Articles: nausea.
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Anesthesia and analgesia · Jul 2024
Effect of Propofol Infusion on Need for Rescue Antiemetics in Postanesthesia Care Unit After Volatile Anesthesia: A Retrospective Cohort Study.
Postoperative nausea and vomiting (PONV) are frequent after volatile anesthesia. We hypothesized that coadministration of propofol with volatile anesthetic compared to pure volatile anesthetics would decrease the need for postoperative antiemetic treatments and shorten recovery time in the postanesthesia care unit (PACU). ⋯ The addition of propofol infusions to volatile-based anesthesia is associated with a dose-dependent reduction in the need for rescue antiemetics in the PACU regardless of the number of prophylactic antiemetics, duration of procedure, and type of volatile agent used, without affecting PACU recovery time.
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Anesthesia and analgesia · Jul 2024
The Association of Guideline-Directed Prophylaxis with Postoperative Nausea and Vomiting in Pediatric Patients: A Single-Center, Retrospective Cohort Study.
Guidelines for postoperative nausea and vomiting (PONV) prophylaxis in pediatric patients recommend escalation of the number of antiemetics based on a preoperative estimate of PONV risk. These recommendations have been translated into performance metrics, most notably by the Multicenter Perioperative Outcomes Group (MPOG), used at over 25 children's hospitals. The impact of this approach on clinical outcomes is not known. ⋯ Guideline-directed PONV prophylaxis is inconsistently associated with incidence of PONV across the guideline-defined risk spectrum. This phenomenon, and its attenuation with weighting, is consistent with 2 points: dichotomous risk-factor summation ignores differential effects of individual components, and prognostic information might exist beyond these risk factors. PONV risk at a given sum of risk factors is not homogeneous, but rather is determined by the unique composition of risk factors and other prognostic attributes. These differences appear to have been identified by clinicians, prompting use of more antiemetics. Even after accounting for these differences, however, addition of a third agent did not further reduce risk.
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Extended-release formulations of buprenorphine offer less frequent dosing, provide consistent medication delivery, and improve adherence for treatment of opioid use disorder (OUD). Although buprenorphine is a partial agonist with seemingly less precipitated withdrawal and easier initiation than full opioid agonists used for OUD, its use is not benign and understanding of the different extended-release formulations is necessary. We report a case of a patient that received a long-acting buprenorphine formulation (Sublocade®) administered subcutaneously that presented to the emergency department with tachycardia, hyperglycemia, elevated anion gap, and sustained nausea and vomiting refractory to pharmacotherapy requiring surgical removal of the buprenorphine depot for resolution of nausea and vomiting symptoms.
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J Pain Symptom Manage · Jul 2024
Effect of music therapy on chemotherapy anticipatory symptoms in adolescents: a mixed methods study.
This study explores the feasibility and effects of music therapy on anticipatory nausea and vomiting, stress, pain and quality of life in adolescents undergoing chemotherapy. ⋯ Results support the feasibility of introducing music therapy with adolescents undergoing chemotherapy. Perceived stress and psychological/physical wellbeing were improved in participants.