Terms Of Nausea Research Articles

Ramosetron, a 5-HT3 receptor antagonist for the control of nausea and vomiting.

Ramosetron is a selective serotonin 5-HT3 receptor antagonist with an affinity higher than that of the previously available drugs ondansetron, granisetron and tropisetron. Ramosetron was shown in pharmacological assays to inhibit activities mediated by 5-HT3 receptors, such as emesis caused by cisplatin. In clinical trials, ramostreon was at least as effective as the reference "setrons" against nausea and vomiting induced by chemotherapy or surgical interventions, but the efficacy was well maintained during a 48-h period, so that efficacy was significantly higher with ramosetron in terms of nausea and vomiting 6-48 h after treatment. Hence, ramosetron represents a good alternative over previously available drugs for the prophylaxis and treatment of chemotherapy-induced and postoperative nausea and vomiting. Data in children also support the efficacy of ramosetron, which is well tolerated by both child and adult patients.

Laparoscopic inguinal hernia repair: quality of recovery following the use of intraperitoneal bupivacaine

In a prospective, randomized, double-blind study in 40 adult patients undergoing laparoscopic inguinal hernia repair, we have compared the quality of recovery following intraperitoneal administration of either 0.15% bupivacaine with adrenaline 1: 666 000 100 ml ( n = 20) or 0.9% NaCl 100 ml ( n = 20). Quality of recovery was assessed in terms of postoperative pain, opioid requirements, nausea and vomiting, change in bowel habit and time to discharge. Patients in the bupivacaine group compared with the saline group had significantly lower visual analogue pain scores on arrival in recovery (2.0 (1–3) vs. 5.5 (4–7.5), P < 0.05). Reporting of severe pain and absent-mild pain (verbal rating scale) over the 48 h period studied significantly favoured the bupivacaine group ( P < 0.05). Postoperative morphine requirement was significantly less in the bupivacaine group (2:20 vs. 10:20, P < 0.05). There were no significant differences between the two groups in terms of nausea and vomiting, change in bowel habit, or duration of hospital stay. Serum bupivacaine assayed in 10 further patients did not approach accepted toxic levels. These data suggest that intraperitoneal bupivacaine, in the dosage used, is effective in reducing postoperative pain following laparoscopic inguinal hernia repair.

Digitoxin causing ventricular tachycardia with peripheral vascular collapse; report of an unusual case.

The widespread use of digitoxin in this country is undoubtedly due to its advantages, so convincingly demonstrated by Gold and associates, 1 of (1) rapid and almost complete absorption from the gastrointestinal tract, (2) insignificant systemic toxicity in terms of nausea and vomiting and (3) resultant ease with which it lends itself to rapid digitalization with multiple or single oral dosage. The possibility of cardiac toxicity, however, appears to be insufficiently emphasized by those advocating use of digitoxin for rapid single dose digitalization. Their only recently repeated recommendation 1e that an average full digitalizing dose of 1.2 mg. may be safely given at one time to patients who have not recently had digitalis (italics ours) makes no allowance for the possibility of serious cardiac toxicity. Reports on the toxic effects of digitoxin on the heart by other observers 2 have only recently made their appearance in the literature. We should