WorldWideScience

Sample records for vomiting

  1. Treating Vomiting

    Science.gov (United States)

    ... hours. Your pediatrician usually won’t prescribe a drug to treat the vomiting, but some doctors will prescribe antinausea medications to children. If your child also has diarrhea, ask your pediatrician for instructions on giving liquids ...

  2. Cyclic Vomiting Syndrome

    Science.gov (United States)

    ... or the flu eating certain foods, such as chocolate or cheese, or additives such as caffeine, nitrites— ... people with cyclic vomiting syndrome. Eating, Diet, and Nutrition During the prodrome and vomiting phases of cyclic ...

  3. Nausea and Vomiting

    Science.gov (United States)

    Nausea is an uneasy or unsettled feeling in the stomach together with an urge to vomit. Nausea and vomiting, or throwing up, are not diseases. ... small amounts of clear liquids to avoid dehydration. Nausea and vomiting are common. Usually, they are not ...

  4. Vomiting (For Parents)

    Science.gov (United States)

    ... child's normal diet vomiting that starts after a head injury vomiting accompanied by fever (100.4°F/38°C rectally in an infant younger than 6 months old or more than 101-102°F/38.3-38.9°C in an older child) vomiting of bright green or yellow-green ...

  5. Acupuncture Treatment of Vomiting

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.

  6. Cyclic Vomiting Syndrome

    Science.gov (United States)

    ... digestive diseases specialist (gastroenterologist). If you or your child is in the middle of a severe vomiting episode, the doctor may ... system disorders There's no cure for cyclic vomiting syndrome, so treatment ... may be prescribed: Anti-nausea drugs Sedatives Medications ...

  7. Nausea and Vomiting (PDQ)

    Science.gov (United States)

    ... to cause nausea and vomiting). A history of morning sickness during pregnancy . The earlier that anticipatory nausea and ... A history of motion sickness. A history of morning sickness. Dehydration . Malnutrition . Recent surgery . Radiation therapy . Patients who ...

  8. Emetophobia: A fear of vomiting.

    Science.gov (United States)

    Faye, Abhijeet D; Gawande, Sushil; Tadke, Rahul; Kirpekar, Vivek C; Bhave, Sudhir H

    2013-10-01

    Emetophobia is an intense, irrational fear of vomiting including fear of feeling nausea, seeing or hearing another person vomit, or seeing vomitus itself. It may occur at any age and we need to understand its symptomatology. We report a case of emetophobic child whose fear of vomiting started after an attack of acute appendicitis. In the initial stage, fear was limited to vomiting, later it became generalized to a fear of seeing the vomitus, worries that parents may suffer vomiting, fear of vomiting in public places followed by avoiding social activities. Patient improved on short course of anti-anxiety drugs and Graded Exposure Therapy.

  9. Diagnosis of Cyclic Vomiting

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-12-01

    Full Text Available In a study at Children’s Hospital, Ann Arbor, MI, and Children’s Memorial Hospital, Chicago, designed primarily to compare cost-effectiveness of three methods of management of cyclic vomiting cases, one group of patients received an extensive diagnostic evaluation, a second was treated with empiric antimigraine drugs for 2 months, and a third an upper GI series with small-bowel follow-through (UGI-SBFT plus empiric therapy.

  10. Opioid induced nausea and vomiting.

    Science.gov (United States)

    Smith, Howard S; Laufer, Andras

    2014-01-05

    Opioids are broad spectrum analgesics that are an integral part of the therapeutic armamentarium to combat pain in the palliative care population. Unfortunately, among the adverse effects of opioids that may be experienced along with analgesia is nausea, vomiting, and/or retching. Although it is conceivable that in the future, using combination agents (opioids combined with agents which may nullify emetic effects), currently nausea/vomiting remains a significant issue for certain patients. However, there exists potential current strategies that may be useful in efforts to diminish the frequency and/or intensity of opioid-induced nausea/vomiting (OINV).

  11. Prognosis of Cyclic Vomiting Syndrome

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2016-03-01

    Full Text Available Investigators from Teikyo University School of Medicine, Tokyo, Japan, evaluated the clinical features, prognosis, and prophylaxis of cyclic vomiting syndrome and the relationship between the syndrome and levels of adrenocorticotropic/antidiuretic hormones (ACTH/ADH.

  12. Nausea and Vomiting Caused by Cancer Treatment

    Science.gov (United States)

    ... prevent it. Risk of nausea and vomiting from cancer treatment Some drugs used for cancer treatment are more ... Options for preventing vomiting from drugs used for cancer treatment ASCO recommends the following options, based on the ...

  13. Vomiting Center reanalyzed: An electrical stimulation study

    Science.gov (United States)

    Miller, A. D.; Wilson, V. J.

    1982-01-01

    Electrical stimulation of the brainstem of 15 decerebrate cats produced stimulus-bound vomiting in only 4 animals. Vomiting was reproducible in only one cat. Effective stimulating sites were located in the solitary tract and reticular formation. Restricted localization of a vomiting center, stimulation of which evoked readily reproducible results, could not be obtained.

  14. Treatment of Nausea and Vomiting During Chemotherapy.

    Science.gov (United States)

    Mustian, Karen M; Devine, Katie; Ryan, Julie L; Janelsins, Michelle C; Sprod, Lisa K; Peppone, Luke J; Candelario, Grace D; Mohile, Supriya G; Morrow, Gary R

    2011-01-01

    Nausea and vomiting are two of the most troubling side effects patients experience during chemotherapy. While newly available treatments have improved our ability to manage nausea and vomiting, anticipatory and delayed nausea and vomiting are still a major problem for patients receiving chemotherapy. Many cancer patients will delay or refuse future chemotherapy treatments and contemplate stopping chemotherapy altogether because of their fear of experiencing further nausea and vomiting. The purpose of this article is to provide an overview of the patho-psychophysiology of chemotherapy-induced nausea and vomiting and the recommended guidelines for treatment.

  15. Chemotherapy-Induced Nausea and Vomiting.

    Science.gov (United States)

    Mustian, Karen M; Darling, Tom V; Janelsins, Michelle C; Jean-Pierre, Pascal; Roscoe, Joseph A; Morrow, Gary R

    2008-01-01

    Despite treatment advances, nausea and vomiting, especially anticipatory nausea and vomiting, delayed nausea and vomiting and nausea alone, are still the most common, expected and feared side effects among patients receiving chemotherapy. Of the 70 to 80% of cancer patients who experience chemotherapy-induced nausea and vomiting many will delay or refuse future chemotherapy treatments and contemplate stopping all treatments because of fear of further nausea and vomiting. The purpose of this chapter is to provide an overview of the patho-psychophysiology of CINV, the recommended guidelines for standard treatment, and highlight newer targeted treatment approaches.

  16. Vomiting Larry: a simulated vomiting system for assessing environmental contamination from projectile vomiting related to norovirus infection

    OpenAIRE

    Makison Booth, Catherine

    2014-01-01

    Infectious diseases such as norovirus can induce emesis (vomiting), which can be of a projectile nature. Although studies have been carried out on transmission, prevalence and decontamination of such micro-organisms within various environments, little is known about the extent to which the surrounding environment is contaminated when an individual vomits. This is an important consideration for infection control purposes. The aim of this study was to develop a simulated vomiting system (Vomiti...

  17. Vomiting Larry: a simulated vomiting system for assessing environmental contamination from projectile vomiting related to norovirus infection.

    Science.gov (United States)

    Makison Booth, Catherine

    2014-09-01

    Infectious diseases such as norovirus can induce emesis (vomiting), which can be of a projectile nature. Although studies have been carried out on transmission, prevalence and decontamination of such micro-organisms within various environments, little is known about the extent to which the surrounding environment is contaminated when an individual vomits. This is an important consideration for infection control purposes. The aim of this study was to develop a simulated vomiting system (Vomiting Larry) to be used for assessing the extent to which projected fluid can contaminate the environment. Vomiting Larry was set up within a Controlled Atmosphere Chamber (CAC) facility at the Health and Safety Laboratory (HSL). Simulated vomiting was undertaken using water as a vomitus substitute containing a fluorescent marker enabling small splashes, ordinarily missed, to be visualised using UV lighting. Experiments revealed that splashes and droplets produced during an episode of projectile vomiting can travel great distances (>3 m forward spread and 2.6 m lateral spread). The research highlighted that small droplets can be hard to see and therefore cleaning all contaminated surfaces is difficult to achieve. Evidence from this study suggests that areas of at least 7.8 m(2) should be decontaminated following an episode of projectile vomiting.

  18. Morning Sickness: Nausea and Vomiting of Pregnancy

    Science.gov (United States)

    ... better if I have nausea and vomiting of pregnancy? Diet and lifestyle changes may help you feel better. You may ... there medical treatment for nausea and vomiting of pregnancy? If diet and lifestyle changes do not help your symptoms, or if ...

