Postoperative nausea and vomiting after breast surgery: efficacy of prophylactic ondansetron and droperidol in a randomized placebo-controlled study

Reihnér, Eva; Grunditz, R.; Giesecke, Kajsa; Gustafsson, LL

doi:10.1046/j.1365-2346.2000.00627.x

Cited by 38 publications

(13 citation statements)

References 32 publications

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“…There was a low incidence of PONV during the first 24 h after surgery in the present study, different from results of previous studies regarding PONV associated with breast and thyroid surgery [1,2]. The incidence of PONV is known to be influenced by patient characteristics, type of surgical procedure, anesthesia technique, and postoperative analgesics [3].…”

Section: Discussioncontrasting

confidence: 99%

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Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study

Lee¹,

Rim²,

Lee³

et al. 2014

Korean J Anesthesiol

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BackgroundWe postulated that palonosetron, a novel antiemetic agent, might have the effect of alleviating injection pain from propofol and rocuronium. A double-blind, controlled study was undertaken to evaluate the effect of palonosetron on injection pain during total intravenous anesthesia and postoperative nausea and vomiting (PONV) using propofol-remifentanil in breast and thyroid cancer surgery.MethodsSixty patients were randomly allocated to one of two groups. Before injection of propofol and rocuronium, patients in group S (n = 30) received 4 ml of saline and patients in group P (n = 30) received 75 µg (1.5 ml) of palonosetron mixed with 2.5 ml of saline (n = 30). Patients were evaluated by a blinded anesthesiologist with regard to the scoring of injection pain of propofol, withdrawal response by rocuronium, PONV, shivering, postoperative pain, recall of pain, and overall satisfaction.ResultsThe differences between groups in the incidence of injection pain due to propofol and rocuronium were insignificant. However, in group P, the severity of propofol-induced injection pain (3% vs. 33%, P = 0.003) and postoperative pain (P = 0.038) was significantly lower during the first 12 h after surgery. No differences were observed between the groups with respect to PONV, shivering, recall of pain, and overall satisfaction.ConclusionsWe concluded that pretreatment of palonosetron was effective to reduce the severity of propofol-induced injection pain and early postoperative pain, although it did not reduce the incidence of injection pain from propofol and rocuronium.

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Section: Discussioncontrasting

confidence: 99%

“…It has been reported that the incidences of PONV are between 60 and 80% for mastectomy and thyroidectomy, respectively [1,2]. The first step for the prevention of PONV is to reduce risk factors, i.e., by the use of propofol-based anesthesia and decreased use of intraoperative N 2 O and postoperative opioids.…”

Section: Introductionmentioning

confidence: 99%

Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study

Lee¹,

Rim²,

Lee³

et al. 2014

Korean J Anesthesiol

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“…[ 14 ] IV pre-treatment with a single dose of ondansetron also does not substantially prevent this. [ 15 ] Bakri et al . reported that reduction in the incidence and severity of PONV due to use of dexmedetomidine was almost similar to dexamethasone with analgesic superiority.…”

Section: Discussionmentioning

confidence: 99%

Role of dexmedetomidine as an anaesthetic adjuvant in breast cancer surgery as a day-care procedure: A randomised controlled study

Das

Sahoo

et al. 2018

Indian J Anaesth

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Background and Aims:Breast cancer surgery can be carried out as day-care procedure to increase patient turnover, decrease disease progression and financial burden. The present study was carried out to assess the role of dexmedetomidine in breast cancer surgery as a day-care procedure.Methods:This prospective randomised, double-blind study was carried out on 100 patients screened for day-care breast cancer surgery. They were divided into two groups of 50 each; who received either normal saline (Group NS) or 0.6 μg/kg/h dexmedetomidine (Group D) infusion from 10 min before induction until skin closure. All patients were given general anaesthesia. The incidence of discharge, post-operative pain (POP), average rescue analgesia (fentanyl) required and side effects were noted. Statistical analysis was performed using Student's t-test and Chi-square test.Results:Incidence of discharge in group NS was 60% compared to 88% in Group D (P = 0.001). Average rescue analgesia requirement by group NS was 136.07 ± 43.06 μg, whereas it was 77.5 ± 29.86 μg in Group D (P = 0.01). The incidence of POP in 6 h and within 2 h of expected discharge time in Group NS was 56% and 28%, respectively, and in Group D, it was 8% in both the periods (P < 0.001 and 0.01). Side effects such as post-operative nausea, vomiting and bleeding were encountered in eight and two patients, respectively, in Group NS and two and one patients, respectively, in Group D.Conclusion:Dexmedetomidine as an anaesthetic adjuvant makes breast cancer surgery feasible on day-care basis.

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“…The incidence of nausea and vomiting was lower in group PCAIB in our study, although there was no significant difference between the two groups. One reason could be that a preemptive antiemetic, ondansetron, was used [ 22 ]. In addition, the regimen of PCA was constituted of fentanyl and ketorolac, which might cause less nausea and vomiting [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Interscalene Nerve Block for Postoperative Pain Management in Patients after Shoulder Surgery

Chen

Shen

Tsai

et al. 2015

BioMed Research International

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Objectives. Shoulder surgery can produce severe postoperative pain and movement limitations. Evidence has shown that regional nerve block is an effective management for postoperative shoulder pain. The purpose of this study was to investigate the postoperative analgesic effect of intravenous patient-controlled analgesia (PCA) combined with interscalene nerve block in comparison to PCA alone after shoulder surgery. Methods. In this study, 103 patients receiving PCA combined with interscalene nerve block (PCAIB) and 48 patients receiving PCA alone after shoulder surgery were included. Patients' characteristics, preoperative shoulder score and range of motion, surgical and anesthetic condition in addition to visual analog scale (VAS) pain score, postoperative PCA consumption, and adverse outcomes were evaluated. Results. The results showed that PCA combined with interscalene nerve block (PCAIB) group required less volume of analgesics than PCA alone group in 24 hours (57.76 ± 23.29 mL versus 87.29 ± 33.73 mL, p < 0.001) and 48 hours (114.86 ± 40.97 mL versus 183.63 ± 44.83 mL, p < 0.001) postoperatively. The incidence of dizziness in PCAIB group was significantly lower than PCA group (resp., 1.9% and 14.6%, p = 0.005). VAS, nausea, and vomiting were less in group PCAIB, but in the absence of significant statistical correlation. Conclusion. Interscalene nerve block is effective postoperatively in reducing the demand for PCA analgesics and decreasing opioids-induced adverse events following shoulder surgery.

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Postoperative nausea and vomiting after breast surgery: efficacy of prophylactic ondansetron and droperidol in a randomized placebo-controlled study

Cited by 38 publications

References 32 publications

Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study

Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study

Role of dexmedetomidine as an anaesthetic adjuvant in breast cancer surgery as a day-care procedure: A randomised controlled study

Effects of Interscalene Nerve Block for Postoperative Pain Management in Patients after Shoulder Surgery

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