Penehyclidine mitigates postoperative nausea and vomiting and intraoperative oculocardiac reflex in patients undergoing strabismus surgery: a prospective, randomized, double-blind comparison

Sun, Jiacheng; Cao, Xiaofei; Lu, Ting; Li, Nan; Min, Xinxu; Ding, Zhengnian

doi:10.1186/s12871-021-01266-0

Cited by 7 publications

(17 citation statements)

References 23 publications

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“…In the present study, 61.0% of patients in the Control group experienced PONV within 72 h following bimaxillary surgery; this was in line with previous studies in a similar patient population [ 5 , 28 ]. Compared with the Control group, patients given a single bolus penehyclidine (Bolus group) had a 34% lower incidence of PONV within 72 h, close to the effect reported by Sun and colleagues [ 15 ]. As expected, patients given bolus-plus-infusion penehyclidine (Infusion group) had a 72-h PONV incidence 30% even lower than those in the Bolus group, although not statistically significant.…”

Section: Discussionsupporting

confidence: 77%

“…> 0.999 [5,28]. Compared with the Control group, patients given a single bolus penehyclidine (Bolus group) had a 34% lower incidence of PONV within 72 h, close to the effect reported by Sun and colleagues [15]. As expected, patients given bolus-plus-infusion penehyclidine (Infusion group) had a 72-h PONV incidence 30% even lower than those in the Bolus group, although not statistically significant.…”

Section: Discussionsupporting

confidence: 75%

“…In a recent randomized trial of 228 pediatric patients who had strabismus surgery, penehyclidine (0.01 mg/kg, maximal dose 0.5 mg) or placebo was injected intravenously immediately after anesthesia induction. The results showed that patients given penehyclidine had a significantly lower incidence of PONV within 48 h (30.7% vs. 54.8%; P < 0.01) [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the above studies, a single-dose penehyclidine was administered for PONV prevention. In accord with its elimination half-life, the antiemetic effect of penehyclidine is diminished or disappeared after 24 h [ 14 , 15 ]. However, PONV following orthognathic surgery may persist for up to 96 h [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Penehyclidine is a new muscarinic antagonist with high selectivity of the M3 receptor [ 13 ]. Previous studies showed that prophylactic penehyclidine administered before surgery helped to prevent PONV [ 14 , 15 ]. Since the mean elimination half-life of a single-dose penehyclidine is about 10.35 h, whereas high frequent PONV may persist for up to 96 h after orthognathic surgery [ 16 ], we hypothesize that a low-dose bolus plus continuous infusion of penehyclidine may be more effective for PONV prevention.…”

Section: Introductionmentioning

confidence: 99%

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Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial

et al. 2021

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Purpose To investigate the efficacy and safety of low-dose bolus plus continuous infusion of penehyclidine in preventing postoperative nausea and vomiting (PONV) following bimaxillary surgery. Methods Three hundred fifty-four patients were randomly allocated into three groups. In the Control group, placebo (normal saline) was injected before anesthesia and infused over 48 h after surgery; in the Bolus group, 0.5 mg penehyclidine was injected before anesthesia, whereas placebo was infused after surgery; in the Infusion group, 0.25 mg penehyclidine were injected before anesthesia, another 0.25 mg penehyclidine was infused after surgery. The primary endpoint was the incidence of PONV within 72 h. Results A total of 353 patients were included in intention-to-treat analysis. The PONV incidence was 61.0% (72/118) in the Control group, 40.2% (47/117) in the Bolus group, and 28.0% (33/118) in the Infusion group. The incidence was significantly lower in the Bolus group than in the Control group (RR 0.66; 95% CI 0.51–0.86; adjusted P = 0.003) and in the Infusion group than in the Control group (RR 0.46; 95% CI 0.33–0.63; adjusted P < 0.001); the difference between the Infusion and Bolus groups was not statistically significant (RR 0.70; 95% CI 0.48–1.00; adjusted P = 0.144). Emergence agitation occurred more frequently in the Bolus group than in the Control group (36.8% [43/117] vs. 21.2% [25/118], adjusted P = 0.027), but did not differ significantly between the Infusion and Control groups. Conclusions A low-dose bolus plus continuous infusion of penehyclidine was effective in preventing PONV without increasing emergence agitation. Trial registration Clinicaltrials.gov. Identifier: NCT04454866.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial

et al. 2021

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Evaluation of penehyclidine for prevention of post operative nausea and vomitting in patients undergoing total thyroidectomy under total intravenous anaesthesia with propofol-remifentanil

