Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design †

Apfel, Christian C.; Kranke, Peter; Katz, Mh; Goepfert, Christine; Papenfuß, T.; Rauch, Stefan; Heineck, Robert J.; Greim, Clemens‐Alexander; Roewer, Norbert

doi:10.1093/bja/88.5.659

Cited by 531 publications

(361 citation statements)

References 30 publications

(22 reference statements)

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“…10 This risk score presented with favourable discriminating and calibration properties for predicting the risk of PONV. 21 Its simplicity also makes it a useful tool for the assessment of the risk of PONV in clinical practice, and for research purposes. 10,21 In our study, all patients had three risk factors of PONV (female, non-smoking, history of motion sickness or previous PONV).…”

Section: Discussionmentioning

confidence: 99%

“…21 Its simplicity also makes it a useful tool for the assessment of the risk of PONV in clinical practice, and for research purposes. 10,21 In our study, all patients had three risk factors of PONV (female, non-smoking, history of motion sickness or previous PONV). Given that the predicted incidence for PONV based upon the Apfel's risk score was 60% before antiemetic treatment amongst our patients, in our view it would have been unethical to have added a control group which excluded patients from prophylactic management of PONV.…”

Section: Discussionmentioning

confidence: 99%

“…10,[21][22][23] Combination of the most important risk factors can be used in an operation-independent risk score to predict the incidence of PONV. 8,9,22,24 In our study, we used Apfel's simplified risk score instead of selecting patients undergoing just one type of surgery.…”

Section: Discussionmentioning

confidence: 99%

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The timing of haloperidol administration does not affect its prophylactic antiemetic efficacy

Yang

Lai

Wang

et al. 2008

Can J Anesth/J Can Anesth

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Purpose: Postoperative nausea and vomiting (PONV) occurs frequently after general anesthesia. We evaluated the timing of 2 mg iv doses of haloperidol on the efficacy of this drug as a prophylactic antiemetic for PONV. Methods: Ninety-four non-smoking female patients with a history of motion sickness and/or PONV (Apfel's simplified risk score = 3; predicted incidence of PONV = 60%) were eligible to participate in this randomized, double-blind study. Patients were divided into two groups. Group 1 patients received haloperidol 2 mg iv during induction of anesthesia. Group 2 patients received haloperidol 2 mg iv approximately 30 min before the end of surgery. The occurrence of nausea and vomiting, nausea scores, pain scores, sedation levels, and adverse effects (cardiac arrhythmias, and extrapyramidal effects) were recorded by a trained, blinded investigator. Results:The percentages of patients who experienced PONV in the first 24 hr were similar for the two groups (Group 1 = 30%; Group 2 = 26%, P = 0.645). The incidence of PONV was significantly smaller in both groups than that predicted (60%) according to the patients' underlying risks (Group 1, P = 0.004; Group 2, P = 0.001). Nausea scores, pain scores, sedation scores, emergence times, and time to first rescue treatment were similar in the two groups. No adverse effects attributable to the study medication were observed. Conclusion:The timing of administration of haloperidol 2 mg iv does not influence its antiemetic efficacy. The recovery profiles were also similar whether haloperidol was administered at the start, or at the end of surgery. Reports of Original InvestigationsThe timing of haloperidol administration does not affect its prophylactic antiemetic efficacy Address correspondence to: Dr. Yi Lee, Department of Anesthesiology, Buddhist Tzu-Chi Medical Center, Buddhist Tzu-Chi University School of Medicine, No. 707, Section 3, Chung-Yang Road, Hualien, Taiwan, ROC. E-mail: drleeyi2001@yahoo.com.tw There were no direct funding sources (departmental, hospital, institutional, commercial) supporting this work. There are no commercial or non-commercial affiliations that were, or might be perceived to be, a conflict of interest amongst the authors relating to publication of the data. The clinical trial registration number (Buddhist Tzu Chi Medical Center): IRB094-41.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The timing of haloperidol administration does not affect its prophylactic antiemetic efficacy

Yang

Lai

Wang

et al. 2008

Can J Anesth/J Can Anesth

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“…Use of volatile anesthetics and nitrous oxide particularly increase the risk. (3,12,13) Use of high doses (above 2.5 mg) of neostigmine is also considered a risk factor. (14) It is proven that opioids in the intra and preoperative periods increase risk of developing PONV.…”

Section: Factors Associated To Anesthesiamentioning

confidence: 99%

“…These scores are relevant in adults, (3) and use as parameters only risk factors associated to the patient and some have already been validated. (17) Accuracy was shown to be relatively low, improving prediction by 12% to 57%.…”

Section: How To Prevent And/or Manage Ponv?mentioning

confidence: 99%

Prevenção e tratamento de náuseas e vômitos no período pós-operatório

Gondim¹,

Japiassú²,

Filho³

et al. 2009

Rev. bras. ter. intensiva

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Drugs for preventing postoperative nausea and vomiting

Carlisle

Stevenson²

2006

Cochrane Database of Systematic Reviews

225

129

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Either nausea or vomiting is reported to affect, at most, 80 out of 100 people after surgery. If all 100 of these people are given one of the listed drugs, about 28 would benefit and 72 would not. Nausea and vomiting are usually less common and, therefore, drugs are less useful. For 100 people, of whom 30 would vomit or feel sick after surgery if given placebo, 10 people would benefit from a drug and 90 would not. Between one to five patients out of every 100 people may experience a mild side effect, such as sedation or headache, when given an antiemetic drug. Collaborative research should focus on determining whether antiemetic drugs cause more severe, probably rare, side effects. Further comparison of the antiemetic effect of one drug versus another is not a research priority.

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Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design †

Cited by 531 publications

References 30 publications

The timing of haloperidol administration does not affect its prophylactic antiemetic efficacy

The timing of haloperidol administration does not affect its prophylactic antiemetic efficacy

Prevenção e tratamento de náuseas e vômitos no período pós-operatório

Drugs for preventing postoperative nausea and vomiting

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