  19. Vomiting as a reliable sign of concussion.

    Science.gov (United States)

    Ledic, Darko; Sosa, Ivan; Linic, Ines Strenja; Cvijanovic, Olga; Kovacevic, Miljenko; Desnica, Andrej; Banicek, Ivanka

    2012-01-01

    Concussion is the most common type of traumatic brain injury, with headache being the most frequent symptom of mild traumatic brain injury (MTBI) (including dizziness, vomiting, nausea, lack of motor coordination or difficulty balancing). Concussion may be caused by a blow to the head, or by acceleration forces without a direct impact. Often, MTBI occurs as the result of a sports injury. Loss of consciousness is always present, unlike vomiting. Therefore, we hypothesize vomiting to be considered as a cardinal sign of concussion. Stimulation of vomiting centres finally triggers vomiting. Professional boxers and mixed martial arts competitions reluctantly agree with stringent rules and protective clothing. We discuss the issue of further protection for those engaged in these and other sports. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Medical complications of self-induced vomiting.

    Science.gov (United States)

    Brown, Carrie A; Mehler, Philip S

    2013-01-01

    Bulimia nervosa, often characterized by self-induced vomiting, is complicated by medical manifestations that affect nearly every organ system in the body. Effects range from superficial skin and dental findings to esophageal pathology, electrolyte abnormalities, cardiac arrhythmias, and in extreme cases, death. Ultimately, cessation of vomiting is necessary to cure most associated medical complications. Improper management of medical complications may lead to significant psychological distress to the patient. Fortunately, efficacious treatments do exist both to ease symptoms and ideally help the patient make a smooth transition to cessation of self-induced vomiting behavior.

  1. Nausea and vomiting in advanced cancer.

    Science.gov (United States)

    Gordon, Pamela; LeGrand, Susan B; Walsh, Declan

    2014-01-05

    Nausea and vomiting are very common symptoms in cancer both treatment and non-treatment related. Many complications of advanced cancer such as gastroparesis, bowel and outlet obstructions, and brain tumors may have nausea and vomiting or either symptom alone. In a non-obstructed situation, nausea may be more difficult to manage and is more objectionable to patients. There is little research on management of these symptoms except the literature on chemotherapy induced nausea where guidelines exist. This article will review the etiologies of nausea and vomiting in advanced cancer and the medications which have been used to treat them. An etiology based protocol to approach the symptom is outlined.

  2. [Emetophobia: morbid fear of vomiting and nausea].

    Science.gov (United States)

    Snaebjarnardottir, Kolfinna; Sigurdsson, Engilbert

    2014-05-01

    Emetophobia is an intense, irrational fear or anxiety of or pertaining to vomiting. It is classified among specific phobias in ICD-10 and DSM-IV. This disorder is often hidden because of the shame associated with it among sufferers. As a result emetophobia has been studied less than most other anxiety disorders. Not much is known about the epidemiology, treatment and outcome of this disorder. We describe a woman in her thirties who has been living with emetophobia since she experienced emesis two successive Christmas Eves as a child. Subsequently her fear of vomiting has influenced many aspects of her daily life.

  3. Prediction of postoperative nausea and vomiting

    NARCIS (Netherlands)

    Bosch, Jolanda Eveline van den

    2006-01-01

    About 30 to 50 percent of patients who undergo surgery suffer from nausea or vomiting (PONV) after the operation. These side-effects of anesthesia are unpleasant for patients. Therefore, prevention of PONV is desirable. This may be achieved by selective administration of prophylactic anti-emetics or

  4. Hyperthyroidism as a cause of persistent vomiting.

    NARCIS (Netherlands)

    Hoogendoorn, E.H.; Cools, B.M.

    2004-01-01

    A 32-year-old woman presented with persistent vomiting, epigastric pain and weight loss. A sinus tachycardia was the clue to the diagnosis of hyperthyroidism due to Graves' disease. On treatment with propylthiouracil and a beta-blocking agent, her symptoms resolved within one day, even though her fr

  5. Nausea in Specific Phobia of Vomiting

    Directory of Open Access Journals (Sweden)

    Eugen Trinka

    2013-08-01

    Full Text Available Specific phobia of vomiting (SPOV is a clinical condition with early onset, chronic course and substantial psychosocial impairment due to a rigorous avoidance behavior. A primary symptom which drives patients to consult a medical practitioner is nausea. In this study our aim was to further analyze this symptom of SPOV and examined its role in the development and manifestation of the phobia. We conducted an internet survey in the german SPOV-internet-forum. We calculated a nausea score and grouped participants in a high- and low-nausea group to examine the relationship between nausea and characteristics of the fear of vomiting. In this sample (N = 131, nausea was fairly common in most participants with fear of vomiting. Participants in the high-nausea group had significantly higher ratings of subjective fear and significantly longer duration of fear of vomiting. Additionally, the high-nausea group contained more participants with a body mass index below 19 than the low-nausea group. The present findings suggest that nausea is a core symptom in SPOV which is closely related to intensity of the fear, duration of the fear, and body weight. Future research should investigate if nausea-specific design of treatment could improve therapy outcome.

  6. Morning Sickness: Nausea and Vomiting of Pregnancy

    Science.gov (United States)

    ... be given to treat nausea and vomiting of pregnancy: Vitamin B 6 and doxylamine—Vitamin B 6 is ... early pregnancy, usually starting before 9 weeks of pregnancy. Nutrients: Nourishing substances supplied through food, such as vitamins and minerals. Thyroid Gland: A butterfly-shaped gland ...

  7. Nausea in specific phobia of vomiting.

    Science.gov (United States)

    Höller, Yvonne; van Overveld, Mark; Jutglar, Heili; Trinka, Eugen

    2013-09-01

    Specific phobia of vomiting (SPOV) is a clinical condition with early onset, chronic course and substantial psychosocial impairment due to a rigorous avoidance behavior. A primary symptom which drives patients to consult a medical practitioner is nausea. In this study our aim was to further analyze this symptom of SPOV and examined its role in the development and manifestation of the phobia. We conducted an internet survey in the german SPOV-internet-forum. We calculated a nausea score and grouped participants in a high-and low-nausea group to examine the relationship between nausea and characteristics of the fear of vomiting. In this sample (N = 131), nausea was fairly common in most participants with fear of vomiting. Participants in the high-nausea group had significantly higher ratings of subjective fear and significantly longer duration of fear of vomiting. Additionally, the high-nausea group contained more participants with a body mass index below 19 than the low-nausea group. The present findings suggest that nausea is a core symptom in SPOV which is closely related to intensity of the fear, duration of the fear, and body weight. Future research should investigate if nausea-specific design of treatment could improve therapy outcome.

  8. Neurochemical mechanisms and pharmacologic strategies in managing nausea and vomiting related to cyclic vomiting syndrome and other gastrointestinal disorders.

    Science.gov (United States)

    Bashashati, Mohammad; McCallum, Richard W

    2014-01-05

    Nausea and vomiting are common gastrointestinal complaints which could be triggered by stimuli in both the peripheral and central nervous systems. They may be considered as defense mechanisms when threatening toxins/agents enter the gastrointestinal tract or there is excessive retention of gastrointestinal contents due to obstruction. The pathophysiology of nausea and vomiting is complex and much still remains unknown. Therefore, treatments are restricted or ineffective in many cases. Nausea and vomiting with functional etiologies including cyclic vomiting syndrome are challenging in gastroenterology. In this article, we review potential pathways, neurochemical transmitters, and their receptors which are possibly involved in the pathophysiology of nausea and vomiting including the entity cyclic vomiting syndrome.

  9. Management of chemotherapy-induced nausea and vomiting.

    LENUS (Irish Health Repository)

    Zubairi, Ishtiaq H

    2006-08-01

    Chemotherapy-induced nausea and vomiting are symptoms that cause major concern to oncology patients. This article explores the types of nausea and vomiting in the context of chemotherapy, and discusses their pathogenesis and management.

  10. Vomiting Disorder on Rise in Weed-Friendly Colorado

    Science.gov (United States)

    ... fullstory_162895.html Vomiting Disorder on Rise in Weed-Friendly Colorado Doctors say problem may become more ... Jan. 5, 2017 (HealthDay News) -- Long-term heavy marijuana use can cause chronic vomiting and abdominal pain ...

  11. Anticipatory nausea and vomiting due to chemotherapy.

    Science.gov (United States)

    Kamen, Charles; Tejani, Mohamedtaki A; Chandwani, Kavita; Janelsins, Michelle; Peoples, Anita R; Roscoe, Joseph A; Morrow, Gary R

    2014-01-05

    As a specific variation of chemotherapy-induced nausea and vomiting, anticipatory nausea and vomiting (ANV) appears particularly linked to psychological processes. The three predominant factors related to ANV are classical conditioning; demographic and treatment-related factors; and anxiety or negative expectancies. Laboratory models have provided some support for these underlying mechanisms for ANV. ANV may be treated with medical or pharmacological interventions, including benzodiazepines and other psychotropic medications. However, behavioral treatments, including systematic desensitization, remain first line options for addressing ANV. Some complementary treatment approaches have shown promise in reducing ANV symptoms. Additional research into these approaches is needed. This review will address the underlying models of ANV and provide a discussion of these various treatment options.

