Articles: nausea.
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To compare the relative cost-effectiveness ratios of (1) therapy with ondansetron, droperidol, and metoclopramide in the prevention of postoperative nausea and vomiting (PONV), and (2) prophylactic versus rescue therapy of PONV with these agents. ⋯ When drug costs, efficacy, and adverse events were all considered, prophylactic droperidol was more cost-effective than ondansetron, and both drugs were more cost-effective than metoclopramide. However, the expected frequency of PONV, as well as local drug acquisition costs, can significantly influence whether a particular antiemetic is cost-effective when given prophylactically or only as therapy for established PONV.
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Randomized Controlled Trial Comparative Study Clinical Trial
Optimal anti-emetic dose of granisetron for preventing postoperative nausea and vomiting.
In order to determine the optimal effective dose of granisetron for preventing postoperative nausea and vomiting, the drug was administered in doses of either 20, 40 or 60 micrograms.kg-1. The efficacy of granisetron was evaluated in a randomized, double-blind comparison with placebo in 100 patients undergoing general anaesthesia for major gynaecological surgery. The patients received a single dose of either granisetron or placebo (saline) iv immediately after recovery from anaesthesia. ⋯ The mean scores were 0.7, 0.6, 0.2 and 0.2 after administration of placebo, granisetron 20, 40 and 60 micrograms.kg-1, respectively. Granisetron 40 micrograms.kg-1 was as effective as 60 micrograms.kg-1 and both resulted in reduction of the scores compared with placebo and granisetron 20 micrograms.kg-1 (P < 0.05). In conclusion, granisetron 40 micrograms.kg-1 is considered to be the appropriate dosage for preventing postoperative emesis after anaesthesia.
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Randomized Controlled Trial Clinical Trial
Effects of sub-hypnotic doses of propofol on the side effects of intrathecal morphine.
We have studied the effect of propofol on the side effects associated with intrathecal morphine in 40 patients undergoing major arthroplasty. Patients received spinal anaesthesia with plain 0.5% bupivacaine 20 mg mixed with preservative-free morphine 0.3 mg. Before injection of the local anaesthetic, the patients were allocated randomly to receive either a bolus dose of propofol 10 mg followed by an infusion of 30 mg/24 h or equal volumes of 10% Intralipid (control group). ⋯ The incidence of urinary retention was similar in both groups. There was no additional sedation attributable to propofol. In conclusion, sub-hypnotic doses of propofol protected significantly against itching and had a modest effect on PONV after intrathecal morphine.
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Comparative Study
Retrospective analysis of postoperative nausea and vomiting to determine antiemetic activity of droperidol added to propofol: a possible drug interaction.
Propofol decreases the frequency of postoperative nausea and vomiting. We investigated whether its antiemetic activity could be improved further by coadministration of droperidol. We retrospectively reviewed the records of 266 women who underwent laparoscopic operations with nitrous oxide anesthesia and thiopental or propofol induction. ⋯ The combination of droperidol and thiopental decreased the frequency of nausea and vomiting over droperidol plus propofol, propofol alone, and thiopental alone. The addition of droperidol to propofol anesthesia doubled the frequency of multiple nausea and vomiting episodes, suggesting a possible interaction between the drugs. We cannot recommend that droperidol be added to propofol anesthesia for prophylaxis of postoperative nausea and vomiting.