Articles: nausea.
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Regional anesthesia · May 1992
Randomized Controlled Trial Clinical TrialThe antiemetic efficacy and safety of prophylactic metoclopramide for elective cesarean delivery during spinal anesthesia.
The efficacy and safety of intravenous metoclopramide administered prophylactically before elective cesarean delivery under spinal anesthesia was studied. ⋯ Metoclopramide administered before induction of spinal anesthesia for cesarean delivery appears to significantly reduce both pre- and postdelivery emetic symptoms without apparent adverse effects on mother or neonate.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Efficacy of orally administered ondansetron in the prevention of postoperative nausea and vomiting: a dose ranging study.
In a placebo-controlled, double-blind study, we have compared the efficacy of ondansetron 16 mg, 8 mg and 1 mg administered 8-hourly for prevention of postoperative nausea and vomiting. We studied 995 patients undergoing major gynaecological surgery; 982 were included in the analysis. ⋯ The frequency of nausea was 75%, 70%, 56% and 55% after placebo and ondansetron 1 mg, 8 mg and 16 mg, respectively; the corresponding frequencies of vomiting were 60%, 55%, 37% and 37%. Ondansetron 8 mg was as effective as 16 mg and both resulted in significant reductions in nausea and vomiting compared with placebo and ondansetron 1 mg (P less than 0.001).
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Anesthesia and analgesia · May 1992
Randomized Controlled Trial Clinical TrialInfluence of promethazine on symptom-therapy scores for nausea during patient-controlled analgesia with morphine.
We assessed whether adding promethazine to the syringe containing morphine for patient-controlled analgesia (PCA) decreases nausea after gynecologic surgery. Patients were assigned randomly to receive PCA (morphine 1.5 mg, 6-min lockout interval) with or without promethazine (0.625 mg/PCA dose, providing an average of 17.6 mg/24 h). ⋯ However, symptom-therapy scores differed significantly, with median values of 0 and 2, respectively, for the promethazine-treated and control groups. We conclude that simultaneous titration of morphine and promethazine decreases nausea associated with PCA therapy; the difference may best be appreciated with use of the combined symptom-therapy score.
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Ondansetron, a selective 5HT3 (serotonin) antagonist, was used in patients refractory to standard antiemetics. Seventy-five patients receiving chemotherapy without cisplatin were given ondansetron 4 mg IV and 4 mg orally immediately prior to chemotherapy, then 8 mg orally after six and 12 hours, followed by 8 mg orally eight hourly during days 2-5. Complete control of vomiting occurred in 52 patients (69%) on the first day and 45 patients (60%) on days 2-5. ⋯ Eight patients (50%) preferred ondansetron to their previous antiemetics. Adverse events with ondansetron were frequent but mild, with constipation and headache being most common. Ondansetron is highly effective in patients refractory to standard antiemetics, especially after noncisplatin chemotherapy.