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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors sought to compare the antiemetic and sedative postanesthetic effects of droperidol versus lidocaine given intravenously. One hundred and fifty children, ASA physical status I or II, ages 2-15 yr, were studied. Each child was randomly assigned to receive either droperidol, 0.075 mg/kg; lidocaine, 1.5 mg/kg; or a combination of lidocaine, 1.5 mg/kg, and a reduced dose of droperidol, 0.025 mg/kg, immediately after induction of anesthesia, which was with thiopental, atropine, and succinylcholine. Anesthesia was maintained with halothane and nitrous oxide. The incidence of postanesthetic vomiting was 22% in the droperidol-alone group, which was significantly less than the lidocaine-alone group (50%). The incidence of vomiting in the combination group (30%) was not significantly different from either the droperidol- or lidocaine-alone groups. The time in the recovery room was significantly shorter for patients given lidocaine alone than those given droperidol alone or the combination. However, the mean time intervals from completion of surgery to recovery of full alertness and to discharge from the hospital did not differ significantly among the three groups. In summary, the authors found that intravenous droperidol is significantly more effective than lidocaine in reducing the incidence of vomiting in unpremedicated children after strabismus surgery. Furthermore, droperidol did not delay either the time to recovery of full alertness or the time to discharge from hospital compared to lidocaine.
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PMID:Incidence of emesis and postanesthetic recovery after strabismus surgery in children: a comparison of droperidol and lidocaine. 264 94

The side-effects of two opioid agonist-antagonists, nalbuphine and pentazocine, were assessed when used for patient-controlled postoperative analgesia. Forty ASA I or II patients scheduled for upper abdominal surgery were randomly allocated to two equal groups. The anaesthetic technique was the same for all the patients: premedication with atropine and diazepam, induction with thiopentone and suxamethonium and maintenance with fentanyl, pancuronium, nitrous oxide and halothane. Patient-controlled computer assisted analgesia (On-Demand Analgesia Computer) was started in the recovery room at least 2 h after the last administration of fentanyl. The parameters used were: a routine hourly dose (the half of that received during the previous hour), with on demand delivery of nalbuphine (15 micrograms.kg-1) or pentazocine (45 micrograms.kg-1) aliquots respectively, with a refractory period between two demands of 4 min and a total hourly maximum dose of 16 mg and 48 mg respectively. The following parameters were measured before the start of self-administration, and every hour afterwards for 24 h: systolic (Pasys) and diastolic blood pressures, heart rate, pressure-rate product (PRP), respiratory rate, end-tidal CO2 and pain (by way of a three point scale). Analgesia was assessed on a four-point scale every 6 h. The total doses of nalbuphine and pentazocine administered were 94 +/- 43 mg and 251 +/- 150 mg respectively. The only parameters significantly different between the two groups were Pasys and PRP, being higher in the pentazocine group. There were no significant differences in the side-effects (drowsiness, nausea, vomiting, headache, amnesia, logorrhoea and urine retention). All patients in both groups were satisfied with this technique.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparison of nalbuphine and pentazocine in the treatment of postoperative pain by self-administration]. 266 Jun 40

A randomized, prospective, comparative study was performed to evaluate induction characteristics, haemodynamic changes and recovery in 60 ASA I-II patients undergoing mainly gynaecological laparotomies with either propofol or thiopentone-enflurane anaesthesia. The propofol group (n = 30) received 2 mg.kg-1 propofol for induction of anaesthesia followed by propofol infusion. The thiopentone-enflurane group (n = 30) received thiopentone 4 mg.kg-1 for induction followed by enflurane (0.5-2 per cent). All patients received nitrous oxide (66 per cent] in oxygen begun one minute after tracheal intubation, and fentanyl (1.5 micrograms.kg-1) four minutes prior to induction. Other drugs administered during or after anaesthesia were similar among the groups. Haemodynamic measurements were similar between propofol and enflurane groups except after tracheal intubation when the mean arterial pressure was lower in the propofol group (P less than 0.05). The propofol group had significantly less (P less than 0.01) emesis in the recovery room than the enflurane group. The propofol group experienced significantly less (P less than 0.05) dizziness, depression/sadness and hunger than the enflurane group in the postoperative period as assessed with a visual analogue questionnaire. We conclude that propofol provided better outcome than enflurane in terms of these nonvital but annoying outcome measures after relatively long intra-abdominal operations.
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PMID:Randomized comparison of outcome after propofol-nitrous oxide or enflurane-nitrous oxide anaesthesia in operations of long duration. 268 41