Sun

et al. 2022

BMC Anesthesiol

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Backgroud Postoperative nausea and vomiting (PONV) is one of the most common complications after total thyroidectomy under general anesthesia. Total intravenous anesthesia (TIVA) has been documented to prevent PONV in patients undergoing total thyroidectomy. Penehyclidine, an anticholinergic agent with an elimination half-life of over 10 h, is widely used as premedication to reduce glandular secretion. This study aimed to explore the preventative effects of penehyclidine with propofol-remifentanil-TIVA to single-TIVA on PONV in patients undergoing total thyroidectomy. Methods A total of 100 patients scheduled for total thyroidectomy were randomly assigned to either the penehyclidine group (n = 50) or TIVA group (n = 50). Propofol and remifentanil were was used for TIVA in all patients. No patients who received premedication. Patients were administrated with either 5 ml of normal saline or 0.5 mg of penehyclidine soon after anesthesia induction. The incidence of nausea and vomiting, the severity of nausea, the requirement of rescue antiemetics, and adverse effects were investigated during the first 24 h in two time periods (0–2 h and 2–24 h). Results The overall PONV incidence during the 24 h after surgery was significantly lower in the penehyclidine group compared with the TIVA group (12% vs 36%, P < 0.005). Besides, the incidence of nausea and the incidence of vomiting were significantly lower in the penehyclidine group compared with the TIVA group at 2–24 h after surgery. However, there was no significant difference between the two groups at 0–2 h after surgery. Conclusions Administration of penehyclidine under TIVA with propofol-remifentanil is more effective for prevention of PONV than TIVA alone, especially 2–24 h after total thyroidectomy. Trial registration https://www.chictr.org.cn/edit.aspx?pid=132463&htm=4 (Ref: ChiCTR2100050278, the full date of first registration: 25/08/2021).

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Penehyclidine hydrochloride for treating postoperative nausea and vomiting after laparoscopic bariatric surgery: a double-blinded randomized controlled trial

et al. 2023

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Background Postoperative nausea and vomiting (PONV) is a common and distressing complication of laparoscopic bariatric surgery (LBS). Penehyclidine hydrochloride has been reported to be effective in preventing PONV. Considering the potential preventive effects of penehyclidine against PONV, we hypothesized that intravenous infusion of penehyclidine may alleviate PONV within the first 48 h in patients scheduled for LBS. Methods Patients who underwent LBS were randomly assigned (1:2) to receive saline (Control group, n = 113) or a single intravenous dose of penehyclidine 0.5 mg (PHC group, n = 221). The primary outcome was incidence of PONV within the first 48 h postoperatively. Secondary endpoints included severity of PONV, need for rescue antiemetic therapy, volume of water intake, and time to first flatus. Results PONV occurred in 159 (48%) patients within the first 48 h postoperatively, including 51% in the Control group and 46% in the PHC group. There was no significant difference in the incidence or severity of PONV between the two groups (P > 0.05). Within the first 24 h and 24–48 h, no significant difference was found in incidence or severity of PONV, postoperative nausea, postoperative vomiting, need for rescue antiemetic therapy, or volume of water intake (P > 0.05). Kaplan–Meier curves showed that penehyclidine was significantly associated with a prolonged time to first flatus (median onset time: 22 h vs. 21 h, P = 0.036). Conclusions Penehyclidine did not decrease incidence and severity of PONV in patients undergoing LBS. However, a single intravenous dose of penehyclidine (0.5 mg) was associated with a slightly prolonged time to first flatus. Trial registration Chinese Clinical Trial Registry (ChiCTR2100052418, http://www.chictr.org.cn/showprojen.aspx?proj=134893, date of registration: 25/10/2021).

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Penehyclidine mitigates postoperative nausea and vomiting and intraoperative oculocardiac reflex in patients undergoing strabismus surgery: a prospective, randomized, double-blind comparison

Cited by 7 publications

References 23 publications

Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial

Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial

Evaluation of penehyclidine for prevention of post operative nausea and vomitting in patients undergoing total thyroidectomy under total intravenous anaesthesia with propofol-remifentanil

Penehyclidine hydrochloride for treating postoperative nausea and vomiting after laparoscopic bariatric surgery: a double-blinded randomized controlled trial

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