Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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 chlorprothixene (Taractan), a neuroleptic agent, administered either intramuscularly (1 mg/kg) or orally as a 4% solution (1,5-2 mg/kg), was compared in a double-blind study in 200 children between 11 months and 10 years of age. In addition, intramuscular 1-hyoscyamine (Bellafolin) was given to all patients 30 minutes before the induction of anaesthesia (0.005-0.01 mg/kg). With regard to antisalivary action, suppression of reflex irritability, frequency of post-anaesthetic vomiting, postoperative sedation and requirement of postoperative analgesics, there was no significant difference between the two methods. Preoperative sedation was slightly more pronounced with the intramuscular technique. An undesirable side-effect, hypotension, was observed more often after intramuscular than oral premedication. To obtain optimum effect, an interval of 2 hours between the oral premedication and induction of anaesthesia is recommended.
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PMID:[Chlorprothixene for premedication in children: oral versus intramuscular route (author's transl)]. 120 Mar 38

A study was performed to evaluate the antiemetic effects after ether anesthesia when dehydrobenzperidol (DHB) and pentobarbital were used for premedication and to compare these effects with halthane anesthesia when pentobarbital was used as premedication. Eighty-four patients undergoing minor surgical operations were randomly divided into three groups. The patients received ether and ether DHB 0.2 mg/kg or pentobarbital 2 mg/kg for premedication, or halothane and pentobarbital 2 mg/kg for premedication. The complaints of nausea and vomiting were recorded 24 h after anesthesia. We found that DHB compared to pentobarbital had a greater antiemetic effect after ether anesthesia, but the difference was not significant (P greater than 0.05). However, if only persistent nausea and vomiting were considered, the difference was significant (P less than 0.05). The incidence of nausea/vomiting after ether anesthesia with DHB as premedication was a little higher compared to halothane anesthesia with pentobarbital as premedication, but the difference was not significant (P greater than 0.05). However, if only persistent nausea/vomiting was considered, the incidence of complaints was equal in the two groups. It is concluded that when used for premedication to ether anesthesia DHB seems to lead to less postanesthetic nausea/vomiting than pentobarbital. Further DHB seems able to reduce the incidence of nausea/vomiting after ether anesthesia roughly to the level of that seen after pentobarbital premedication for halothane anesthesia.
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PMID:The postanesthetic antiemetic effect of premedication with dehydrobenzperidol before ether anesthesia. 126 58

A double-blind clinical trial was conducted to evaluate the efficacy and safety of flumazenil, a benzodiazepine antagonist, in 146 hospitalized patients, who had had general anesthesia induced by midazolam and a long-acting opioid. Ninety-eight patients received flumazenil and 48 received placebo. Administered postoperatively at a mean intravenous dose of 0.84 mg (range: 0.2 mg to 1 mg), flumazenil reversed benzodiazepine-induced sedation to a greater extent than did placebo. At 5 minutes posttreatment, 61 (76%) of 80 flumazenil-treated patients and 7 (18%) of 40 placebo-treated patients had attained a score of 4 or 5 on the Observer's Assessment of Alertness/Sedation Scale, indicating that they were drowsy or fully awake and alert. This level of arousal was maintained for the full 180-minute posttreatment assessment period in 79% of flumazenil-treated patients. Between-group differences in mean change from baseline in level of alertness were statistically significant (P < 0.01) until 60 minutes posttreatment, when the spontaneous recovery of placebo-treated patients resulted in declining intergroup differences. The global efficacy rating (based on the physician's general impression of the effectiveness of the reversal of sedation 5 minutes after test drug administration) was good or excellent in 64 (80%) of the 80 flumazenil-treated patients and 5 (13%) of the 40 placebo-treated patients evaluated. Flumazenil, compared with placebo, was not associated with an increased frequency of operative-site pain, and no serious adverse effects of this benzodiazepine antagonist were reported. The most frequent adverse experiences in both treatment groups were nausea, shivering, and operative-site pain. Vomiting, dizziness, and injection-site reactions were also reported in > or = 5% of patients treated with flumazenil.
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PMID:Reversal of the central effects of midazolam by intravenous flumazenil after general anesthesia and use of a long-acting opioid in hospitalized patients: report of a multicenter double-blind clinical study. The Flumazenil in General Anesthesia in Hospitalized Patients Study Group II. 128

