Efficacy of antiemetic therapy in patients undergoing laparoscopic cholecystectomy

Llanes-Garza, H. A.; López-Cabrera, Norma Guadalupe; Vega, Roger; Palacios-Ríos, Dionicio; Millan-Corrales, A.L.; Pacheco-Juárez, M.; Cárdenas-Estrada, Eloy

doi:10.1016/j.rmu.2015.04.003

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…They have also shown the lack of cognitive imbalance later on, but with no significant differences at 7 days (p = 0.062), and at 90 days (p = 0.372) [46]. Postoperative complication rate has been shown to vary between 20% and 42% [47]; they have an impact both on the clinical outcome of patients, as well as on the OR management and patient outflow [48]. This is due to longer times of stay in the recovery room and longer hospital length of stay [49][50][51][52].…”

Section: Discussionmentioning

confidence: 97%

Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

Dinu¹,

Rogobete²,

Popovici³

et al. 2020

Preprint

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Study background and aims: Laparoscopic cholecystectomy is one of the most frequently performed interventions in departments of general surgery. One of the most important aims in achieving perioperative stability of these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact monitoring the depth of anesthesia through Entropy (state entropy – SE and response entropy -RE) has on the hemodynamic stability and on the doses of volatile anesthetic. Material and Methods: This is a prospective, observational, randomized, monocentric study carried out between January 2019 and December 2019 in the Clinic of Anesthesia and Intensive Care from the “Pius Brînzeu” Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups; patients in Group A (target group) received multimodal monitoring that included monitoring of standard parameters and of Entropy (SE and RE), while patients in Group B (control group) only received standard monitoring. Anesthetic dose in group A were optimized to achieve a target entropy of 40-60. Results: 68 patients met the inclusion criteria and were allocated to one of the two study groups, Group A (N=43) and Group B (N=25). There were no statistically significant differences identified between the two groups for both demographical and clinical data (p>0.05). Statistically significant differences have been identified for the number of hypotensive episodes (p = 0.011, 95% CI 0.1851 to 0.7042) and for the number of episodes of bradycardia (p < 0.0001, 95% CI 0.3296 to 0.7923). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI -0.3942 to 0.9047). Conclusions: The implementation of the multimodal monitoring protocol that includes the standard parameters and the measurement of Entropy for determining the depth of anesthesia (SE and RE) lead to a considerable improvement in perioperative hemodynamic stability. Optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient leads to a considerable decrease in drug consumption as well as to a lower incidence of hemodynamic side-effects.

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Section: Discussionmentioning

confidence: 97%

Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

Dinu¹,

Rogobete²,

Popovici³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…They also showed the lack of cognitive imbalance later on, but with no significant differences at 7 days (p = 0.062) and at 90 days (p = 0.372) [ 46 ]. Post-operative complication rate has been shown to vary between 20% and 42% [ 47 ]; they have an impact both on the clinical outcome of patients as well as on the OR management and patient outflow [ 48 ]. This is due to longer times of stay in the recovery room and a longer hospital length of stay [ 49 , 50 , 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study

Dinu

Rogobete

Popovici

et al. 2020

Entropy

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Laparoscopic cholecystectomy is one of the most frequently performed interventions in general surgery departments. Some of the most important aims in achieving perioperative stability in these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact, as monitored through entropy (both state entropy (SE) and response entropy (RE)), that the depth of anesthesia has on the hemodynamic stability, as well as the doses of volatile anesthetic. A prospective, observational, randomized, and monocentric study was carried out between January and December 2019 in the Clinic of Anesthesia and Intensive Care of the “Pius Brînzeu” Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups: patients in Group A (target group) received multimodal monitoring, which included monitoring of standard parameters and of entropy (SE and RE); while the patients in Group B (control group) only received standard monitoring. The anesthetic dose in group A was optimized to achieve a target entropy of 40–60. A total of 68 patients met the inclusion criteria and were allocated to one of the two study groups: group A (N = 43) or group B (N = 25). There were no statistically significant differences identified between the two groups for both demographical and clinical characteristics (p > 0.05). Statistically significant differences were identified for the number of hypotensive episodes (p = 0.011, 95% CI: [0.1851, 0.7042]) and for the number of episodes of bradycardia (p < 0.0001, 95% CI: [0.3296, 0.7923]). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI: [−0.3942, 0.9047]). The implementation of the multimodal monitoring protocol, including the standard parameters and the measurement of entropy for determining the depth of anesthesia (SE and RE) led to a considerable improvement in perioperative hemodynamic stability. Furthermore, optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient led to a considerable decrease in drug consumption, as well as to a lower incidence of hemodynamic side-effects.