  12. Chemotherapy induced nausea AND vomiting (CINV

    Directory of Open Access Journals (Sweden)

    Bannur R. Nandeesh

    2012-06-01

    Full Text Available Chemotherapy is the first line treatment in management of many cancers, both for cure and palliation; hence it’s crucial to minimize the unpleasant side effects of chemotherapy to increase tolerability to chemotherapy. Most of the conventional anti cancer drugs are emetogenic. Patients receiving chemotherapy experience different degrees of nausea and vomiting depending on the emetogenic potential of the anti cancer drugs given and the patient characteristics. With a better understanding of the pathophysiology, distinct phases of chemotherapy-induced nausea and vomiting (CINV i.e., acute emesis, delayed emesis and anticipatory emesis have been identified. Identification of various mediators has led to the development of different drugs acting through different mechanisms which are useful in the prevention and treatment of CINV. Serotonin receptor three (5-HT3 antagonists, corticosteroids and neurokinin type one receptor (NK-1 antagonists are of proven usefulness and have wide therapeutic indexes in the prevention of CINV. Other drugs like dopamine receptor antagonists & benzodiazepines are not routinely used because of their narrow therapeutic index. Practice guidelines for prevention of CINV will not only improve patient’s tolerability to chemotherapy & wellbeing, but also decrease hospital stay and overall cost of treatment of the patient. [Int J Basic Clin Pharmacol 2012; 1(3.000: 125-131

  13. Children's vomiting following posterior fossa surgery: A retrospective study

    Directory of Open Access Journals (Sweden)

    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  14. A Chronic Psychogenic Vomiting Case of Dramatic Response to Escitalopram

    Directory of Open Access Journals (Sweden)

    Onur OZTURK

    2016-06-01

    Full Text Available This case report describes the treatment of an interesting patient with vomiting for years. The patient admitted to the family health center with chronic vomiting and weight loss. Her physical examination was unremarkable. The complaint of patient in who organic pathogen were excluded by biochemical and radiological examinations was evaluated psychologically; her complaints were ended following the initiation of escitalopram therapy unlike previous treatment. In this report, we represent a specific patient for the escitalopram treatment and thanks to this, it contributes a unique sample to the literature about escitalopram usage in the treatment of chronic vomiting.

  15. Association of Marijuana Use and Cyclic Vomiting Syndrome

    Directory of Open Access Journals (Sweden)

    Mithun B. Pattathan

    2012-06-01

    Full Text Available Cannabis use has become one of the most commonly abused drugs in the world. It is estimated that each year 2.6 million individuals in the USA become new users and most are younger than 19 years of age. Reports describe marijuana use as high as 40–50% in male Cyclic Vomiting Syndrome patients. It is this interest in cannabis in the World, coupled with recognition of a cyclic vomiting illness associated with its chronic use that beckons a review of the most current articles, as well as a contribution from our own experiences in this area. The similarities we have demonstrated for both cannibinoid hyperemesis syndrome and cyclic vomiting make the case that cannibinoid hyperemesis syndrome is a subset of patients who have the diagnoses of cyclic vomiting syndrome and the role of marijuana should always be considered in the diagnosis of CVS, particularly in males.

  16. Nursing interventions to prevent or relieve postoperative nausea and vomiting.

    Science.gov (United States)

    Hinojosa, R J

    1992-02-01

    The purpose of this study was to identify documented interdependent and independent nursing interventions to prevent or relieve nausea and vomiting during the first 24 hours following uncomplicated cholecystectomy. A systematic sampling method was used to select 40 hospital records from 1986 to 1988. Results showed that nausea and vomiting was documented in only two PACU records and nine postoperative nursing unit records. Documentation was typically brief or absent altogether. There was no way to determine if this meant no occurrence of nausea and vomiting or just that interventions were not documented. Lack of interventions may be due to a fear of potentiating the anesthesia or belief that symptoms would subside with time. Documented interventions included repositioning patients (independent) and administering medications (interdependent). This study illustrates the need for education about nurses' responsibility to prevent or relieve postoperative nausea and vomiting and the importance in documenting the interventions used.

  17. Ice massage on chemotherapy induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Mehdi Sadeghi Shermeh

    2012-05-01

    Full Text Available Background and Aim: Nausea and vomiting are the most common side effects of chemotherapy. The aim of the current study was to assess the effect of ice massage applied to the pericardium 6 (P6 or Neigaun acupuncture point on nausea– vomiting due to chemotherapy in cancer patient. Materials and Methods: In a randomized clinical trial one- blind, 114 patients were randomly divided into three groups. Ice massage group were massaged gently on the skin around P6 point of the hand with ice cube into a wet gauze pad for 7 minutes twice a day with 12-hours interval for 24 hours by the patient. Placebo group were massaged with wooden cube and the control group received no interventions. Nausea and vomiting in three groups rated by Morrow Assessment of Nausea and Emesis (MANE Questionnaire in 4 periods of time in 24 hours was used for the assessment of nausea and vomiting. Results: There were significant decreases in the frequency of nausea (P<0.01 and vomiting (P<0.03 and a decrease in the intensity of nausea (P=0.63 and vomiting (P=0.34 in the case group. Frequency of nausea was significantly lower among placebo group than the control group (P<0.02. Conclusion: Ice massage on Neigaun point is effective on reducing the frequency of chemotherapy induced nausea and vomiting in cancer patients. Placebos, patient-practitioner relationship, suggestion, and the patient's view on nausea and vomiting and the role of interaction between the therapist and the patient is effective to some extent.

  18. Current Concepts in the Management of Postoperative Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    S. Chatterjee

    2011-01-01

    Full Text Available Postoperative nausea and vomiting (PONV are still common following surgery. This is not only distressing to the patient, but increases costs. The thorough understanding of the mechanism of nausea and vomiting and a careful assessment of risk factors provide a rationale for appropriate management of PONV. Strategy to reduce baseline risk and the adoption of a multimodal approach will most likely ensure success in the management of PONV.

  19. [Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment].

    Science.gov (United States)

    Gómez-Arnau, J I; Aguilar, J L; Bovaira, P; Bustos, F; De Andrés, J; de la Pinta, J C; García-Fernández, J; López-Alvarez, S; López-Olaondo, L; Neira, F; Planas, A; Pueyo, J; Vila, P; Torres, L M

    2010-10-01

    Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Española de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.

  20. A New Approach to the Prophylaxis of Cyclic Vomiting: Topiramate

    Science.gov (United States)

    Sezer, Oya B; Sezer, Taner

    2016-01-01

    Background/Aims The aim of this study was to compare the efficacy and tolerability of topiramate and propranolol in preventing pediatric cyclic vomiting syndrome. Methods A retrospective medical-record review of patients who underwent prophylaxis after receiving a diagnosis of cyclic vomiting syndrome was performed. Patients who completed at least 12 months of treatment were included in the analysis. Responder rate, and adverse-event rates were also calculated from all patients. Response to treatment was assessed as the total number of vomiting attacks per year. Patients in whom the frequency of vomiting attack reduced greater or equal to 50% were defined as responders, and the remaining patients were classified as nonresponders. Results A total of 38 patients who were treated prophylactically with either topiramate (16 patients) or propranolol (22 patients) were identified. Fifty-nine percent of the patients in the propranolol group and 81% of the patients in the topiramate group reported freedom from attacks. A decrease of more than 50% in attacks per year occurred in 23% of patients in the propranolol group and 13% of patients in the topiramate group. The responder rates were 81% for propranolol group and 94% for topiramate group (P = 0.001). Despite minor adverse effects (drowsiness, nervousness, and dizziness) observed in a few patients, the adverse event rates were not significantly different between the 2 groups (P = 0.240). Conclusions The efficacy of topiramate was superior to propranolol for the prophylaxis of pediatric cyclic vomiting syndrome. PMID:27302967

  1. Gastric Duplication: A Rare Cause of Recurrent Vomiting

    Science.gov (United States)

    Koduri, Brahmananda; Yost, Christina; Goodman, Michael H.; Hoelzer, Dennis

    2017-01-01

    Vomiting is a physical finding that can occur at any age but presents the greatest challenge when it is recurrent in a child. The etiology is varied (Sieunarine and Manmohansingh, 1989; Suzuki, 1982), and recurrent vomiting can be a symptom of life threatening medical or surgical emergencies. Early recognition is mandatory for preventing delay in management and potential complications. Gastric duplication is rare and mostly diagnosed in infancy with only a few cases documented in the medical literature presenting in childhood. We present a three-year-old Vietnamese female with recurrent vomiting. Obstruction and sepsis were ruled out as a cause of the recurrent vomiting by history and appropriate tests. Persistent vomiting and paucity of air on the plain abdominal films provided a clue to the diagnosis. A CT scan of the abdomen with contrast revealed a uniformly thin walled fluid attenuation mass in the epigastric region which did not opacify with contrast. An abdominal ultrasound confirmed gastric duplication cyst and the patient was taken to the operating room for excision of the cyst.

