Background Postoperative nausea and vomiting (PONV) are 2 of the most frequent adverse effects of anesthesia. PONV prolongs hospital stays and also delays the recovery of patients. Objective In this study, the effects of ondansetron, tropisetron, and palonosetron on PONV in patients who had undergone middle ear surgeries such as mastoidectomy or tympanoplasty were compared. Methods The study included 165 American Society of Anesthesiologists grade 1 and 2 patients aged 18 to 65 years. Patients were randomized into 3 groups by a closed envelope method. Neither the patients nor the nurses administering the treatments knew which patient belonged to which group. The anesthetic technique was standardized for all groups. During skin closure, 0.075 mg palonosetron, 5 mg tropisetron, and 8 mg ondansetron were administered intravenously to the palonosetron, tropisetron, and ondansetron groups, respectively. After completion of the surgery, the patients were followed for 48 hours. Diclofenac sodium (100 mg IM) was administered to patients experiencing pain and metoclopramide chloride (10 mg IM) was administered to patients with nausea or vomiting. Potential side effects such as headache and constipation were recorded in the postanesthesia care unit and ear, nose, and throat clinic. Results There was no significant difference in the effects of all 3 antiemetic agents on the severity of PONV ( P = 0.081). At 48 hours postoperatively, the incidence of PONV was significantly lower in the palonosteron group (38.2%) than the ondansetron group (63.6%) and tropisetron group (61.8%) ( P = 0.011). At 48 hours postoperatively, the incidence of postoperative nausea was significantly lower in the palonosetron group (32.7%) than in the ondansetron group (63.6%) and the tropisetron group (56.4%) ( P = .003). The incidence of PONV between hours 12 and 24 postoperatively was significantly higher in the ondansetron group (27.3%) than in the palonosetron group (9.1%) ( P = 0.013). The antiemetic requirement in the first hour after surgery was significantly higher in the tropisetron group (25.5%) than in the palonosetron group (7.3%) ( P = .019). Conclusions The results of the current study support those of earlier studies that suggest that palonosetron was statistically more effective than the other 2 formulations in the prevention of PONV in patients who have undergone middle ear surgery. ( Curr Ther Res Clin Exp. 2019; 80:XXXXXX).
Flumazenil antagonized the analgesic effect exerted by acetaminophen, while naloxone had no significant effect on acetaminophen's antinociceptive action in this pain model in rats.
Objectives: This study aims to compare the effects of spinal anesthesia and femoral nerve block and to determine the optimal anesthesia method for embolization of vena saphena magna.Patients and methods: Between December 2019 and March 2021, a total of 160 patients (89 males, 71 females; mean age: 44.4 years; range, 18 to 69 years) who were diagnosed with varicose veins and hospitalized for surgery in our cardiovascular surgery clinic were included. The patients were divided into two groups. The first group (Group S, n=80) underwent spinal anesthesia and the second group (Group F, n=80) underwent femoral nerve block for the surgical operation. Results:The mean arterial pressures (MAPs) were significantly lower in Group S compared to Group F. The mean time until surgery was earlier in Group S (4.57±1.0 min vs. 9.9±3.4 min, respectively; p<0.01). The mean duration of motor block was longer in Group S (3.4±1.1 h vs. 2.7±0.8 h, respectively; p<0.05). The mean duration of mobilization was statistically significantly shorter in Group F (6.1±1.7 h vs. 5.2±1.4, respectively; p<0.05). The development of urinary retention was statistically significantly higher in Group S (p<0.05). The mean patient satisfaction score after discharge was higher in Group F (3.5±0.5 vs. 2.9±0.8, respectively; p<0.05). The incidence of postoperative shivering was statistically significantly higher in Group S (p<0.05). Conclusion:Femoral nerve block, which is used for intraoperative anesthesia during the procedure of endovenous laser ablation, can be preferred as an alternative method to spinal anesthesia.
Amaç: Çalışmamızın amacı, yoğun bakım ünitesinde solunumu mekanik ventilasyon ile sağlanan hastalarda, toplam gastrik kalıntı hacim miktarları ve iki farklı gastrik kalıntı hacmi eşiği ile gastrointestinal komplikasyon gelişimi arasında ilişki olup olmadığının tespiti, ikinci hedefimiz ise farklı gastrik kalıntı hacimlerinin, ventilatör ilişkili durumlar üzerindeki etkilerini belirlemektir. Metod: Çalışmaya en az 3 gün enteral beslenme planlanan, 18 yaşın üzerindeki 70 adet yetişkin hasta dahil edildi. Birinci gruptaki 35 hastada gastrik kalıntı hacmi eşiği 250 ml, ikinci grupta ise 500 ml olarak belirlendi. İzlem süresi boyunca, belirlenen her iki gastrik kalıntı hacmi eşiğinden herhangi birini aşmamış olan hastaların, 72 saat boyunca kaydedilen gastrik kalıntı hacimlerinin toplam miktarı hesaplandı. Tüm hastaların yüksek gastrik kalıntı hacim oranları, hedef kaloriye ulaşma süreleri, ortalama mide kalıntı hacim miktarları, abdominal distansiyon, kusma, diyare, ventilatör ilişkili durum ve enfeksiyona bağlı ventilatör ilişkili komplikasyon oranları gözlendi. Bulgular: Çalışmamızın sonunda, iki grup arasında yüksek gastrik kalıntı hacim oranları, belirlenen eşik değerini aşan yüksek gastrik kalıntı hacim oranları arasına, anlamlı bir fark oluşmasına rağmen (p<0.05), her iki grup arasında abdominal distansiyon, kusma, diyare, ventilatör ilişkili durum ve enfeksiyona bağlı ventilatör ilişkili komplikasyon açısından anlamlı bir fark yoktu. (p >0.05) Sonuç: Bu sonuçlar, enteral yolla beslenen yoğun bakım hastalarında, gastrointestinal motiliteyi ölçmek ve komplikasyon oranını azaltmak için gastrik kalıntı hacim miktarlarının ölçülmesinin gerekli olmadığı düşündürmektedir.
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