SummaryWe investigated whether combined dexamethasone and ondansetron is more effective than ondansetron alone in preventing postoperative nausea and vomiting in patients with fentanyl-based intravenous patient-controlled analgesia. One hundred and thirty patients undergoing videoassisted thoracoscopic surgery were assigned to either an ondansetron group or a dexamethasone and ondansetron group. In all patients, ondansetron 4 mg was administered at the end of surgery and 12 mg was added to the patient-controlled analgesia solution. The dexamethasone and ondansetron group received dexamethasone 8 mg at the induction of anaesthesia. The overall incidence of nausea and vomiting during the first 48 h postoperatively did not differ between groups (34/61 (56%) vs 28/62 (45%) in the ondansetron group and dexamethasone and ondansetron groups, respectively). The incidence of severe nausea and vomiting ( ‡ 7 nausea on an 11-point verbal numerical rating scale, retching or vomiting) was higher in the ondansetron group than in the dexamethasone and ondansetron group (15/61 (25%) vs 6/62 (10%, respectively, p = 0.028). Combined dexamethasone and ondansetron is more effective in reducing severe nausea and vomiting than ondansetron alone in patients receiving fentanyl-based intravenous patient-controlled analgesia. Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after surgery. The incidence of PONV varies from 10% to 78% according to surgical, anaesthetic and patient factors [1,2]. Intravenous patient-controlled analgesia (PCA) with opioids is an effective, safe method of postoperative analgesia. Video-assisted thoracoscopic surgery is associated with less postoperative pain than thoracotomy [3], and PCA with fentanyl is an alternative to invasive regional analgesia such as epidural or paravertebral block [4]. However, to be safe and acceptable, PCA in patients undergoing video-assisted thoracoscopic surgery should be accompanied by effective prophylaxis of nausea and vomiting.While several investigators have reported that prophylactic administration of ondansetron reduces PONV in patients using morphine-based PCA [5,6], the incidence of PONV incidence in patients using
The present study has provided data regarding the bone quantity of the trabeculae of the mandibular condyle according to the presence or absence of teeth.
Chest x ray and CT scan are sufficient to diagnose SPM. Additional diagnostic assessments such as oesophagography and oesophagoscopy are not necessary in patients without evidence of mediastinitis or a history of oesophageal injury.
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