Patient-controlled analgesia (PCA, intravenous self-application of narcotics) was studied during the early postoperative period. Subjects were 40 ASA I-III patients recovering from elective major and minor surgery (20 each having undergone abdominal or orthopedic operations). Whenever the patients required pain relief, piritramid demand doses of 2.0 mg were given via the hand-button of a microprocessor-controlled injection pump (On-Demand Analgesia Computer, ODAC). Hourly maximum dose was set to 15 mg with a pump refractory time of 1 minute between valid demands. A continuous low-dose piritramid infusion (0.24 mg/h) was additionally administered in order to prevent catheter obstruction. Duration of the PCA period was 19.7 +/- 6.5 hours (mean +/- SD). During this time, 17.1 +/- 13.8 demands per patient were recorded resulting in mean individual piritramid consumptions of 30.4 +/- 28.1 micrograms/kg/h. Self-administration was characterized by considerable intra- and interindividual variability. Following abdominal surgery, slightly more piritramid was needed compared with orthopedic patients, although less pain relief was achieved in the former group. The same proved to be true for a comparison between the sexes, males requiring significantly more piritramide for less pain relief than females (p = 0.05). Over-all efficacy and patient acceptance proved to be excellent. Effectiveness of PCA was judged superior by about 73% of patients when compared with previously experienced conventional postoperative analgesia. Side effects (sweating, nausea, emesis) occurred in about 20% but were usually of minor intensity. No serious circulatory or respiratory problems were observed during the PCA period. Patient-controlled analgesia is discussed as a promising concept for the treatment of acute pain and for clinical pain research.
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PMID:Patient-controlled analgesia with piritramid for the treatment of postoperative pain. 288 42

Temazepam 0.5, 1.0 and 1.5 mg kg-1 in an elixir formulation (Euhypnos Elixir), was compared with trimeprazine tartrate 3 mg kg-1 in a syrup (Vallergan Forte Syrup), as premedication in 220 children (ASA grade I) undergoing tonsillectomy and associated procedures. Each patient was randomly allocated to one of the four treatments. The administration was blind to the observers in theatre, recovery room and postoperative ward, who assessed each patient according to a total of 14 criteria. A modelling technique allowed account to be taken of the effects of concomitant variables (e.g. age and duration of anaesthesia) where appropriate. No statistically significant difference was found between the efficacy of the treatments. The only statistically significant differences were that temazepam was associated with more ectopic beats under anaesthesia (P = 0.03 or 0.002, depending on the test applied), more postoperative vomiting (P = 0.04) and more postoperative restlessness (P less than 0.0001).
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PMID:Comparison of temazepam elixir and trimeprazine syrup as oral premedication in children undergoing tonsillectomy and associated procedures. 288 66

To evaluate nasally administered sufentanil, 1.5-4.5 micrograms/kg, for pre-induction (i.e., pre-medication/induction) of anesthesia in pediatric patients, the authors studied ASA PS 1 or 2 patients scheduled for elective surgery. Eighty children, ages 6 months to 7 yr, were randomized to receive sufentanil (1.5, 3.0, or 4.5 micrograms/kg) or placebo (normal saline, 0.03 ml/kg) nasally over 15-20 s. Induction of anesthesia was completed with 5% halothane and O2 via facemask. After tracheal intubation, anesthesia was maintained with N2O (60-70%) and halothane, as clinically indicated. A blinded observer remained with the child from prior to drug administration until discharge from the recovery room. Patients given sufentanil were more likely to separate willingly from their parents and be judged as calm at or before 10 min compared to those given saline. Ventilatory compliance during induction of anesthesia decreased markedly in 25% of subjects given sufentanil, 4.5 micrograms/kg. Subjects given sufentanil moved or coughed less during tracheal intubation and required less halothane compared to those given placebo. During recovery, patients given sufentanil cried less and fewer needed analgesics; recovery times were similar for all groups. However, patients given sufentanil, 4.5 micrograms/kg, had a higher incidence of vomiting in the recovery room and during the first postoperative day. The authors conclude that nasally administered sufentanil, 1.5 or 3.0 micrograms/kg, facilitates separation of children from parents, has minimal side effects, may improve intubating conditions, and can provide postoperative analgesia.
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PMID:Pre-induction of anesthesia in pediatric patients with nasally administered sufentanil. 289 72

Fifty ASA physical status class I or II patients undergoing outpatient D & C (dilatation and curettage of the uterus) were studied. Patients were divided into two groups in a random double-blind manner and given either a fentanyl bolus 0.7 microgram X kg-1 followed by continuous fentanyl infusion of 0-50 micrograms X min-1 or sufentanil bolus 0.1 microgram X kg-1 followed by continuous sufentanil infusion of 0-7 micrograms X min-1 as an adjuvant to thiopentone, nitrous oxide: oxygen anaesthesia. Patients were followed throughout the recovery process with respect to level of consciousness, nausea, vomiting, pain, and discharge time. Groups were equal with respect to awakening and discharge time. The incidence of nausea (p less than 0.05) and pain requiring analgesics (p less than 0.05) were less in the sufentanil group. It is concluded that the technique of continuous sufentanil infusion was superior to fentanyl in healthy outpatients undergoing D & C.
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PMID:Comparison of continuous sufentanil and fentanyl infusions for outpatient anaesthesia. 295 1

