Risk factors and their impact on postoperative nausea and vomiting

Kovac, Anthony L.; Gan, Tong J.; Habib, Ashraf S.; Kehlet, Henrik

doi:10.1017/cbo9781316135853.005

Cited by 3 publications

(4 citation statements)

References 57 publications

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“…Pascaoperasi payudara sendiri berkaitan dengan angka kejadian mual muntah pascaoperasi yang tinggi mencapai 60%. [1][2][3] Upaya mengurangi kejadian mual muntah pascaoperasi dapat dilakukan dengan memakai beberapa strategi pencegahan maupun penanganan mual dan muntah baik dengan terapi farmakologi ataupun nonfarmakologi (aromaterapi, akupunktur, akupresur, terapi relaksasi, terapi hipnotik, dan terapi musik). Obat antiemetik merupakan lini pertama untuk terapi mual muntah pascaoperasi, namun obat antiemetik tidak selalu efektif dan dengan harga yang mahal serta tidak terlepas dari efek samping yang berpengaruh pada kondisi klinis pasien.…”

Section: Pendahuluanunclassified

“…Lima jalur persarafan antara lain jalur CTZ, jalur saraf aferen vagus dari viseral sistem gastrointestinal, jalur persarafan sistem vestibuler, jalur refleks saraf aferen korteks serebral, dan alur saraf aferen otak tengah (midbrain) yang distimulasi oleh berbagai faktor risiko dari pasien, anestesi maupun operasi sehingga mengaktifkan pusat muntah yang terletak pada formasi retikularis di medula oblongata untuk terjadi refleks mual dan muntah pascaoperasi. 3,4 Aromaterapi pepermin itu bekerja secara langsung menghambat fungsi reseptor 5-HT 3 di area chemoreceptor trigger zone (CTZ) pada sistem saraf pusat maupun reseptor 5-HT 3 di gastrointestinal serta menghambat kerja reseptor kolinergik dan histaminergik pada usus, serta menghambat kanal kalsium yang menyebabkan relaksasi sistem gastrointestinal sehingga dapat mengurangi mual dan muntah. Aromaterapi pepermin inhalasi memengaruhi tubuh dan pikiran melalui interaksi dengan sistem olfaktorius yang secara langsung memengaruhi fungsi otak.…”

Section: Pendahuluanunclassified

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Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi

Fransisca

Fuadi

Bisri

2019

jap

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Mual muntah pascaoperasi merupakan salah satu komplikasi anestesi dan operasi yang menjadi perhatian khusus karena memengaruhi kualitas pelayanan kesehatan, memperpanjang lama perawatan, dan meningkatkan angka morbiditas perioperatif. Pascaoperasi payudara berkaitan dengan angka kejadian mual muntah pascaoperasi yang tinggi. Beberapa konsensus penatalaksanaan mual muntah pascaoperasi merekomendasikan pemberian terapi nonfarmakologi dengan aromaterapi sebagai terapi rescue untuk mengatasi mual muntah pascaoperasi. Tujuan penelitian ini adalah membandingkan aromaterapi pepermin dengan ondansetron sebagai terapi rescue dalam menurunkan kejadian mual muntah pascaoperasi mastektomi. Penelitian ini merupakan penelitian eksperimental yang dilakukan secara prospektif dengan desain penelitian double blind randomized controlled trial dan consecutive sampling terhadap 32 subjek penelitian yang menjalani operasi mastektomi elektif dan memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli–September 2018. Pada penelitian ini, data ordinal diuji dengan Uji Mann Whitney dan untuk data kategorik diuji dengan uji chi-square. Hasil penelitian ini didapatkan penurunan kejadian mual muntah pascaoperasi yang signifikan pada kelompok pepermin dibanding dengan kelompok ondansetron dengan perbedaan yang bermakna (p<0,05) pada penilaian menit kedua dan menit kelima setelah perlakuan. Simpulan, aromaterapi pepermin efektif menurunkan kejadian mual muntah pascaoperasi mastektomi dan dapat digunakan sebagai alternatif terapi atau terapi tambahan untuk penatalaksanaan mual muntah pascaoperasi.Comparison of Peppermint Aromatherapy with Ondansetron Intravenous as a Rescue for Postoperative Nausea Vomiting after Mastectomy SurgeryPostoperative nausea and vomiting are among anesthesia and surgery complications that receive special considerations as it affects the quality of healthcare services, prolongs care, and increases perioperative morbidities. The incidence of postoperative nausea and vomiting is high in patients that have undergone breast surgery. The consensus for postoperative nausea and vomiting management recommends non-pharmacological treatments, one of which is through the use of aromatherapy as a rescue to resolve postoperative nausea and vomiting. This study aimed to compare the effects of peppermint aromatherapy and ondansetron as a rescue in reducing the incidence of postoperative nausea and vomiting after elective mastectomies. This was a prospective experimental double blind randomized controlled trial study with consecutive sampling on 32 research subjects underwent elective mastectomies and met the inclusion criteria in Dr. Hasan Sadikin General Hospital in July–September 2018. The ordinal data were tested using the Mann Whitney statistics test and the categorical data using the chi square test. The results show a significant decrease in nausea and vomiting incidence in the peppermint group compared to the ondansetron group with significant difference (p<0.05) in two minutes and five minutes after treatment. In conclusion, peppermint aromatherapy is effective in reducing the incidence of postoperative nausea and vomiting after mastectomies and can be used as an alternative or additional treatment in managing postoperative nausea and vomiting.

