Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose...Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose of the present study was to compare the effects of preemptive and preventive intravenous ondansetron on PONV in patients undergoing diagnostic gynecologic laparoscopy. Materials & Methods: In a randomized double-blind clinical trial, 80 women candidate of diagnostic laparoscopy, were enrolled to study in two preemptive or preventive groups (n = 40). Ondansetron 4 mg IV was administered 5 min before anesthesia induction or 5 min before extubation in preemptive or preventive groups, respectively. The frequency and severity of the PONV were compared at post-anesthetic care unit (PACU), 3th, 6th and 24th postoperatively in two groups. Also the first time of need for the antiemetic drug was studied. Results: Demographic data were similar but duration of anesthesia was shorter in preventive group. The PONV rate was similar in two groups [(37.5% and 32.5% in preemptive and preventive groups, respectively (P = 0.815)]. In preemptive group it was more intense at PACU and 24 hours after surgery (P-value <0.05) and rate of vomiting was high (11 vs. 3, P-value 0.037). The first request for antiemetic drug was earlier and the antiemetic consumption dose (P-value <0.05), recovery and hospital stay times were high in preemptive group (P-value = 0.001). Conclusion: Preventive ondansetron is more effective than preemptive form, in reducing the severity of PONV but not rate of the PONV in diagnostic gynecologic laparoscopy.展开更多
Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting i...Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Methods: In 3 months period, this descriptive study was conducted on 250 patients who scheduled for elective eye surgery. The investigator interviewed with patients before beginning of anesthesia and evaluated fasting duration for heavy meal, light meal and clear liquids and his or her satisfaction from NPO time and also investigated which staff recommended NPO time before anesthesia induction. Results: Fasting duration from heavy and light meal and clear liquids was 14.31 hours (8 - 23 hours), 12.46 hours (6 - 21 hours) and 11.54 hours (3 - 18 hours), respectively, that was not consistent with ASA guidelines. The discontent of the patients from prolonged NPO time was 60.8%. The most complaint was thirsty (42%). Ward nurses were the personnel who had the primary role in patients fasting time period (47.6%). Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines. Ward nurses had the major role in this malpractice. Thus it seems that personnel education may be very helpful.展开更多
文摘Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose of the present study was to compare the effects of preemptive and preventive intravenous ondansetron on PONV in patients undergoing diagnostic gynecologic laparoscopy. Materials & Methods: In a randomized double-blind clinical trial, 80 women candidate of diagnostic laparoscopy, were enrolled to study in two preemptive or preventive groups (n = 40). Ondansetron 4 mg IV was administered 5 min before anesthesia induction or 5 min before extubation in preemptive or preventive groups, respectively. The frequency and severity of the PONV were compared at post-anesthetic care unit (PACU), 3th, 6th and 24th postoperatively in two groups. Also the first time of need for the antiemetic drug was studied. Results: Demographic data were similar but duration of anesthesia was shorter in preventive group. The PONV rate was similar in two groups [(37.5% and 32.5% in preemptive and preventive groups, respectively (P = 0.815)]. In preemptive group it was more intense at PACU and 24 hours after surgery (P-value <0.05) and rate of vomiting was high (11 vs. 3, P-value 0.037). The first request for antiemetic drug was earlier and the antiemetic consumption dose (P-value <0.05), recovery and hospital stay times were high in preemptive group (P-value = 0.001). Conclusion: Preventive ondansetron is more effective than preemptive form, in reducing the severity of PONV but not rate of the PONV in diagnostic gynecologic laparoscopy.
文摘Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Methods: In 3 months period, this descriptive study was conducted on 250 patients who scheduled for elective eye surgery. The investigator interviewed with patients before beginning of anesthesia and evaluated fasting duration for heavy meal, light meal and clear liquids and his or her satisfaction from NPO time and also investigated which staff recommended NPO time before anesthesia induction. Results: Fasting duration from heavy and light meal and clear liquids was 14.31 hours (8 - 23 hours), 12.46 hours (6 - 21 hours) and 11.54 hours (3 - 18 hours), respectively, that was not consistent with ASA guidelines. The discontent of the patients from prolonged NPO time was 60.8%. The most complaint was thirsty (42%). Ward nurses were the personnel who had the primary role in patients fasting time period (47.6%). Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines. Ward nurses had the major role in this malpractice. Thus it seems that personnel education may be very helpful.
