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Postoperative nausea and vomiting PONV remains an anesthetic complication that can cause significant patient discomfort, delay discharge from hospital, and even lead to unanticipated hospital admission after ambulatory surgery.
It is effective in a lower dose 50 micro gram [centered dot] kg sup -1 than the micro gram [centered dot] kg sup -1 doses required to prevent chemotherapy-induced emesis CIE. Methods After Institutional Review Board approval, written informed parental consent was obtained for each patient.
After a minimum preoperative fast of 3 h for clear liquids and 6 h for milk or solids, all children received 0. Anesthesia was then induced with halothane and nitrous oxide in oxygen via a face mask, and intravenous access was established.
Tracheal intubation was facilitated with 0. Patients received a placebo or intravenous granisetron in a dose of 10 or 40 micro gram [centered dot] kg sup -1 before surgical incision, in a double-blind fashion, according to a computer-generated random number.
The granisetron dose of 10 micro gram [centered dot] kg sup -1 was chosen because it is the dose recommended in the Food and Drug Administration-approved package insert for the control of CIE.
At the end of surgery, residual neuromuscular blockade was antagonized with 50 micro gram [centered dot] kg sup -1 intravenous neostigmine and 10 micro gram [centered dot] kg sup -1 glycopyrrolate, the stomach was suctioned, and the trachea was extubated when the patient was awake.
In the postanesthesia care unit PACUpain was assessed according to a pain scale described by Hannallah et al.
The time from the end of surgery to spontaneous eye opening, obeying commands, ambulation, first oral intake, and discharge readiness from both phase 1 and 2 recovery areas were recorded, as well as any episodes of retching or emesis. Oral intake was permitted but not required before discharge.
However, adequate intravenous fluids were administered to correct the preoperative fluid deficits and intraoperative blood losses and to provide for normal maintenance requirements.
Vomiting was defined as the forceful expulsion of gastric contents through the mouth, whereas retching was defined as labored, spasmodic, rhythmic contractions of the respiratory muscles without the expulsion of gastric contents.
Both vomiting and retching were considered as emetic episodes. Nausea, a subjective feeling of the urge to vomit, was not evaluated in this study because of the young age of the patients. Patients with emesis before discharge received 0.
The protocol permitted the administration of other antiemetics, including 25 micro gram [centered dot] kg sup -1 intravenous droperidol, at the discretion of the attending anesthesiologist, if emesis persisted.
Record was made of all emetic episodes vomiting and retching in the hospital. Twenty-four hours after surgery, the investigators, who remained blinded to the study group assignment, conducted followup interviews via telephone to determine the incidence of post-discharge emesis and other adverse side effects, as well as any need for analgesic, antiemetic, or other medication at home.
The parent was asked to provide a rating on the same scale of their overall satisfaction with the perioperative experience.
Cost-effectiveness Analysis We also examined the financial impact of using granisetron as a prophylactic antiemetic in this patient population. The perspective used was that of an ambulatory surgery facility in a managed care environment.
Each treatment group was partitioned into subsets according to a decision analysis tree Figure 1. The criteria for partitioning were based on the observed frequency of: Patients could be divided into nine mutually exclusive subgroups, and the probability and confidence limits of a patient following a specific path was calculated.
Decision analysis tree for dividing data sets into nine mutually exclusive subgroups tree paths TP The costs for each subgroup are assigned along with the probabilities of a patient reaching that end-point. The sum of the weighted costs divided by the number of patients without postoperative emesis and the side effects of the antiemetic drugs gives the cost-effectiveness ratio.antagonists has proved a promising role in the prophylaxis of PONV.
Aim: We aim to compare the anti-emetic responsiveness of ramosetron and palonosetron in post-operative patients of middle Ondansetron is the most favored drug among the medical that bind ondansetron and granisetron Comparative study of ondansetron, granisetron and ramosetron for prevention of postoperative nausea and vomiting (PONV) in surgeries However there was no significant statistical difference between granisetron and ramosetron group during the same period.
(P > ). ondansetron for prophybaxis of PONV between EBSCOhost serves thousands of libraries with premium essays, articles and other content including Comparison of the Effectiveness of Metoclopramide, Ondansetron, and Granisetron on the Prevention of Nausea and Vomiting After Laparoscopic Cholecystectomy.
Get access to over 12 million other articles! Conclusions: Granisetron, when given prophylactically, resulted in a significantly lower incidence of PONV than metoclopramide and ondansetron, whereas metoclopramide was ineffective.
Garnisetron may be an effective treatment in the proflaxy of PONV. Episodes of PONV were noted at , 1, 2, 4 h, 6, 12, and 18 h postoperatively. statistically significant difference between Groups A and B (P.
Antiserotinins (ondansetron, granisetron, and ramosetron) are highly effective in decreasing the incidence of PONV for 24 h postoperatively, compared with traditional antiemetics.