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Section: Pendahuluanunclassified

Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi

Fransisca

Fuadi

Bisri

2019

jap

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“…The main approach to control CINV is to block neurotransmitters and their receptors which mediate the generation of impulses from sensory neurons in the GI tract (5-HT 3 , D 2 , NK 1 ) and central nervous system (5-HT 3 , D 2 , NK 1 , ACh 1 , opioid µ). Therapeutic agents that can block neurotransmitter receptors in the vomiting center, chemoreceptor trigger zone (CTZ), and GI tract are useful in preventing or controlling CINV [5,7]. Antiemetic prophylaxis is usually performed with a combination of drugs.…”

Section: Introductionmentioning

confidence: 99%

A Novel Semi-Solid Self-Emulsifying Formulation of Aprepitant for Oral Delivery: An In Vitro Evaluation

et al. 2023

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Aprepitant is the first member of a relatively new antiemetic drug class called NK1 receptor antagonists. It is commonly prescribed to prevent chemotherapy-induced nausea and vomiting. Although it is included in many treatment guidelines, its poor solubility causes bioavailability issues. A particle size reduction technique was used in the commercial formulation to overcome low bioavailability. Production with this method consists of many successive steps that cause the cost of the drug to increase. This study aims to develop an alternative, cost-effective formulation to the existing nanocrystal form. We designed a self-emulsifying formulation that can be filled into capsules in a melted state and then solidified at room temperature. Solidification was achieved by using surfactants with a melting temperature above room temperature. Various polymers have also been tested to maintain the supersaturated state of the drug. The optimized formulation consists of CapryolTM 90, Kolliphor® CS20, Transcutol® P, and Soluplus®; it was characterized by DLS, FTIR, DSC, and XRPD techniques. A lipolysis test was conducted to predict the digestion performance of formulations in the gastrointestinal system. Dissolution studies showed an increased dissolution rate of the drug. Finally, the cytotoxicity of the formulation was tested in the Caco-2 cell line. According to the results, a formulation with improved solubility and low toxicity was obtained.

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“…Even with the application of the essential therapies, one of the most frequent anesthesia-related complication is nausea and vomiting (N/V). 4 During CS, hypotension, defined as a 30% fall in mean blood pressure, is a frequent issue linked to N/V in the mother and the possibility of neonatal and fetal acidosis. 5 A variety of therapeutic options, including dopamine, serotonin receptor antagonists, antihistamines, corticosteroids, sedatives, and anticholinergic medications, have been used.…”

Section: Introductionmentioning

confidence: 99%

Sub-hypnotic dose of midazolam is effective in reducing intraoperative nausea and vomiting during cesarean sections under spinal anesthesia

Ibrahem

2023

Anaesth. pain intensive care

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Background & Objectives: Intra and postoperative nausea and vomiting under regional anesthesia is a common problem in cesarean sections. Globally, the incidence has been documented to be from 40−80%, and various drugs have been used to control it. We aimed to determine if a subhypnotic dose of midazolam will be effective to reduce intraoperative nausea and vomiting during an elective cesarean section under spinal anesthesia. Methodology: A randomized interventional study was done through a period of 6 months from March 11, 2019 to September 11, 2019 and included 100 full term pregnant women undergoing elective cesarean sections (CS) under spinal anesthesia. The participants were allocated to one of two groups: Midazolam group (received midazolam 1 mg bolus then 1.0 mg/h infusion after umbilical cord clamping), and placebo group (received normal saline). Bellville score was used to evaluate nausea and vomiting (N/V). The hemodynamic parameters were monitored at three-minute intervals. Results: No statistically significant differences were noted between study groups regarding mean arterial pressure, heart rate and total ephedrine used in the two groups. Intraoperative nausea and vomiting were recorded midazolam (81.6%) with a significant association between prevention of intraoperative N/V and receiving midazolam. Insignificant association was noticed between the level of sedation and receiving midazolam. Conclusion: Administration of low dose of midazolam during cesarean sections under spinal anesthesia can lessen intraoperative nausea/vomiting without significantly effect on blood pressure or heart rate and without any negative side effects. Abbreviations: BMI – Body Mass Index; CS - Cesarean Section; LA – Local Anesthesia; N/V - Nausea/Vomiting; RASS - Richmond Agitation Sedation Score SA - Spinal Anesthesia Key words: Nausea; Vomiting; Anesthesia, Spinal; Midazolam; Cesarean Section Citation: Ibrahem IG. Sub-hypnotic dose of midazolam is effective in reducing intraoperative nausea and vomiting during cesarean sections under spinal anesthesia. Anaesth. pain intensive care 2023;27(4):485−489; DOI: 10.35975/apic.v27i4.2087 Received: October 12, 2022; Reviewed: May 16, 2023; Accepted: June 23. 2023

show abstract

Risk factors and their impact on postoperative nausea and vomiting

Cited by 3 publications

References 57 publications

Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi

Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi

A Novel Semi-Solid Self-Emulsifying Formulation of Aprepitant for Oral Delivery: An In Vitro Evaluation

Sub-hypnotic dose of midazolam is effective in reducing intraoperative nausea and vomiting during cesarean sections under spinal anesthesia

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