Flumazenil was studied in a double-blind multicenter trial to confirm its efficacy and safety in antagonizing the central effects of benzodiazepines after general anesthesia (midazolam, short-acting narcotic, nitrous oxide) with muscle relaxants and selected potent volatile anesthetics as needed. One hundred seventy-two outpatients were randomly assigned to receive either flumazenil or placebo titrated to the point of reversal of sedation or a maximum dose of 1 mg of flumazenil or 10 ml of placebo. The test drug was given intravenously (0.2 mg flumazenil or 2 ml placebo) at 1-minute intervals. Tests of alertness, psychomotor function, and memory were conducted prestudy and at baseline before the administration of flumazenil and at 5-, 15-, 30-, 60-, 120-, and 180-minute intervals after administration. The changes from prestudy or baseline scores were analyzed to compare differences between treatment groups. Seventy-five percent of the 105 flumazenil-treated patients and 14% of the 55 placebo-treated patients who met the qualifications for efficacy evaluations obtained a criterion level of response as measured by the Observer's Assessment of Alertness/Sedation Scale. Most (76%) patients who were alert at 5 minutes maintained their level of wakefulness throughout the 180-minute observation period. All 172 patients were included in evaluations of safety. Fifty percent of 113 flumazenil-treated patients and 31% of 59 placebo-treated patients reported one or more adverse experiences. The most frequently reported were nausea, vomiting, and dizziness. Only 6 adverse effects in the flumazenil group and 1 in the placebo group were considered severe; the remainder were mild or moderate. None were considered serious or potentially serious. Postoperative administration of flumazenil (mean dose, 0.85 mg) safely provided a prompt, controlled reversal of the sedative and psychomotor effects of midazolam in most patients.
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PMID:Reversal of the central effects of midazolam by intravenous flumazenil after general anesthesia in outpatients premedicated with an opioid and a muscle relaxant: report of a multicenter double-blind clinical study. The Flumazenil in General Anesthesia in Outpatients Study Group II. 128 1

In a US double-blind, multicenter study, flumazenil, a benzodiazepine antagonist, administered postoperatively in a mean intravenous dose of 0.67 mg (range, 0.2 to 1 mg), was superior to placebo in reversing sedation and other central nervous system effects of benzodiazepines in outpatients recovering from general anesthesia induced by midazolam, fentanyl or sufentanil, and nitrous oxide. Within 5 minutes after administration of flumazenil, sedation was reversed in 94% (87 of 93) of flumazenil-treated patients, compared with 13% (6 of 46) of placebo-treated patients. The criterion response (Observer's Assessment of Alertness/Sedation Scale score of 4 or 5) that was achieved at 5 minutes was maintained in 79 (93%) of 85 patients throughout the 180-minute observation period. Psychomotor performance, measured by the Finger-to-Nose Test, was rated as normal at 5 minutes posttreatment for 77% (71 of 92) of flumazenil-treated patients, and 4% (2 of 46) of placebo-treated patients. The reversal of amnesia, as determined by the Picture Recall Test was less consistent. Patients given flumazenil did not experience more pain at the operative site or require more analgesic medication than did those given placebo. Nausea (flumazenil 24%; placebo 15%), dizziness (flumazenil 12%; placebo 2%), and vomiting (flumazenil 10%; placebo 9%) were the most frequent adverse effects in each group. In conclusion, flumazenil provided prompt arousal from benzodiazepine-induced sedation and was well tolerated.
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PMID:Reversal of the central effects of midazolam by intravenous flumazenil after general anesthesia in outpatients: a multicenter double-blind clinical study. The Flumazenil in General Anesthesia in Outpatients Study Group I. 128 2

In the last twenty years maternal mortality attributed to anaesthesia has decreased. Inhalation of gastric contents is the commonest cause in patients undergoing cesarean section; in fact pregnant women are considered "high risk" because of gravidic modifications. In this retrospective study of 10017 caesarean sections performed under general anaesthesia in our institution between January 1980 and December 1990, we evaluated the frequency of this syndrome (7 cases = 1:1431). We had no case of maternal and neonatal mortality. All these seven patients were admitted at our recovery room for less than 5 days; aspiration pneumonitis occurred in only three patients. Our results suggested that induction of anaesthesia with high doses of thiopental reduces complications related to light anaesthesia, including vomiting. At a dose of 5-6 mg/kg thiopental didn't produce any significant neonatal depression as documented by Apgar scores.
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PMID:[Aspiration syndrome in cesarean section. Our experience from 1980 to 1990]. 129 2