  2. Can nausea and vomiting be treated with ginger extract?

    Science.gov (United States)

    Giacosa, A; Morazzoni, P; Bombardelli, E; Riva, A; Bianchi Porro, G; Rondanelli, M

    2015-04-01

    Ginger (Zingiber officinale) is a spice traditionally used to treat indigestion, nausea and vomiting. Ginger extracts accelerate gastric emptying and stimulate gastric antral contractions. These effects are mainly due to the presence of gingerols and shogaols and their activity on cholinergic M receptors and serotonergic 5-HT and 5-HT receptors. Various researches on this subject have led to controversial results, due to the chemical instability of ginger extracts and particularly of gingerols, which are readily-oxidizable substances. A systematic review of double-blind, placebo-controlled, randomized studies highlighted the potential efficacy of ginger on the prevention and treatment of nausea and vomiting of various origins, even though additional controlled studies are needed. This review focuses on pregnancy-induced nausea and vomiting and on chemotherapy induced nausea, and hypothesizes a therapeutic role for ginger extracts in case of side effects, as an alternative to traditional prokinetic drugs such as domperidone, levosulpiride or metoclopramide.

  3. Alternative Methods to Treat Nausea and Vomiting from Cancer Chemotherapy

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Sheikhi

    2015-01-01

    Full Text Available Chemotherapy Induced Nausea and Vomiting (CINV is among the most intensive side effects and critical concerns for patients with cancer. Most of these patients experience nausea and vomiting after chemotherapy. Sometimes, this is so annoying that it may prevent them from continuing the therapy. With the recent advances, a variety of therapeutic methods are innovated and applied to control CINV. Among them, the main methods include medicinal therapy, relaxation, and herbal therapy. Yet, using dexamethasone together with massage therapy and ginger is identified as the most effective method.

  4. Nausea and vomiting of pregnancy: An evolutionary hypothesis

    OpenAIRE

    LEE,RICHARD V

    2002-01-01

    Nausea and vomiting of pregnancy, "morning sickness", is a common contemporary complaint. Many pregnant patients note alterations in smell and taste which can precipitate "morning sickness", symptoms that characterize early gestation. Epidemiologic studies suggest that pregnancies accompanied by "morning sickness" have better outcomes than asymptomatic pregnancies. The intimate connection between immunogenetic identity, chemoidentity, and chemocommunication by olfactory mechanisms suggests a ...

  5. Intraoperative Gastric Suctioning and Postoperative Nausea, Retching, and Vomiting.

    Science.gov (United States)

    1984-07-01

    retching, and vomiting was investigated in nineteen adult female pa- tients undergoing general anesthesia for elective laparoscopy in an ambulatory...tients undergoing general anesthesia for elective laparoscopy in an ambulatory surgical setting. Eight ... patients in the control group received no...which may be related to higher gonadotropin levels (Bell- ville, 1961). Obesity which is associated with delayed gastric emptying, increased

  6. Ginger as a miracle against chemotherapy-induced vomiting

    Science.gov (United States)

    Yekta, Zohreh Parsa; Ebrahimi, Seyyed Meisam; Hosseini, Mostafa; Nasrabadi, Alireza Nikbakht; Sedighi, Sanambar; Surmaghi, Mohammad-Hosein Salehi; Madani, Hossein

    2012-01-01

    Background: Vomiting is one of the most prevalent side effects of chemotherapy in cancer patients. The aim of this study was to evaluate the effect of ginger plant on chemotherapy-induced vomiting, since the previous studies were somehow imperfect and have provided controversial results. Materials and Methods: This randomized double-blind placebo-controlled clinical trial was conducted on 80 women with breast cancer undergoing chemotherapy and suffering from vomiting in Imam Khomeini Hospital, Tehran, Iran, between July and December 2009. During a convenience sampling the participants were randomly allocated into treatment and placebo groups after taking a written informed consent. Two groups were matched based on the age and emetic risk of chemotherapy drugs. The treatment group received 250 mg ginger powder capsules (Zintoma) and placebo group 250 mg starch capsules 4 times a day (1 g/day) for 6 days since 3 days before chemotherapy session. A two-part self-made questionnaire was used to assess the effect of ginger. Patients completed the instrument every day. Then by STATA software version 8, the gathered data were analyzed using Fisher’s exact, Kruskal-Wallis, and Chi-square tests. Results: The 2 groups had no significant age differences and were matched (ginger: 41.8±8.4 vs placebo: 45.1±10, P = 0.1). Vomiting cases were significantly lower in ginger group at anticipatory (P = 0.04), acute (P = 0.04), and delayed (P = 0.003) phases. Also, heartburn was the only and venial reported side effect (P > 0.05). Conclusions: Taking ginger capsules (for 6 days since 3 days before chemotherapy) accompanied by the routine antiemetic treatment could relieve chemotherapy-induced vomiting in all phases. PMID:23853643

  7. The Central Nervous Connections Involved in the Vomiting Reflex

    Science.gov (United States)

    Brizzee, K. R.; Mehler, W. R.

    1986-01-01

    The vomiting reflex may be elicited by a number of different types or classes of stimuli involving many varieties of receptor structures and considerable diversity in afferent pathways and central connections. Central relay or mediating structures thus may vary widely according to the type of initial emetic stimulus. The emetic circuits which have been most completely delineated to date are probably those in which the Chemoreceptor Trigger Zone (CTZ) in the Area Postrema (AP) functions as a key mediating structure. Even in this system, however, there are large gaps in our knowledge of the nerve tracts and central nervous connections involved. Knowledge of most other emetic circuits subserving the emetic reflex resulting from many diverse types of stimuli such, for example, as emotional stress (e.g. psychogenic vomiting, Wruble et al. 1982), pain (e.g. testicular trauma), and chemical or mechanical irritation of the gastrointestinal tract or urinary tract is quite incomplete at this time, thus precluding any very adequate description of their central connections at present. One physiological system, however, which has received considerable attention recently in relation to the vomiting reflex elicited by motion stimuli is the vestibular system. Due to the paucity of data on central nervous connections of several or the non-vestibular types of emetic stimuli cited above, we will devote most of our attention in this brief review to the central connections of the vestibular system which seem likely to be involved in the vomiting response to motion stimuli. However, the latter part of the review will be concerned with the concept of the reticular vomiting centre in relation to the ParviCellular Reticular Formation (PCRF), and will thus probably pertain to all of the many classes of emetic stimuli since it will address the question of the final common emetic pathway.

  8. Vomiting as a Symptom and Transmission Risk in Norovirus Illness: Evidence from Human Challenge Studies

    National Research Council Canada - National Science Library

    Kirby, Amy E; Streby, Ashleigh; Moe, Christine L

    2016-01-01

    .... Outbreak investigations frequently implicate vomiting as a major transmission risk. However, little is known about the characteristics of vomiting as a symptom or the amount of virus present in emesis...

  9. Aerosolization of a Human Norovirus Surrogate, Bacteriophage MS2, during Simulated Vomiting

    National Research Council Canada - National Science Library

    Tung-Thompson, Grace; Libera, Dominic A; Koch, Kenneth L; de Los Reyes, 3rd, Francis L; Jaykus, Lee-Ann

    2015-01-01

    .... Epidemiological studies of outbreaks have suggested that vomiting facilitates transmission of human NoV, but there have been no laboratory-based studies characterizing the degree of NoV release during a vomiting event...

  10. Aerosolization of a Human Norovirus Surrogate, Bacteriophage MS2, during Simulated Vomiting: e0134277

    National Research Council Canada - National Science Library

    Grace Tung-Thompson; Dominic A Libera; Kenneth L Koch; L de los Reyes III; Lee-Ann Jaykus

    2015-01-01

    .... Epidemiological studies of outbreaks have suggested that vomiting facilitates transmission of human NoV, but there have been no laboratory-based studies characterizing the degree of NoV release during a vomiting event...

  11. The additional effect of granisteron over propofol and sevoflurane on prophylaxis of vomiting after pediatric adenotonsillectomy

    Directory of Open Access Journals (Sweden)

    Ibrahim Rezk

    2014-07-01

    Conclusions: On performing adenotonsillectomy in children, the incidence of postoperative vomiting is lower with (i.v. anesthetics propofol than (volatile anesthetics sevoflurane. Use of granisteron significantly reduces the incidence of postoperative vomiting in children undergoing this procedure.

