Articles: general-anesthesia.
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Anesthesia and analgesia · Jan 1997
Randomized Controlled Trial Clinical TrialSmall-dose propofol by continuous infusion does not prevent postoperative vomiting in females undergoing outpatient laparoscopy.
This study was designed to test the hypothesis that there is a direct prophylactic antiemetic effect of small-dose propofol given by continuous infusion. Sixty female patients undergoing outpatient laparoscopy under general anesthesia were randomized to receive, in a double-blind fashion, either a bolus of 0.1 mg/kg followed by a constant infusion of 1 mg.kg-1.h-1 of propofol or an equivalent volume of 10% Intralipid (placebo) beginning 30 min before induction of anesthesia and continuing until discharge from Stage I postanesthesia care unit (PACU). Anesthesia was induced and maintained in a standard fashion in all patients. ⋯ No significant differences between Intralipid and propofol were found for any of the outcome variables tested. While small-dose propofol is an effective adjuvant in reducing chemotherapy-induced emesis, we were unable to demonstrate any beneficial effect of propofol in reducing postoperative nausea and vomiting when used as the sole prophylactic medication in this patient population. Propofol may have a synergistic effect when administered with other antiemetics, or the specific antiemetic effect of propofol, if it exists, may be dose-dependent and the dose used in this study was below the efficacy threshold.
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The spinal cord is a crucial site wherein anesthetics suppress movement in response to noxious stimuli. The balance of excitatory and inhibitory influences on the spinal cord likely determines the extent of motor response, and is thus important to anesthetic requirements. ⋯ These results are best explained by a differential effect of anesthetics on spinal cord neurons and cerebral neurons (midbrain reticular formation). Examination of neurons in the dorsal horn and midbrain reticular formation, and the electromyogram, during differential delivery of isoflurane to brain and spinal cord, will test this hypothesis.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prophylactic intravenous ondansetron in patients undergoing cataract extraction under general anesthesia.
During the past decade the demand for outpatient surgery has grown rapidly. Postoperative nausea and vomiting is one of the more common undesirable consequences of surgery, which may significantly delay the patient's discharge from the ambulatory surgery center. None of the currently used antiemetic drugs is considered totally effective in abolishing nausea or vomiting. ⋯ The incidence of postoperative nausea was significantly less in the ondansetron group than that in the metoclopramide group (p = 0.046). Although the incidence of vomiting was clinically less frequent in the ondansetron group, there were no significant differences between both treatment groups. To our knowledge, this is the first study to demonstrate that ondansetron is effective to prevent postoperative emesis after extracapsular cataract extraction.