Since transdermal scopolamine (TS) seems effective against seasickness, we compared its antiemetic effect with intravenous droperidol (DHBP), our routine antidote for postoperative emesis. Ninety-six female patients (ASA I-II) scheduled for short-stay surgery were randomly allocated to three study groups after giving their informed consent. The three groups were as follows: TS adhesive, delivering 140 micrograms initially and 5 micrograms/h thereafter + placebo 0.5 ml i.v. 5 min before the end of surgery; transdermal placebo adhesive preoperatively + DHBP 0.5 ml (1.25 mg) i.v. 5 min before the end of surgery; transdermal placebo + 0.5 ml placebo i.v. as indicated above. Oxycodone i.m. and glycopyrrolate i.v. were given for premedication together with the test adhesive. Anaesthesia was induced with thiopental and maintained with nitrous oxide and oxygen, enflurane, vecuronium and fentanyl. Neostigmine and glycopyrrolate were administered for reversal. In the recovery room no differences in nausea or vomiting were observed between the groups. Sedation was significantly more marked (P less than 0.15-0.0001) after DHBP than after either TS or the given DHBP and 6% of those given the placebo (P less than 0.05). During the following 24 h nausea was reported more by the placebo patients (25) than by those on TS (20) or DHBP (15) (P less than 0.05). However, actual vomiting on the ward did not differ between the groups. Visual disturbances were more frequent after TS (P less than 0.01). We conclude that prophylactic transdermal scopolamine does not diminish postoperative emetic sequelae.
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PMID:Double-blind comparison of transdermal scopolamine, droperidol and placebo against postoperative nausea and vomiting. 305 39

The efficacy and tolerance of flumazenil were assessed in a double-blind randomized multicentre trial on 120 ASA I or II patients aged 40.3 +/- 13.9 years. They were anaesthetized with flunitrazepam (25.1 +/- 10.5 micrograms.kg-1.h-1), fentanyl (4.4 +/- 1.9 micrograms.kg-1.h-1) and either vecuronium or pancuronium; residual neuromuscular blockade was antagonized at the end of surgery. 61 patients received flumazenil and 59 a placebo. Sedation comprehension and temporo-spatial orientation were scored at 0, 5, 15, 30, 60, 120 and 240 min after the administration of flumazenil or placebo. Local and general tolerances were evaluated 1 h and 24 h after administration. At the 24th h, the observer's assessment of consciousness, pain, respiration, coughing and vomiting were noted, as well as his identification, or not, of flumazenil or the placebo and their efficacy. Both groups were statistically homogeneous and comparable. Significant and marked efficacy was noted between the 5th and 30th min. There was no difference, at 24 h, between the flumazenil and placebo groups. In most cases, flumazenil was identified by the observer and its efficacy felt to be excellent. No major untoward effect of flumazenil was noted; however a mild and short lasting anxiety occurred in three patients. Tolerance was deemed to be excellent.
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PMID:[Evaluation of the efficacy and tolerance of flumazenil in antagonism of the effects of flunitrazepam on the central nervous system]. 312 69

In a preliminary pilot study, the effect of disoprivan for sedation during regional anesthesia was investigated. In 15 patients (ASA I or II), lumbar epidural anesthesia with bupivacaine 0.75% was performed at L 3/4. For premedication morphine or pethidine combined with scopolamine was given. After injection of the local anesthetic, a 30-min period was allowed for establishing the physiological side effects of epidural blockade, to present any further changes in circulatory and/or cardiac function. Disoprivan (1 mg/kg body weight) was injected i.v. followed by continuous disoprivan infusion. Three groups of 5 patients each were given 1, 1.5, or 2 mg/kg per hour disoprivan. Changes in heart rate, blood pressure, and respiratory rate were studied. Recovery time and personal assessment of sleep were registered. Side-effects of clinical relevance from the cardiovascular and pulmonary systems were also registered. A dose-dependent upper airway obstruction that could easily be managed by an oral or nasal airway was seen in 9 of 15 patients. Eight patients had postoperative nausea or vomiting; 9 complained of pain during the bolus injection that they could not remember postoperatively. All patients described their sleep as pleasant. Recovery time from sleep was between 1 and 12 min. All changes from normal values increased in percentage with increasing disoprivan dosage. Disoprivan (1 or 1.5 mg/kg per hour) seems to be excellent for sedation during regional anesthesia and is perhaps even superior to other available drugs.
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PMID:[Disoprivan (Propofol) sedation during regional anesthesia. A pilot study]. 325 31


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