The effects of dexamethasone and metoclopramide on early and late postoperative nausea and vomiting in women undergoing myomectomy under spinal anaesthesia

Tobi, Kingsley Ufuoma; Imarengiaye, CO; Amadasun, FE

doi:10.4103/1119-3077.134036

Cited by 9 publications

(10 citation statements)

References 16 publications

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“…Treatment plan included tramadol 1mg/kg and active warming using forced air warming device set at 40°C if score was >2. PONV was assessed using 0‐3 score: 0 = no PONV, 1 = nausea only, 2 = vomiting, 3 = >1 episode of vomiting and ondensetron 4 mg administered for scores >1. Pruritis was assessed using NRS (0‐10) with 0 = no itching and 10 = severe itching with NRS >3 being treated with 22.75 mg of pheniramine maleate.…”

Section: Methodsmentioning

confidence: 99%

Comparison of intraoperative fentanyl with dexmedetomidine for perioperative analgesia and opioid consumption during craniotomies: A randomised controlled pilot study with non‐inferiority design

et al. 2019

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Background: Moderate to severe pain is common despite the use of potent opioids during craniotomies. Non-opioid agents such as dexmedetomidine reduce undesirable opioid effects and are successfully used as primary analgesic during bariatric surgeries. This study assessed the feasibility of conducting a large randomised controlled trial comparing fentanyl with dexmedetomidine for perioperative analgesia during craniotomy. Methods:This was a prospective single-centre randomised controlled feasibility trial.Twenty-four consenting adult patients undergoing supratentorial craniotomy at NIMHANS, Bangalore, India, were recruited after ethical approval in March and April 2018. They received either fentanyl 1 µg kg −1 h −1 (n = 12) or dexmedetomidine 0.5 µg kg −1 h −1 (n = 12) as primary intraoperative analgesic drug. Patient, anaesthesiologist, outcome assessor and data analyst were blinded to the study intervention.Our feasibility outcomes (primary) were recruitment and adherence rates. We also explored the potential efficacy of intervention and adverse events. Results:We recruited 24 out of 30 eligible patients and had 100% protocol adherence, thereby demonstrating the feasibility of a larger randomised controlled trial. All 24 patients completed the study. The demographic and clinical parameters were similar between the groups. Compared between fentanyl and dexmedetomidine, there was no difference in the intraoperative fentanyl (top-up) consumption (µg), expressed as median and interquartile range: 25 (0-50) and 0 (0-50); P = 0.844; and no difference in postoperative pain at 15 and 60 minutes. Adverse events were few and similar with fentanyl and dexmedetomidine. Conclusions:A large-scale randomised controlled trial of perioperative dexmedetomidine versus fentanyl is feasible. Dexmedetomidine has the potential to be non-inferior to fentanyl for perioperative analgesia during craniotomies.

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Section: Methodsmentioning

confidence: 99%

Comparison of intraoperative fentanyl with dexmedetomidine for perioperative analgesia and opioid consumption during craniotomies: A randomised controlled pilot study with non‐inferiority design

et al. 2019

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“…Penelitian lain tahun 2011 yang meneliti tentang penggunaan steroid dalam menurunkan insidens PONV didapatkan bahwa steroid efektif dalam mencegah late PONV dan kurang efektif pada early PONV. 15,16 Dalam penelitian ini deksametason diduga menghambat PONV pada 2-24 jam pascaoperasi sehingga didapatkan hasil bahwa kelompok kontrol dan CHO tidak berbeda signifikan dalam menurunkan PONV 2-24 jam pascaoperasi. Dalam hal ini CHO dapat berfungsi sebagai terapi tambahan pencegahan PONV.…”

Section: Subjek Dan Metodeunclassified

Pengaruh Pemberian Minuman Karbohidrat (Maltodekstrin 12,5%) Praoperasi terhadap Kejadian Mual dan Muntah Pascamastektomi

