Ephedrine Minimizes Postoperative Nausea and Vomiting in Outpatients

Rothenberg, David M.; Parnass, Samuel M.; Newman, Louise; Litwack, Kim; Ivankovich, A. D.

doi:10.1097/00000542-198909001-00322

Cited by 10 publications

(7 citation statements)

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“…Betamethasone is a corticosteroid drug. Prevention of postoperative nausea and vomiting by a single pre‐anesthetic corticosteroid dose has been shown in this and other studies 4,5 . Corticosteroids have also been used as adjuvant analgesics in specific situations 9,19 …”

Section: Discussionmentioning

confidence: 64%

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The Analgesic Effect of Betamethasone Administered to Outpatients before Conscious Sedation in Gynecologic and Obstetric Surgery

Pace¹,

Palagiano²,

Passavanti³

et al. 2008

Annals of the New York Academy of Sciences

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Conscious sedation, used with or without peripheral or central blocks, is an elective anesthetic technique used for many outpatient procedures. The aim of this study was to evaluate the effects of a single pre-anesthetic dose of betamethasone (4 mg) on intraoperative and postoperative pain in 380 women, 18 to 75 years old, undergoing gynecologic and obstetric surgery (diagnostic curettage, operative and diagnostic hysteroscopy, conization, minilaparoscopy, cone biopsy, endometrial ablation, assisted reproduction techniques, and induced and therapeutic abortion) in a outpatient service. In this randomized, double-blind, placebo-controlled study, the patients were divided into two equal groups according to a computer-generated randomized list. One group received 4 mg of betamethasone i.v. as a premedication (group B), whereas the placebo group (group P) received only saline. All patients underwent the same sedation, associated with a peripheral block. Pain was evaluated using a 5-point verbal rating scale during surgery, after 2 h, and on discharge. In group B, intraoperative and postoperative pain was significantly less frequent than in group P (P < 0.001). Consequently, fewer women belonging to group B requested additional analgesic drugs during and after surgery (P < 0.01). Patients in group B also experienced a greater degree of satisfaction (P < 0.01). Briefly, a single dose of betamethasone seemed to reduce the incidence and severity of perioperative pain after gynecologic outpatient surgery.

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Section: Discussionmentioning

confidence: 64%

“…Corticosteroids have been used to decrease the incidence of vomiting and to reduce postoperative pain symptoms and inflammatory reactions in oral and laparoscopic surgery 4–8 . They have also been used as adjuvant analgesics in the management of pain associated with edema and in cases of tumor infiltration and nerve compression 9 …”

Section: Introductionmentioning

confidence: 99%

The Analgesic Effect of Betamethasone Administered to Outpatients before Conscious Sedation in Gynecologic and Obstetric Surgery

Pace¹,

Palagiano²,

Passavanti³

et al. 2008

Annals of the New York Academy of Sciences

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“…[ 9 10 11 12 28 29 ] Dexamethasone has exhibited its antiemetic characteristics in many studies[ 30 ] by reducing prostaglandins as a potent stimulant for nausea and vomiting, as well as by decreasing the excretion of serotonin from the gastrointestinal tract. [ 4 19 23 30 31 32 33 34 35 ] In addition, dexamethasone can stimulate the secretion of endorphin, which can lead to happiness and a feeling of well-being in patients. [ 36 ]…”

Section: Introductionmentioning

confidence: 99%

“…Epidural and spinal steroids are used to reduce chronic pain. [ 33 41 ] In some studies, intrathecal dexamethasone prolonged the duration of sensory block and postoperative analgesia. [ 42 43 44 ]…”

Section: Introductionmentioning

confidence: 99%

Effects of intrathecal and intravenous dexamethasone on complications associated with intrathecal morphine after cesarean section