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“…8,9 The incidence of nausea and vomiting after laparoscopic cholecystectomy is higher than in other types of surgery. 10,11 If patients undergo laparoscopic cholecystectomy do not receive antinausea and antiemetic drugs as prophylaxis, this rate reaches 50% to 70%, 11 which can lead to complications, such as surgical sutures opening, increased intraocular pressure, and cranial, electrolyte imbalance, dehydration, and even pulmonary aspiration. 12 Therefore, nausea and vomiting prevention by prescribing antiemetic and antinausea drugs is of great importance, and it makes patients more satisfied with the surgery and reduces recovery time.…”

mentioning

confidence: 99%

“…Female sex, gynecologic surgery, laparoscopic procedures, and volatile anesthetics use are associated with increased PONV 8,9 . The incidence of nausea and vomiting after laparoscopic cholecystectomy is higher than in other types of surgery 10,11 . If patients undergo laparoscopic cholecystectomy do not receive antinausea and antiemetic drugs as prophylaxis, this rate reaches 50% to 70%, 11 which can lead to complications, such as surgical sutures opening, increased intraocular pressure, and cranial, electrolyte imbalance, dehydration, and even pulmonary aspiration 12 .…”

mentioning

confidence: 99%

Comparison of Nausea and Vomiting Incidence After Laparoscopic Cholecystectomy With Pretreatment With Haloperidol and Ondansetron: A Randomization Clinical Trial Study

Karami,

Ramadani,

Banifatemi

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Objective: Nausea and vomiting after surgery are the most common complications. Therefore, we performed this study to compare the effect of ondansetron and haloperidol on nausea and vomiting after laparoscopic cholecystectomy. Patients and Methods: In this randomized clinical trial, 60 patients candidates for elective laparoscopic cholecystectomy were allocated to haloperidol (0.05 mg/kg, n = 30) and ondansetron (0.15 mg/kg, n = 30) groups. An Ocular Analog Scale was used to assess postoperative nausea and vomiting. Every 15 minutes in the recovery room, heart rate and blood pressure were measured up to 6 hours after surgery. In addition, patient satisfaction was assessed postoperatively. Results: Haloperidol and ondansetron have the same effect on postoperative nausea and vomiting in the recovery room and ward. It was found that the trend of Visual Analog Scale variable changes in the recovery room was similar in the haloperidol and ondansetron group (P = 0.58); it was also true for the ward (P = 0.79). Comparing the length of stay in a recovery room in the 2 groups was not statistically significant (P = 0.19). In addition, the 2 groups did not differ in satisfaction postoperatively (P = 0.82). Conclusion: Haloperidol and ondansetron had an equal effect on reducing nausea and vomiting in the recovery room and ward after laparoscopic cholecystectomy. Patient satisfaction and length of stay in the recovery room did not differ between groups.

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Efficacy of antiemetic therapy in patients undergoing laparoscopic cholecystectomy

Cited by 3 publications

References 10 publications

Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study

Comparison of Nausea and Vomiting Incidence After Laparoscopic Cholecystectomy With Pretreatment With Haloperidol and Ondansetron: A Randomization Clinical Trial Study

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