Antiemetic Requirements Research Articles

Diclofenac in Combination with Opiate Infusion After Joint Replacement Surgery

The effect of intramuscular diclofenac or placebo on analgesia obtained and on opiate and antiemetic requirements was observed in a randomised double-blind study of sixty patients receiving continu...

Lignocaine vs bupivacaine in prominent ear correction: a controlled trial

Thirty patients were assigned to two equal groups to compare the effects of ear infiltration with bupivacaine versus lignocaine prior to correction of prominent ears. There was a statistically significant decrease in narcotic requirement in the first 4 h postoperatively in the bupivacaine group, associated with a decrease in the antiemetic requirement. The choice of local anaesthetic did not significantly affect the incidence of vomiting.

Diclofenac in Combination with Opiate Infusion after Joint Replacement Surgery

The effect of intramuscular diclofenac or placebo on analgesia obtained and on opiate and antiemetic requirements was observed in a randomised double-blind study of sixty patients receiving continuous intravenous papaveretum. Those patients receiving diclofenac required less papaveretum (P = 0.001) than those receiving placebo. They also had lower visual analogue pain scores (VAS) at four hours (P less than 0.05) and decreased requirement for antiemetics (P less than 0.02). No gastrointestinal complications were observed in either group and blood loss did not differ significantly between the two.

NITROUS OXIDE AND DAY-CASE LAPAROSCOPY: EFFECTS ON NAUSEA, VOMITING AND RETURN TO NORMAL ACTIVITY

Patients admitted for day-case laparoscopy were assigned randomly to receive nitrous oxide-oxygen or oxygen, with enflurane, during a standard anaesthetic technique. Postoperative morbidity, in particular nausea and vomiting, and ability to resume normal activity were assessed over the ensuing 48 h. Supplementary administration of propofol during the operative procedure was required significantly more often (P less than 0.05) in the absence of nitrous oxide. There was no significant difference in the incidence of vomiting before discharge when nitrous oxide was omitted. The incidence and severity of nausea over the 48 h following operation was similar in both groups. There was no difference in analgesic or anti-emetic requirements before discharge and the time taken to resume normal activity was similar. It is concluded that nitrous oxide may be avoided readily in day-case laparoscopy without affecting postoperative morbidity or time taken to return to "street fitness" and normal activity.

Transcutaneous electrical nerve stimulation after thoracotomy

Forty patients scheduled to undergo thoracotomy were randomly allocated to receive either transcutaneous electrical nerve stimulation with intramuscular papaveretum (20 patients) or intramuscular papaveretum alone (20 patients) for postoperative pain relief. Total intramuscular analgesic requirements in the first 24 hours, time to satisfactory transfer to oral analgesia, antiemetic requirements and length of stay in hospital postoperatively were noted. Peak expiratory flow rate was compared pre- and postoperatively in the two groups. Use of nerve stimulation did not significantly alter the requirements for analgesia although there was a reduction in postoperative nausea and vomiting in the nerve stimulation group. There was no difference between the two groups with respect to changes in peak expiratory flow rate.

A COMPARATIVE STUDY OF ONDANSETRON VERSUS METOCLOPRAMIDE IN THE PREVENTION OF POST-OPERATIVE VOMITING IN ROUTINE MAJOR GYNECOLOGICAL SURGERY UNDER GENERAL ANESTHESIA

This is a comparative study of ondansetron versus metoclopramide in the prevention of post-operativevomiting in routine major gynecological surgery under general anesthesia. The purpose of this study was toperform a comparative study of injection ondansetron 8 mg I.V. with injection metoclopramide 10 mg I.V.in preventing post-operative vomiting.This was a randomized, double blinded study conducted in sixtypatients of American Society of Anaesthesiologist (ASA) I and ASA II undergoing routine major gynecologicalsurgery (Transabdominal Hysterectomy, laprotomy and cystectomy, tubal surgery) under general anesthesia.Either of the drug was diluted to 5 ml of normal saline and given intravenously prior to induction ofanesthesia. The post-operative period of first 24 hours was divided into two phases, the early (0-6 hrs.) andlate (6-24 hrs.). The frequencies of vomiting and requirement of rescue antiemetics in both groups werestudied. The general characteristics of the patients in the two groups were similar. In both groups, induction,maintenance, duration of anesthesia as well as the type of surgery and opioids requirement were similar.The data recorded were statistically analyzed using Chi -square test and t - test. The frequency of vomitingwas less in ondansetron group compared to metoclopramide group. Rescue antiemetics was given only oncein ondansetron group patients, whereas the need of rescue antiemetics was eight times in the metoclopramidegroup. The difference was statistically significant (p=0.03). No unwanted effects were noticed in both groups.Ondansetron seems more effective in preventing Post-Operative Nausea & Vomiting (PONV) thanmetoclopramide but it has to be evaluated further by more clinical trials and tests in larger series.Key Words: Antiemetics, vomiting, general anesthesia, gynaecological surgery.