  12. Advantageous Use of Hypnosis in a Case of Psychogenic Vomiting.

    Science.gov (United States)

    Chandrashekhar, Roopa

    2016-04-01

    This case study describes in detail the role of hypnosis in treatment of a case of psychogenic vomiting. The patient, a 60-yearold woman, had been suffering for 9 months from episodes of vomiting which resulted in weight loss, dehydration, and hypokalemia. She was a conscientious woman with high standards of behavior, which did not allow an expression of the extreme hostility she felt toward her daughter-in-law. Hypnotherapeutic sessions reduced her anxiety, restored her sleep, improved mood, and helped deepen rapport, all of which created the ideal setting for Gestalt's empty chair technique. Integrating hypnosis greatly enhanced the quality of the empty chair dialogue, which by bringing about a shift in the patient's emotions from hostility to sympathy, facilitated recovery.

  13. The pharmacologic management of nausea and vomiting of pregnancy.

    Science.gov (United States)

    Niebyl, Jennifer R; Briggs, Gerald G

    2014-02-01

    Nausea and vomiting are common in early pregnancy. Forty percent or more of pregnant women may continue to suffer beyond the first trimester and 10% beyond the second trimester. A focus of the assessment is to confirm that the nausea and vomiting is due to the pregnancy and not some other cause. Nonpharmacologic options, particularly dietary modification, are a mainstay of treatment. For those who continue to experience symptoms, pharmacologic management can be employed. The combination of doxylamine succinate/pyridoxine hydrochloride was reintroduced in the United States following FDA approval in early 2013. The product was given a pregnancy safety rating of A and is recommended as first-line pharmacologic treatment for NVP. Other options include antihistamines, metoclopramide, ondansetron, phenothiazines, and after the first trimester, corticosteroids.

  14. Bilateral spontaneous chylothorax after severe vomiting in children

    Science.gov (United States)

    Rodrigues, Antonio Lucas Lima; Romaneli, Mariana Tresoldi das Neves; Ramos, Celso Dario; Fraga, Andrea de Melo Alexandre; Pereira, Ricardo Mendes; Appenzeller, Simone; Marini, Roberto; Tresoldi, Antonia Teresinha

    2016-01-01

    Abstract Objective: To report the case of a child with bilateral chylothorax due to infrequent etiology: thoracic duct injury after severe vomiting. Case description: Girl, 7 years old, with chronic facial swelling started after hyperemesis. During examination, she also presented with bilateral pleural effusion, with chylous fluid obtained during thoracentesis. After extensive clinical, laboratory, and radiological investigation of the chylothorax etiology, it was found to be secondary to thoracic duct injury by the increased intrathoracic pressure caused by the initial manifestation of vomiting, supported by lymphoscintigraphy findings. Comments: Except for the neonatal period, chylothorax is an infrequent finding of pleural effusion in children. There are various causes, including trauma, malignancy, infection, and inflammatory diseases; however, the etiology described in this study is poorly reported in the literature. PMID:27178371

  15. Treating nausea and vomiting in palliative care: a review

    Directory of Open Access Journals (Sweden)

    Glare P

    2011-09-01

    Full Text Available Paul Glare, Jeanna Miller, Tanya Nikolova, Roma TickooPain and Palliative Care Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USAAbstract: Nausea and vomiting are portrayed in the specialist palliative care literature as common and distressing symptoms affecting the majority of patients with advanced cancer and other life-limiting illnesses. However, recent surveys indicate that these symptoms may be less common and bothersome than has previously been reported. The standard palliative care approach to the assessment and treatment of nausea and vomiting is based on determining the cause and then relating this back to the “emetic pathway” before prescribing drugs such as dopamine antagonists, antihistamines, and anticholinergic agents which block neurotransmitters at different sites along the pathway. However, the evidence base for the effectiveness of this approach is meager, and may be in part because relevance of the neuropharmacology of the emetic pathway to palliative care patients is limited. Many palliative care patients are over the age of 65 years, making these agents difficult to use. Greater awareness of drug interactions and QTc prolongation are emerging concerns for all age groups. The selective serotonin receptor antagonists are the safest antiemetics, but are not used first-line in many countries because there is very little scientific rationale or clinical evidence to support their use outside the licensed indications. Cannabinoids may have an increasing role. Advances in interventional gastroenterology are increasing the options for nonpharmacological management. Despite these emerging issues, the approach to nausea and vomiting developed within palliative medicine over the past 40 years remains relevant. It advocates careful clinical evaluation of the symptom and the person suffering it, and an understanding of the clinical pharmacology of medicines that are available for palliating

  16. Postoperative vomiting and fever following tonsillectomy in Enugu, Nigeria.

    Science.gov (United States)

    Okafor, U V; Nwosu, J N; Onyekwulu, F A

    2013-01-01

    To determine the incidence of postoperative vomiting and fever in patients that had tonsillectomy in our centre over a five year period. The hospital records (case files) of patients that had tonsillectomy with or without adenoidectomy under general anaesthesia at the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria from January 2004 to December 2008 were retrieved and analyzed. Patients that had an adenoidectomy only were excluded. The patients were of the American Society of Anesthesiologists (ASA) I to III status. There were fifty two (52) patients that had tonsillectomy and adenotonsillectomy under general anaesthesia during the period under review. Forty one (41) patients were between the ages of 1-13 years (78%) and eleven (11) patients between the ages of 18-62 years (12%). There were 32 males and 20 females. The average age for all the patients was 9.03 years. There were seven (7) patients with post operative vomiting (13.4%). These included four (4) patients in the paediatric population (9.75%) and three (3) in the adult population (27.2%). Twenty one (21) patients (40.3%) developed postoperative fever. There were no deaths The other significant morbidity was postoperative pain. The number of patients that had tonsillectomy in our center was small compared to other studies. The incidence of postoperative vomiting in this study is lower than that reported from Western World, showing possible racial variations, a trend that has been reported in some earlier studies in Black populations.

  17. Type 1 diabetes complicated with uncontrollable adult cyclic vomiting syndrome: a case report

    OpenAIRE

    Ogiso, Kazuma; Koriyama, Nobuyuki; Akao, Ayako; Otsuji, Mayumi; Goto, Takahiko; Fujisaki, Natsuko; Minobe, Machiko; Kinowaki, Mayumi; Matsuki, Shigeru

    2015-01-01

    We herein describe the case of a 29-year-old woman with type 1 diabetes from 10 years of age who developed adult cyclic vomiting syndrome. Beginning at 25 years of age, she was frequently hospitalized for stress-induced vomiting. Her vomiting episodes developed acutely and remitted after severe vomiting of more than 30 times a day for a few days. The vomiting periods were accompanied by leukocytosis with a predominance of neutrophils, high blood pressure and fever. In addition, it was noted t...

  18. Eosinophilia in a patient with cyclical vomiting: a case report

    Directory of Open Access Journals (Sweden)

    Fitzgerald S Matthew

    2004-05-01

    Full Text Available Abstract Background Eosinophilic gastritis is related to eosinophilic gastroenteritis, varying only in regards to the extent of disease and small bowel involvement. Common symptoms reported are similar to our patient's including: abdominal pain, epigastric pain, anorexia, bloating, weight loss, diarrhea, ankle edema, dysphagia, melaena and postprandial nausea and vomiting. Microscopic features of eosinophilic infiltration usually occur in the lamina propria or submucosa with perivascular aggregates. The disease is likely mediated by eosinophils activated by various cytokines and chemokines. Therapy centers around the use of immunosuppressive agents and dietary therapy if food allergy is a factor. Case presentation The patient is a 31 year old Caucasian female with a past medical history significant for ulcerative colitis. She presented with recurrent bouts of vomiting, abdominal pain and chest discomfort of 11 months duration. The bouts of vomiting had been reoccurring every 7–10 days, with each episode lasting for 1–3 days. This was associated with extreme weakness and cachexia. Gastric biopsies revealed intense eosinophilic infiltration. The patient responded to glucocorticoids and azathioprine. The differential diagnosis and molecular pathogenesis of eosinophilic gastritis as well as the molecular effects of glucocorticoids in eosinophilic disorders are discussed. Conclusions The patient responded to a combination of glucocorticosteroids and azathioprine with decreased eosinophilia and symptoms. It is likely that eosinophil-active cytokines such as interleukin-3 (IL-3, granulocyte macrophage colony stimulating factor (GM-CSF and IL-5 play pivotal roles in this disease. Chemokines such as eotaxin may be involved in eosinophil recruitment. These mediators are downregulated or inhibited by the use of immunosuppressive medications.