Combined spinal anesthesia with the use of hyperbaric solution of lignocaine at an average dose of (69.4 +/- 1.4) mg and morphine hydrochloride at a dose of 0.3 mg was used in 50 patients with II-IV degree anesthesiologic risk during one-stage appendectomy. Effective intraoperative anesthesia was achieved in (96.2 +/- 2.5) % of cases. Duration of postoperative analgesia was (26.8 +/- 1.1) h. Suppression of breathing, hyperalgesia on termination of the effect of a local anesthetic were not noted. In (50.1 +/- 1.7) % of the patients, intraoperative hypotension was revealed. After the operation, nausea was noted in (20 +/- 11.5) % of these patients, vomiting--in (6.0 +/- 2.3) %, itch at the site of puncture--in (22.0 +/- 10.4) %, shiver--in (2.0 +/- 1.4) %.
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PMID:[Effectiveness of combined spinal anesthesia]. 129 45

This prospective study was conducted to determine the sedative effects of IV ketamine and fentanyl on vital signs and behavior. Twenty-seven children, classified as ASA I, with a mean age of 34 months, were studied. The dosages of IV ketamine and fentanyl given were 0.5 mg/kg and 0.5 mcg/kg, respectively, approximately every 15-20 min. The pulse rate averaged 125 throughout the case. Blood pressure averaged 112/64. The respiration rate averaged 22 breaths per min. Mean behavior composite scores were 1.9 at the initial examination and 3.3 during treatment. One child vomited during treatment. Post-treatment complications were discomfort in 19% (5), nausea in 22% (6), and vomiting in 15% (4) of the patients. We concluded that IV sedation of precooperative healthy pediatric patients with ketamine, fentanyl, and nitrous oxide/oxygen appears to be a safe and effective sedation modality with minimal side effects when administered and monitored by a qualified anesthetist, offering the practitioner an alternative to general anesthesia.
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PMID:IV sedation in pediatric dentistry: an alternative to general anesthesia. 130 25

Such hygroscopic compounds as LiCl, CaCl2, and MgCl2 are used to improve water retention capacity and, as a consequence, the effectiveness of heat and moisture exchangers (HME). Resorption of these substances via the bronchopulmonary tract and a resulting systemic action cannot be excluded, especially if additional active moisturizing devices are used. The narrow therapeutic range of lithium is known, as are its unwanted side effects, such as nausea, vomiting, somnolence and even cardiac arrhythmia. These are symptoms that also frequently occur during anaesthesia and intensive care, so that differentiation against effects of lithium is nearly impossible. We investigated whether, in theory and in practice, LiCl-coated HME could result in effective Li plasma concentrations. We measured (1) total LiCl content of HMEs, (2) release of this content, simulating the worst-case situation with a breathing model, and (3) lithium plasma concentrations of adult patients being ventilated during anaesthesia with a rebreathing circuit and LiCl-coated HME, but with no additional active moisturizing system incorporated. RESULTS. The results show striking differences with LiCl content ranging from 3 to 251 mg varying not only between different types of HME but also within the same lots. After 20 min of ventilation more than 90% of the LiCl coating was rinsed into the test lung of the breathing model. In practical use, we observed an increase in lithium plasma concentration in 3 of 20 investigated patients. The plasma values of maximum 49.5 micrograms/l (= 0.007 mmol/l) do not amount to potentially toxic concentrations. Nevertheless, clinically relevant concentrations might occur in patients with small distribution volumes, e.g. newborns or infants with frequent exposition within short intervals such as in intensive care units. The differences in lithium content also indicate qualitative differences in water retention capacity. Because of the potential side effects of lithium, we prefer qualitatively equivalent HMEs, e.g., with MgCl2 or CaCl2 as hygroscopic substance.
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PMID:[Is the lithium chloride-coated heat and moisture exchanger a danger for patients?]. 131 37

One hundred consecutive endoscopically placed peritoneal dialysis catheters inserted in 95 patients over an 18-month period have been reviewed. All catheters were placed for chronic dialysis (CAPD). Following insertion there were five early catheter failures (4 failed to drain, 1 perforated viscus) and 13 early complications (7 leaks, 3 tunnel bleeds, 2 scrotal oedema, 1 wound infection). In the long term six patients required transfer to haemodialysis (2 recurrent peritonitis, 2 pain on outflow, 1 unable to cope, 1 persistent vomiting). Overall probability of catheter survival as predicted by Kaplan-Meier analysis was 0.85 at 18 months. These results confirm that endoscopic placement of CAPD catheters is safe and reliable. In addition there is a low early failure rate and the long-term catheter survival figure is comparable with the best series reported. This procedure allows direct visualization of the peritoneal cavity, thus minimizing the risk of visceral damage. Furthermore, the procedure is well tolerated under local anaesthesia and allows early institution of dialysis because of the extremely low leakage rate (11%). Endoscopic placement of CAPD catheters is now the procedure of choice in our centre. General anaesthetic and mini-laparotomy are thus avoided in most of this high-risk group.
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PMID:Endoscopic placement of CAPD catheters: a review of one hundred procedures. 132 21


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