Kiasari

Nahid

Aezzi

et al. 2022

Journal of Education and Health Promotion

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BACKGROUND: Pain and nausea and vomiting are of serious complications following the use of opiates after surgery, especially cesarean section. Control of postoperative complications is one of the necessities of quality promotion of health-care system. Medications with few side effects such as corticosteroids including dexamethasone can be an appropriate option. In addition, the route of administration can have a significant effect on the effectiveness of the drug. The aim of the present study was to compare the effects of intrathecal with intravenous dexamethasone in reducing the complications associated with intrathecal morphine after cesarean section. MATERIALS AND METHODS: The study was a double-blind randomized controlled clinical trial and determined the effect of intrathecal and intravenous dexamethasone on the incidence and severity of complications of intrathecal morphine after cesarean section on 120 patients and its relationship with serious complications after surgery. Descriptive and analytical statistics were used to examine the characteristics of the case and control groups, and STATA SPSS software was used to compare the two groups. RESULTS: There was no significant association between the two groups in terms of baseline characteristics. Pain score in the intrathecal injection group was lower than the intravenous injection group, with a statistically significant difference (P = 0.02). In addition, there was a significant association regarding to the incidence of nausea, vomiting, and itching between intrathecal and intravenous injection groups (P = 0.008). CONCLUSION: Dexamethasone was effective to reduce opiate complications after cesarean section. Establishing a suitable association between dexamethasone half-life, efficacy, type of use, and time of use can result the best outcomes and promote patients' satisfaction in cesarean section.

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“…It is believed that analgesic mechanism of magnesium sulfate implies the NMDA receptor's antagonism and calcium ion channel's influence 2,3 . Dexametasone as additive substance in pain therapy implies an inhibitory effect on prostaglandin synthesis with central mechanism, enlarge number of serotonin receptors on cell membrane, change in blood CSF barrier permselectivity to serum protein 4,5 . Regarding this mechanism of analgesic activity, dexametasone improves postoperative recovery of patient by providing both, analgesic and antiemetic effect.…”

Section: Introductionmentioning

confidence: 99%

Effectivness of dexametasone vs. Magnesium sulphate in postoperative analgesia: Dexametasone vs. Magnesium sulphate

Dautaj¹,

Bulku²,

Jaho³

et al. 2016

Serb J Anes Inten Therap

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Introduction: Preoperative use of additive substances may be very helpful in perioperative acute pain management. Intravenous administration of dexametasone in preoperative period prevents postoperative nausea and vomiting but also provides better pain relief. It is also well known that magnesium sulphate (the NMDA receptor's antagonist) by its central mechanism of action may be effective in postoperative pain control. Aim: The purpose of this study was to evaluate the effect of dexametasone and magnesium sulphate on postoperative pain management in patients undergoing abdominal surgery (open cholecystectomy). Methods: Seventy eight patients scheduled for elective surgery (open cholecystectomy) were included in this study. This was the prospective cohort randomized placebo-controlled study. A total of 78 patients were randomized into three groups. Each group had twenty six patients. The group D, received dexametasone 0.1 mg/ kg iv 30 minutes before surgery. The group M received magnesium sulphate 3 mg/kg iv 30 minutes before surgery. The third group S was placebo group and patients in this group received saline in the same volume for each patient. For pain control after surgery all patients received tramadol 0.9-1.2 mg/kg and diklophenac 1.76 mg/kg. When necessary (VAS ≥ 7), morphine sulphate in dose 0.15 mg/kg was administred subcutaneously. For treatment of emetic episodes metoclopramid 10 mg iv. was used. The patients were observed for intensity of pain measured VAS 0-10, pain relief and satisfaction with therapy, sedation, adverse events, emetic episodes and hemodynamic parameters. Results: There was no difference between groups regarding demographic data (age, gender, body weight), ASA score, comorbidity, duration of surgery and anesthesia and amount of fentanyl received during surgery. In group D 11.54% of patients received additional analgesia (morphine sulphate 0.15 mg/kg sc) in the first 4 hours and 27% of patients in the first 24 hours postoperatively. In group M 38.45% of patients received additional analgesia in the first 4 hours and total of 53.8% of patients in the first 24 hours. In placebo group only 2 patients did not require additional analgesia. There was significant statistic difference between groups in morphine consumption in the first 24 hours postoperatively (p ˂ 0.01). There was no side effects. Conclusion: Dexametasone and magnesium sulphate given intravenously in preoperative period (30 minutes before surgery) improved pain control in first 24 hour postoperatively. Dexametasone administered alone provided faster onset and better pain relief including prevention PONV compare with magnesium sulphate iv. There was no side effect of this therapy.

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Ephedrine Minimizes Postoperative Nausea and Vomiting in Outpatients

Cited by 10 publications

References 0 publications

The Analgesic Effect of Betamethasone Administered to Outpatients before Conscious Sedation in Gynecologic and Obstetric Surgery

The Analgesic Effect of Betamethasone Administered to Outpatients before Conscious Sedation in Gynecologic and Obstetric Surgery

Effects of intrathecal and intravenous dexamethasone on complications associated with intrathecal morphine after cesarean section

Effectivness of dexametasone vs. Magnesium sulphate in postoperative analgesia: Dexametasone vs. Magnesium sulphate

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