Aditya¹,

Fuadi

Rachman

2020

jap

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Mual dan muntah pascaoperasi (postoperative nausea and vomiting, PONV) menjadi masalah yang umum terjadi setelah operasi mastektomi dengan angka kejadian berkisar 21–92%. Pemberian minuman karbohidrat (CHO) praoperasi ditawarkan sebagai sebuah solusi menurunkan PONV dan juga merupakan salah satu komponen penting dan disarankan untuk mencapai enhanced recovery after surgery (ERAS). CHO berhubungan dengan penurunan katabolisme dan resistensi insulin pascaoperasi. Penelitian ini bertujuan mengetahui pengaruh pemberian minuman berkarbohidrat (CHO) oral sebelum operasi terhadap tingkat kejadian PONV pascaoperasi mastektomi. Penelitian menggunakan eksperimental uji acak buta tunggal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada November 2019–Februari 2020. Sebanyak 46 pasien dibagi menjadi dua kelompok, yakni kelompok K (kelompok kontrol, air mineral, n=23 subjek) dan kelompok C (kelompok CHO, n=23 subjek). Analisis data hasil penelitian dilakukan dengan Uji Mann-hitney. Kejadian mual muntah pada kelompok kontrol lebih besar dibanding dengan kelompok CHO pada menit 0–30 (57% vs 22%), pada menit 30–60 (91% vs 61%), dan pada menit 60–120 (78% vs 61%) dengan perbedaan yang bermakna (p<0,05). Simpulan, pemberian minuman karbohidrat praoperasi dapat menurunkan kejadian mual muntah pascamastektomi dibandingkan dengan kelompok kontrol.

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“…Its use is widely accepted owing to its simplicity and high reliability as well as its rapid time-to-effect. Epidural anesthesia is an alternative technique and has the advantage of reduced rates of hypotension [2].…”

Section: Introductionmentioning

confidence: 99%

“…Considering that one of the common causes of death during general anesthesia is complications from intubation (with the incidence approximately 10 times higher in pregnant women than in non-pregnant women), the American College of Obstetricians and Gynecologists released a statement in 2013 advising local anesthesia as the preferred method for cesarean procedures [1,2].…”

Section: Introductionmentioning

confidence: 99%

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The effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after surgery in cesarean section under spinal anesthesia

et al. 2020

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Objective Postoperative nausea and vomiting is one of the most common side effects after anesthesia in surgeries, such as cesarean section. This study aimed to investigate the effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after cesarean section. Methods This clinical trial was conducted on 180 patients aged 18-40 years who underwent cesarean section under spinal anesthesia. The first group received 10 mg of metoclopramide via intravenous injection (metoclopramide group), and the second group received 1 g of oral ginger (ginger group) half an hour before spinal anesthesia. The frequency and severity of nausea and vomiting during surgery and at 2, 6, 12, and 24 hours postoperatively were compared in both groups. To analyze the results, the t-test, chi-square test, and Mann-Whitney test were used. Results There was no significant difference in the frequency of nausea and vomiting between the 2 groups during operation, 2 hours and 6 hours after surgery (P=0.182, 0.444 and 0.563 respectively). The severity of nausea and vomiting was also similar in the 2 groups (P=0.487 and 0.652 respectively); however, the metoclopramide group had a lower systolic blood pressure (P<0.001; df=2.176; f=18.66) and mean arterial pressure (P<0.001; df=2.176; f=6.36) than the ginger group. Conclusion The results revealed that ginger reduced nausea and vomiting to the same extent as metoclopramide in patients undergoing cesarean section.

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The effects of dexamethasone and metoclopramide on early and late postoperative nausea and vomiting in women undergoing myomectomy under spinal anaesthesia

Abstract: Dexamethasone protects against the incidence of late PONV with a minimal effect on early PONV. The combination of dexamethasone and metoclopramide had comparable effect on both and of better magnitude than metoclopramide alone.

Cited by 9 publications

References 16 publications

Comparison of intraoperative fentanyl with dexmedetomidine for perioperative analgesia and opioid consumption during craniotomies: A randomised controlled pilot study with non‐inferiority design

Comparison of intraoperative fentanyl with dexmedetomidine for perioperative analgesia and opioid consumption during craniotomies: A randomised controlled pilot study with non‐inferiority design

Pengaruh Pemberian Minuman Karbohidrat (Maltodekstrin 12,5%) Praoperasi terhadap Kejadian Mual dan Muntah Pascamastektomi

The effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after surgery in cesarean section under spinal anesthesia

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