Articles: nausea.
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Clin. Pharmacol. Ther. · Jul 1992
Randomized Controlled Trial Multicenter Study Clinical TrialOndansetron is effective in decreasing postoperative nausea and vomiting.
The efficacy of ondansetron, a selective 5-HT3 receptor antagonist, in preventing postoperative nausea and vomiting in surgical patients was studied. Fifty women were randomized in a double-blind manner to receive either two 8 mg doses of intravenous ondansetron or two doses of placebo vehicle: the first given just before general anesthesia induction and the second 8 hours later. During the first 24 postoperative hours, the number of emetic episodes was recorded and the subjects rated their nausea on a scale from 0 to 10. ⋯ The number of complete responders (no emetic episodes and no rescue therapy) was 1 of 24 (4%) and 15 of 26 (58%) in the placebo and ondansetron groups, respectively (p less than 0.001). Ondansetron is clearly more effective than placebo in the prophylaxis of postoperative nausea and vomiting. The adverse event profile for ondansetron was similar to that of placebo.
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Am J Hosp Palliat Care · Jul 1992
Clinical Trial Controlled Clinical TrialAcupressure wrist bands to relieve nausea and vomiting in hospice patients: do they work?
This study assessed the effects of acupressure wrist bands on the nausea and vomiting of terminally ill patients. Using a single subject experimental design, six hospice patients were exposed to three conditions: An acupressure wrist band; A placebo wrist band; A no wrist band condition. Patients and their caregivers rated nausea and vomiting during the treatment. Despite some difficulty obtaining complete data, the results of this preliminary test indicate that acupressure wrist bands were not effective in reducing nausea and vomiting in this small sample of hospice patients.
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We prospectively studied 952 patients to identify the incidence of hypotension (systolic blood pressure less than 90 mmHg), bradycardia (heart rate less than 50 beats/min), nausea, vomiting, and dysrhythmia during spinal anesthesia. Historical, clinical, and physiologic data were correlated with the incidence of these side effects by univariate and multivariate analysis. Hypotension developed in 314 patients (33%), bradycardia in 125 (13%), nausea in 175 (18%), vomiting in 65 (7%), and dysrhythmia in 20 (2%). ⋯ Variables conferring increased odds of developing bradycardia include a baseline heart rate less than 60 beats/min (odds ratio 4.9, P less than 0.001), ASA physical status classification of 1 versus 3 or 4 (3.5, P less than 0.001), current therapy with beta-adrenergic blocking drugs (2.9, P less than 0.001), and peak block height greater than or equal to T5 (1.7, P = 0.02). Variables conferring increased odds of developing nausea or vomiting include addition of phenylephrine or epinephrine to the local anesthetic (3.0-6.3, P less than or equal to 0.003), peak block height greater than or equal to T5 (odds ratio 3.9, P less than 0.001), use of procaine (2.6-4.4, P less than or equal to 0.003), baseline heart rate greater than or equal to 60 beats/min (2.3, P = 0.03), history of carsickness (2.0, P = 0.01), and development of hypotension during spinal anesthesia (1.7, P = 0.009). Our results indicate that the incidence of side effects during spinal anesthesia may be reduced by 1) minimizing peak block height; 2) using plain solutions of local anesthetics; 3) performing the spinal puncture at or below the L3-L4 interspace; and 4) avoiding the use of procaine in the subarachnoid space.
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Am. J. Gastroenterol. · Jun 1992
Gastric myoelectrical activity in the first trimester of pregnancy: a cutaneous electrogastrographic study.
Recently, it has been shown that changes in gastric electrical rhythm can be connected with clinical syndromes characterized by nausea and vomiting, among these the nausea of pregnancy. We studied gastric electrical activity during the first trimester of pregnancy in nine women with nausea and vomiting (study group) by means of cutaneous electrogastrography. Recordings were made before and after a standardized meal in the 6th-8th wk of gestation, and 2 months after voluntary interruption of pregnancy (VIP). ⋯ Comparison of the EGGc data for the pregnant women in the study and control groups revealed a similar pattern of gastric electrical activity in the two, the only exception being the power ratio, which was lower in the study group (p less than 0.01). We conclude that pregnant women without symptoms of nausea and vomiting at the time of EGG recordings have normal 3-cpm myoelectrical activity, and that EGGc activity is more unstable and less responsive to the ingestion of food during pregnancy than after VIP. Furthermore, in pregnant women with a history of nausea and vomiting, EGGc activity is less responsive to the ingestion of food than it is in symptom-free pregnant women.
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Oncology nursing forum · Jun 1992
Management of chemotherapy-related nausea and vomiting using a serotonin antagonist.
Patients receiving chemotherapy continue to experience nausea and vomiting despite recent strides to understand the physiology of these symptoms and despite current antiemetic therapies. Ondansetron, a serotonin antagonist, has shown to be a safe and effective drug in alleviating nausea and vomiting. This research-synthesis article provides summaries of eight clinical trials completed between 1988 and 1991. It includes a discussion of the pharmacodynamics and pharmacokinetics of ondansetron, suggestions for adverse events, and implications for nursing practice and future research.