  19. Nausea, vomiting and return of bowel function after colorectal surgery.

    Science.gov (United States)

    Barclay, Karen L; Zhu, Ying-Yan; Tacey, Mark A

    2015-11-01

    Although patterns of return of bowel function (ROBF) following colorectal surgery with enhanced recovery after surgery (ERAS) programmes have been well delineated, regular morphine use is uncommon. This study describes the patterns of post-operative nausea and vomiting (PONV) and ROBF in this context. Patients undergoing elective major colorectal surgery on an ERAS programme over 1 year were included. Patient details, intra-operative course, post-operative management, outcomes and complications were collected retrospectively from clinical records. Statistical analysis was performed using Stata version 12. A total of 136/142 (96%) patients received morphine for post-operative analgesia. Most (112/142, 79%) experienced either no vomiting (87/142, 61%) or small amounts (25/142, 18%). On average, patients without an ileostomy passed flatus and opened their bowels after 2.4 and 4.3 days, those with an ileostomy taking 1.5 and 2.1 days. Vomiting was not related to ROBF (P = 0.370) or overall complications; wound complications (odds ratio (OR) = 8.1, 95% confidence interval (CI): 2.0-32.5), electrolyte abnormalities (OR = 2.9, 95% CI: 1.2-7.1) and length of stay (hazard ratio = 1.3, 95% CI: 1.2-1.5) were related. Most patients do not experience PONV in this context. ROBF is predictable without prolonged delays. This information could be used to allow confident early discharge and identify patients whose deviation from normal may indicate complications. © 2015 Royal Australasian College of Surgeons.

  20. Prevalence and persistence of nausea and vomiting along the pregnancy

    Directory of Open Access Journals (Sweden)

    Pluvio J. Coronado

    2014-05-01

    Full Text Available Background/aims: Nausea and vomiting of pregnancy (NVP impact in the pregnant woman's quality of life, especially when are persistent or severe. The objective is to estimate the prevalence and factors associated with the persistence of NVP in each trimester of pregnancy. Methods: We studied a cohort of 263 pregnant women with gestational age < 12 weeks. Data were collected using the Gastro-Esophageal Reflux Questionnaire validated for use in the Spanish population. Data were collected through telephone interviews at the end of each trimester of pregnancy. The main variable was the presence of NVP in each trimester and their persistence along the pregnancy. Results: The prevalence of nausea in the each trimester was 63.5 %, 33.8 %, 26.2 %, and vomiting was 29.3 %, 22.1 %, 14.1 %, respectively. Factors associated with nausea in the first trimester were Latin-American origin (OR: 3.60, 95 %IC 1.61-80.5 and primary education (OR: 0.31; 0.13-0.73; vomiting was associated with Latin-American origin (OR: 13.80, 1.82-104.4 and was inversely associated with weight gain (OR: 0.58, 0.35-0.97. Persistence of NVP were only associated with suffering the symptom in the previous trimester (p < 0.01, and did not find other predictor factors. Conclusions: NVP's prevalence declines along pregnancy, is associated with race and inversely with weight gain, and its persistence over time cannot be predicted.

  1. A new pharmacologic treatment for nausea and vomiting of pregnancy.

    Science.gov (United States)

    Fantasia, Heidi Collins

    2014-01-01

    Nausea and vomiting of pregnancy (NVP) affects up to 80 percent of pregnant women. This condition is usually self-limiting, but the symptoms can be distressing and interfere with work, social activities and sleep. Symptoms can often be managed by diet and lifestyle changes, but these interventions may not be successful for everyone. In April 2013, the U.S. Food and Drug Administration approved doxylamine succinate 10 mg/pyridoxine hydrochloride 10 mg (Diclegis) as the first medication to specifically treat NVP in more than 30 years. This article reviews the indications, dosage and nursing interventions associated with using doxylamine succinate/pyridoxine to treat NVP.

  2. Hypnosis for the Management of Anticipatory Nausea and Vomiting

    Science.gov (United States)

    Kravits, Kathy G.

    2015-01-01

    CASE STUDYBJ is a 34-year-old woman who was diagnosed with metastatic breast cancer. She was treated with surgical removal of the primary tumor and sentinel node biopsy. Following surgery, she received chemotherapy. She was given antiemetic therapy prior to and immediately following chemotherapy. She began to experience significant and persistent nausea with intermittent episodes of vomiting after the second cycle of chemotherapy. She completed her chemotherapy but still experienced nausea and vomiting in response to several cues, such as smelling food cooking and going to the hospital. Her nausea and vomiting resulted in segregation from her family during meal time, which negatively impacted her quality of life. A hypnosis consultation was requested, and BJ was cooperative. She reported feeling very nauseated at the time of the interview. Hypnosis was discussed; her questions were answered, and the potential risks and benefits of hypnosis were reviewed. She agreed that she would like to try hypnosis. A hypnosis assessment was conducted and revealed that she had a history of profound motion sickness and severe, chronic childhood trauma associated with feelings of anxiety and hypervigilance. The therapeutic suggestions that were used with BJ included hypnotic suggestions for relaxation and removal of discomfort. A metaphor describing the central processing of the anticipatory nausea and vomiting as a thermostat that could be adjusted to reduce and eliminate the sensation was used to suggest that she could control her perceptions and in turn control the nausea. Posthypnotic suggestions included that at the earliest awareness of discomfort, rubbing the throat would eliminate that discomfort, and cooking aromas would be transformed into her favorite fragrance. Reversal went smoothly, and BJ reported satisfaction with the experience. BJ experienced significant reduction in symptoms after the first session. She had two more sessions, at which time she was able to eat

  3. Anorexia resulting from fear of vomiting in four adolescent girls.

    Science.gov (United States)

    Manassis, K; Kalman, E

    1990-08-01

    Four adolescent girls were referred for psychiatric assessment because of suspected anorexia nervosa. Although all of them had lost at least 15% of their body weight, investigation showed that they did not meet the criteria for anorexia nervosa. In all cases, refusal to eat resulted from fear of vomiting following a viral illness and not from a desire to lose weight. Their family configurations and personal histories showed many similarities, including constricted range of affect and a notable lack of anger. With counseling and, in one case, psychotropic medication, the patients recovered promptly.

  4. Pattern of cerebral glucose metabolism on F-18 FDG brain PET during vomiting and symptom free periods in cyclic vomiting syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yu Kyeong; Lee, Dong Soo; Kang, Eun Joo; Seo, Jeong Kee; Yeo, Jeong Seok; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2001-06-01

    Cyclic Vomiting Syndrome (CVS) is characterized by recurrent, periodic, self-limiting vomiting. However, its pathogenesis is not yet established. We investigated the changes of the cerebral glucose metabolism using F-18 FDG during the vomiting attack and symptom free period in two children with CVS. FDG PET study showed the markedly increased metabolism in both temporal lobes and also in the medulla and cerebellum during the vomiting period. Also, FDG PET showed the decreased metabolism in the parieto-occipital and occipital areas during the in vomiting period. The area with decreased metabolism seemed to be related with the region showing abnormalities in EEG and perfusion SPECT studies. We expect that what we observed would be a helpful finding in clarifying the pathogenesis of the CVS.

  5. Alternative Therapies for the Prevention of Postoperative Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Nicoleta eStoicea

    2015-12-01

    Full Text Available Post-operative nausea and vomiting (PONV is a complication affecting between 20% and 40% of all surgery patients, with high-risk patients experiencing rates of up to 80%. Recent studies and publications have shed light on the uses of alternative treatment for PONV, through their modulation of endogenous opioid neuropeptides and neurokinin ligands. In addition to reducing PONV, hypnosis was reported to be useful in attenuating postoperative pain, anxiety, and contributing to hemodynamic stability. Music therapy has been utilized to deepen the sedation level and decrease patient anxiety, antiemetic and analgesic requirements, hospital length of stay, and fatigue. Isopropyl alcohol and peppermint oil aromatherapy have both been used to reduce postoperative nausea. With correct training in traditional Chinese healing techniques, acupuncture (APu at the P6 acupoint has also been shown to be useful in preventing early PONV, post-discharge nausea and vomiting, and alleviating of pain. Electro-acupuncture (EAPu, as with APu, provided analgesic and antiemetic effects through release of opioid neuropeptides and modulation. These non-pharmacological modalities of treatment contribute to an overall patient wellbeing, assisting in physical and emotional healing.

  6. Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting.

