluate efficacy and tolerability of the buprenorphine transdermal system (buprenorphine TDS, Transtec). A total of 445 patients were enrolled in the studies. All suffered from moderate to severe and very severe pain, both cancer- or non-cancer-related. The percentage of responders increased as the rate of buprenorphine delivered by the transdermal system rose, ranging from a 29% (cancer) and 36% (non-cancer) response rate associated with the lowest dose (35 microg/h), to 40% (cancer) and 46% (non-cancer) with the highest dose (70 microg/h). Patients receiving buprenorphine TDS slept longer, uninterrupted by pain, than patients from the placebo group. Systemic adverse effects reported in the drug cohorts included nausea, vomiting and dizziness, and were typical of those reported in other studies of opioids; local adverse events, most commonly erythema and pruritus, were transient and mild to moderate. In an open-label, follow-up trial, in which 239 patients from the original clinical studies participated, 90% of patients reported that their analgesia was satisfactory or even better over a mean duration of 4.7 months; nearly 95% of patients found the patch to be user-friendly. The new buprenorphine TDS appears to be an important new modality for administering analgesia in patients with non-acute pain.
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PMID:Buprenorphine TDS: the clinical development rationale and results. 1266 19

This study is a review of the Acute Pain Service in Hospital Kuala Lumpur for the years 1998 to 2001. 5042 records from post-operative patients were analysed. The majority of patients (81.8%) had satisfactory pain control. Eighty-two percent of patients experienced only mild pain at rest on the first post-operative day. The highest pain score occurred on the first day in 68.3% of patients. Nausea or vomiting occurred in 23.2% of the patients. Eight patients had respiratory depression. The low pain scores recorded by most patients and the low incidence of side effects reflect the efficiency of the service provided.
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PMID:A review of the acute pain service in Hospital Kuala Lumpur. 1456 36

A 77-year-old woman who had been examined 8 months previously because of chronic abdominal pain and an altered pattern of defecation presented to the emergency department with complaints of nausea, vomiting and acute pain in the abdomen. Her appetite was diminished and she had lost 10 kg in the past year. The abdominal X-ray showed a balloon-like, gas-filled intra-abdominal configuration, which proved to be a giant diverticulum of the sigmoid. She was treated by resection of the diverticulum and the sigmoid. A giant diverticulum is a rare complication of diverticulosis, a frequently occurring condition that is encountered most often in the sigmoid; the complication can easily be missed. The presenting symptoms can vary from an acute abdomen to chronic non-specific abdominal complaints. The most important complications of a giant diverticulum are perforation, obstruction or a volvulus. In view of the severity of these complications, resection of that part of the intestine in which the giant diverticulum arises is the treatment of choice.
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PMID:[Giant diverticulum of the sigmoid]. 1514 55

The objective of this study was to compare the analgesic efficacy of tramadol/acetaminophen (APAP) (total dose 75 mg/650 mg) and tramadol (total dose 100 mg) for the control of pain after oral surgery. A total of 456 patients with moderate-to-severe pain within 5 h after extraction of two or more third molars were randomized to receive two identical encapsulated tablets containing tramadol/APAP 37.5 mg/325 mg, tramadol 50 mg, or placebo. Tramadol/APAP was superior to tramadol (P < 0.001) or placebo (P < 0.001) on all efficacy measures: total pain relief (PAR) over 6 h (7.4, 2.5, and 1.5, respectively, on a scale of 0-24); sum of pain intensity differences (PIDs) (3.1, 0.6, and 0.1, respectively, on a scale of -6 to 18); and sum of PAR and PID (10.5, 3.1, and 1.6, respectively, on a scale of -6 to 42). Median times to onset of perceptible and meaningful PAR were 37.6 and 126.5 min, respectively, for the tramadol/APAP group (P < 0.001) for each, compared with tramadol and placebo arms). The most common adverse events with active treatment were nausea, dizziness, and vomiting; these events occurred more frequently in the tramadol group than in the tramadol/APAP group. This study established the superiority of tramadol/APAP 75 mg/650 mg over tramadol 100 mg in the treatment of acute pain following oral surgery.
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PMID:A double-blind placebo-controlled comparison of tramadol/acetaminophen and tramadol in patients with postoperative dental pain. 1515 85


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