    Science.gov (United States)

    Horn, Charles C; Wallisch, William J; Homanics, Gregg E; Williams, John P

    2014-01-05

    Clinical research shows that postoperative nausea and vomiting (PONV) is caused primarily by the use of inhalational anesthesia and opioid analgesics. PONV is also increased by several risk predictors, including a young age, female sex, lack of smoking, and a history of motion sickness. Genetic studies are beginning to shed light on the variability in patient experiences of PONV by assessing polymorphisms of gene targets known to play roles in emesis (serotonin type 3, 5-HT3; opioid; muscarinic; and dopamine type 2, D2, receptors) and the metabolism of antiemetic drugs (e.g., ondansetron). Significant numbers of clinical trials have produced valuable information on pharmacological targets important for controlling PONV (e.g., 5-HT3 and D2), leading to the current multi-modal approach to inhibit multiple sites in this complex neural system. Despite these significant advances, there is still a lack of fundamental knowledge of the mechanisms that drive the hindbrain central pattern generator (emesis) and forebrain pathways (nausea) that produce PONV, particularly the responses to inhalational anesthesia. This gap in knowledge has limited the development of novel effective therapies of PONV. The current review presents the state of knowledge on the biological mechanisms responsible for PONV, summarizing both preclinical and clinical evidence. Finally, potential ways to advance the research of PONV and more recent developments on the study of postdischarge nausea and vomiting (PDNV) are discussed.

  7. Management of postoperative nausea and vomiting: focus on palonosetron

    Directory of Open Access Journals (Sweden)

    Neil A Muchatuta

    2008-11-01

    Full Text Available Neil A Muchatuta1, Michael J Paech21Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Perth, Western Australia; 2Pharmacology and Anaesthesiology Unit, The School of Medicine and Pharmacology, The University of Western Australia, Perth, Western AustraliaAbstract: Postoperative nausea and vomiting (PONV remains a significant problem in modern anesthetic practice, with an incidence in high-risk groups of up to 80%. In addition to being unpleasant and distressing for the patient, PONV has the potential to adversely affect patient and surgical outcomes. Advances in PONV prophylaxis over recent years include using non-pharmacological means to reduce baseline risk, a change to less emetogenic anesthetic techniques and the combination of multiple antiemetic drugs. The 5-hydroxytryptamine-3 (5-HT3 antagonists have proven a particularly valuable addition to the armamentarium against PONV. Palonosetron is a second-generation 5-HT3 antagonist that has recently been approved for prophylaxis against PONV. It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class. This review summarizes current evidence on PONV prophylaxis, reviews the 5-HT3 antagonists in particular and focuses on the established and future roles of palonosetron.Keywords: palonosetron, antiemetics, 5-HT3 antagonists, postoperative nausea and vomiting

  8. Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Møller, Ann M

    2011-01-01

    Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded stu......, we aimed to investigate the effect of P6 acupoint stimulation on the incidence of postoperative nausea and vomiting within 24 h postoperatively with an acupressure wristband: Vital-Band....

  9. Nausea and vomiting of pregnancy: an evolutionary hypothesis.

    Science.gov (United States)

    Lee, Richard V

    2002-05-01

    Nausea and vomiting of pregnancy, "morning sickness", is a common contemporary complaint. Many pregnant patients note alterations in smell and taste which can precipitate "morning sickness", symptoms that characterize early gestation. Epidemiologic studies suggest that pregnancies accompanied by "morning sickness" have better outcomes than asymptomatic pregnancies. The intimate connection between immunogenetic identity, chemoidentity, and chemocommunication by olfactory mechanisms suggests a relationship between maternal symptoms and maternal accommodation of paternal antigens contained in the fetoplacental unit. Most mammalian species utilize olfaction to reduce inbreeding and thus do not require an intimate placental connection between mother and fetus. The evolution of Homo sapiens included prolonged periods of small, genetically homogeneous foraging groups which limited selection of genetically heterogeneous mates. Adaptation to this circumstance included a reduction of olfactory precision in mate selection and a more intimate association between mother and fetus, the hemochorial placenta.

  10. Advances in the management of nausea and vomiting.

    Science.gov (United States)

    Hogan, C M

    1990-06-01

    The successful management of cancer-related nausea and vomiting is dependent upon many factors. An understanding of the various pharmacologic and nonpharmacologic interventions serve as the foundation for symptom control. The most important variable, however, is the nurse's commitment to alleviate these symptoms. Such commitment requires flexibility, tenacity, and a willingness to serve as a patient advocate. Regardless of the care setting, the nurse remains in a pivotal position to facilitate the optimal management of symptoms. Tremendous opportunities exist for nurses to collaborate across a variety of settings in order to ensure continuity. Such continuity enhances patient care but most important assures individuals (and their significant others) that their history is known and that they do not have to fear poor emetic control because of caregiver ignorance. The ability to initiate or support behavioral interventions demonstrates the nurse's commitment to holistic care. Such holism is the foundation and reward of cancer nursing practice.

  11. [Control of vomiting induced by antineoplastic chemotherapy in childhood].

    Science.gov (United States)

    Madero López, L; Pérez Jurado, L; Martín Ramos, N; Contra Gómez, T; Ruiz López, M J; Robles Cascallar, P

    1991-03-01

    Twenty four children aged 2 to 13 years who were to receive cancer chemotherapy were enrolled in a prospective study (before-after-trial) in order to evaluate the efficacy of systematic antiemetic prophylaxis. The regimen of three drugs (metilpednisolone 4 mg/Kg/dose/iv 2 doses; metodopamide 0.5 mg/Kg/dose/iv 4 doses; diphenydramine 1 mg/Kg/dose/iv 4 doses) was used. We found a significative reduction (P less than 0.001) in the incidence of vomiting and nauseousness duration when the antiemetic prophylaxis was used. There were very few and slight adverse effects secondary to antiemetic drugs: Sedation happened in 25% of chemotherapic cycles and hypotension without clinical repercussion in 15%. No patient had distonia. We conclude that systematical antiemetic protection should be used in children receiving chemotherapy. The association of metilpednisolone, metopramide and diphenhydramine is a safe and effective combination.

  12. Mitochondrial disorder caused Charles Darwin's cyclic vomiting syndrome

    Directory of Open Access Journals (Sweden)

    Finsterer J

    2014-01-01

    Full Text Available Josef Finsterer,1 John Hayman21Krankenanstalt Rudolfstiftng, Vienna, Austria; 2Department of Pathology, University of Melbourne, Victoria, AustraliaBackground: Charles Darwin (CD, “father of modern biology,” suffered from multisystem illness from early adulthood. The most disabling manifestation was cyclic vomiting syndrome (CVS. This study aims at finding the possible cause of CVS in CD.Methods: A literature search using the PubMed database was carried out, and CD's complaints, as reported in his personal writings and those of his relatives, friends, colleagues, biographers, were compared with various manifestations of mitochondrial disorders (MIDs, known to cause CVS, described in the literature.Results: Organ tissues involved in CD's disease were brain, nerves, muscles, vestibular apparatus, heart, gut, and skin. Cerebral manifestations included episodic headache, visual disturbance, episodic memory loss, periodic paralysis, hysterical crying, panic attacks, and episodes of depression. Manifestations of polyneuropathy included numbness, paresthesias, increased sweating, temperature sensitivity, and arterial hypotension. Muscular manifestations included periods of exhaustion, easy fatigability, myalgia, and muscle twitching. Cardiac manifestations included episodes of palpitations and chest pain. Gastrointestinal manifestations were CVS, dental problems, abnormal seasickness, eructation, belching, and flatulence. Dermatological manifestations included painful lips, dermatitis, eczema, and facial edema. Treatments with beneficial effects to his complaints were rest, relaxation, heat, and hydrotherapy.Conclusion: CVS in CD was most likely due to a multisystem, nonsyndromic MID. This diagnosis is based upon the multisystem nature of his disease, the fact that CVS is most frequently the manifestation of a MID, the family history, the variable phenotypic expression between affected family members, the fact that symptoms were triggered by stress

  13. Clinical Features, Prevalence and Psychiatric Complaints in Subjects with Fear of Vomiting

    NARCIS (Netherlands)

    van Hout, Wiljo J. P. J.; Bouman, Theo K.

    2012-01-01

    Specific phobia of vomiting (also known as emetophobia) is a relatively understudied phobia with respect to its aetiology, clinical features and treatment. In this stage, research is mostly based on people with self-reported fear of vomiting. This paper presents a survey on the clinical features of

  14. Speed of Eating as a Determinant of Bulimic Desire to Vomit: A Controlled Study

    Science.gov (United States)

    Azrin, Nathan H.; Kellen, Michael J.; Ehle, Christopher T.; Brooks, Jeannie S.

    2006-01-01

    Studies of self-induced vomiting of retarded persons have found that the rate of eating and the amount eaten alter this problem. The present study attempted to determine whether this same relationship was exhibited by the nonretarded bulimic. A nonretarded bulimic woman provided her subjective ratings of her desire to vomit after eating her taboo…

  15. Pre- and Postoperative Vomiting in Children Undergoing Video-Assisted Gastrostomy Tube Placement

    Directory of Open Access Journals (Sweden)

    Torbjörn Backman

    2014-01-01

    Full Text Available Background. The aim of this study was to determine the incidence of pre- and postoperative vomiting in children undergoing a Video-Assisted Gastrostomy (VAG operation. Patients and Methods. 180 children underwent a VAG operation and were subdivided into groups based on their underlying diagnosis. An anamnesis with respect to vomiting was taken from each of the children’s parents before the operation. After the VAG operation, all patients were followed prospectively at one and six months after surgery. All complications including vomiting were documented according to a standardized protocol. Results. Vomiting occurred preoperatively in 51 children (28%. One month after surgery the incidence was 43 (24% in the same group of children and six months after it was found in 40 (22%. There was a difference in vomiting frequency both pre- and postoperatively between the children in the groups with different diagnoses included in the study. No difference was noted in pre- and postoperative vomiting frequency within each specific diagnosis group. Conclusion. The preoperative vomiting symptoms persisted after the VAG operation. Neurologically impaired children had a higher incidence of vomiting than patients with other diagnoses, a well-known fact, probably due to their underlying diagnosis and not the VAG operation. This information is useful in preoperative counselling.

  16. Mitochondrial disorder caused Charles Darwin's cyclic vomiting syndrome.

    Science.gov (United States)

    Finsterer, Josef; Hayman, John

    2014-01-08

    Charles Darwin (CD), "father of modern biology," suffered from multisystem illness from early adulthood. The most disabling manifestation was cyclic vomiting syndrome (CVS). This study aims at finding the possible cause of CVS in CD. A literature search using the PubMed database was carried out, and CD's complaints, as reported in his personal writings and those of his relatives, friends, colleagues, biographers, were compared with various manifestations of mitochondrial disorders (MIDs), known to cause CVS, described in the literature. Organ tissues involved in CD's disease were brain, nerves, muscles, vestibular apparatus, heart, gut, and skin. Cerebral manifestations included episodic headache, visual disturbance, episodic memory loss, periodic paralysis, hysterical crying, panic attacks, and episodes of depression. Manifestations of polyneuropathy included numbness, paresthesias, increased sweating, temperature sensitivity, and arterial hypotension. Muscular manifestations included periods of exhaustion, easy fatigability, myalgia, and muscle twitching. Cardiac manifestations included episodes of palpitations and chest pain. Gastrointestinal manifestations were CVS, dental problems, abnormal seasickness, eructation, belching, and flatulence. Dermatological manifestations included painful lips, dermatitis, eczema, and facial edema. Treatments with beneficial effects to his complaints were rest, relaxation, heat, and hydrotherapy. CVS in CD was most likely due to a multisystem, nonsyndromic MID. This diagnosis is based upon the multisystem nature of his disease, the fact that CVS is most frequently the manifestation of a MID, the family history, the variable phenotypic expression between affected family members, the fact that symptoms were triggered by stress, and that only few symptoms could not be explained by a MID.

  17. Cyclic vomiting syndrome masking a fatal metabolic disease.

    LENUS (Irish Health Repository)

    Fitzgerald, Marianne

    2013-05-01

    Disorders of fatty acid oxidation are rare but can be fatal. Hypoglycaemia with acidosis is a cardinal feature. Cases may present during early childhood or can be delayed into adolescence or beyond. We present a case of multiple acyl-coenzyme A dehydrogenase deficiency (MADD), an extremely rare disorder of fatty acid oxidation. Our 20-year-old patient presented with cardiovascular collapse, raised anion gap metabolic acidosis and non-ketotic hypoglycaemia. She subsequently developed multi-organ failure and sadly died. She had a previous diagnosis of cyclic vomiting syndrome (CVS) for more than 10 years, warranting frequent hospital admissions. The association between CVS and MADD has been made before though the exact relationship is unclear. All patients with persistent severe CVS should have metabolic investigations to exclude disorders of fatty acid oxidation. In case of non-ketotic hypoglycaemia with acidosis, the patient should be urgently referred to a specialist in metabolic diseases. All practitioners should be aware of these rare disorders as a cause of unexplained acidosis.

  18. Optimal management of nausea and vomiting of pregnancy

    Directory of Open Access Journals (Sweden)

    Neda Ebrahimi

    2010-08-01

    Full Text Available Neda Ebrahimi1,2, Caroline Maltepe2, Adrienne Einarson21Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada; 2Motherisk Program, The Hospital for Sick Children, Toronto, Ontario, CanadaAbstract: Nausea and vomiting of pregnancy (NVP is a common medical condition in pregnancy with significant physical and psychological morbidity. Up to 90% of women will suffer from NVP symptoms in the first trimester of pregnancy with up to 2% developing hyperemesis gravidarum which is NVP at its worst, leading to hospitalization and even death in extreme cases. Optimal management of NVP begins with nonpharmacological approaches, use of ginger, acupressure, vitamin B6, and dietary adjustments. The positive impact of these noninvasive, inexpensive and safe methods has been demonstrated. Pharmacological treatments are available with varying effectiveness; however, the only drug marketed specifically for the treatment of NVP in pregnancy is Diclectin® (vitamin B6 and doxylamine. In addition, the Motherisk algorithm provides a guideline for use of safe and effective drugs for the treatment of NVP. Optimal medical management of symptoms will ensure the mental and physical wellbeing of expecting mothers and their developing babies during this often stressful and difficult time period. Dismissing NVP as an inconsequential part of pregnancy can have serious ramifications for both mother and baby.Keywords: pharmacological/nonpharmacological treatments, NVP

  19. [THE APPROACH TO NAUSEA AND VOMITING IN PREGNANCY].

    Science.gov (United States)

    Shtomo, Meital; Cohen, Rana; Berkovitch, Mati; Koren, Gideon

    2015-11-01

    Nausea and vomiting of pregnancy (NVP) is the most prevalent medical condition during gestation. Approximately 85% of pregnant women suffer from some degree of this condition, while hyperemesis gravidarum (HG), the most severe form, affects up to 2% of women. Although being the leading cause for hospitalization during pregnancy, NVP has received little attention from the medical community. NVP negatively affects women's quality of life, household activity and work productivity. In Canada, the financial cost of NVP, ranges from $132 to $653 per woman/week. In extreme cases, severe NVP results in therapeutic abortions. On the other hand, NVP has been shown to have a protective effect against spontaneous abortions and congenital malformations. Lately, there has been an interest in the hypothesis that NVP is a mechanism protecting the fetus from phytochemicals. Early treatment can prevent future complications and deterioration of the symptoms. Various studies have demonstrated the effectiveness and safety of antiemetic therapy in pregnancy. However, fear of teratogenicity and lack of clinical guidelines lead to trial and error NVP management. We present an updated algorithm for the management of NVP.

  20. Observations on the pattern of vomiting and morbidity in patients with acute sigmoid volvulus

    Directory of Open Access Journals (Sweden)

    Raveenthiran V

    2004-01-01

    Full Text Available Background: Vomiting is usually a late and an infrequent symptom of colonic obstructions. Contrary to this general rule, it occurs early and more frequently in some cases of sigmoid volvulus. Aim: To study the clinical significance of vomiting in patients with sigmoid volvulus. Setting: Teaching hospital in Western Orissa, India Study Design: Prospective observational study Material and Methods: Prospectively enrolled subjects with sigmoid volvulus diagnosed on the basis of clinical, radiological and laparotomy evidence were included in the study carried out in a tertiary care centre in India. Detailed history was obtained from them, especially to elicit information about the occurrence of various symptoms. Information regarding type of vomiting was also obtained. Efforts were made to exclude other causes of vomiting. Statistical tests such as Chi-Square test, Fisher's exact test or Student's t test were used. Results: Ninety-three consecutive subjects with sigmoid volvulus were enrolled. Five patients with possible other aetiologies for vomiting and seven patients with compound sigmoid volvulus were eliminated from further analysis. Two patterns of vomiting were noted in 81 evaluable patients with sigmoid volvulus. In 33 patients (Group A, vomiting preceded or coincided with the onset of other abdominal symptoms (Type 1 vomiting. In 48 patients (Group B vomiting occurred after the onset of other abdominal symptoms (Type 2 vomiting. The period between the onset of these symptoms and that of vomiting varied from a few hours to several days. Group A patients sought medical help much earlier than those of Group B. Incidences of circulatory shock (24% vs. 8%, haemorrhagic ascites (21% vs. 6% and colonic gangrene (64% vs. 35% were significantly higher in Group A than in Group B. The mortality rate (15% vs. 4% was higher in Group A as well. About 25% (n = 7 of Group A patients in contrast to 4% (n=2 of Group B required hospitalization exceeding 3

  1. Nausea and vomiting in Iranian Traditional Medicine based on Avicenna’s viewpoint

    Science.gov (United States)

    Nazari, Mohammad; Taghizadeh, Ali; Orafaei, Hossein; Rakhshandeh, Hassan; Bazzaz, Mojtaba Mousavi; shokri, Jafar; Shokri, Sadegh

    2015-01-01

    Background: Nausea and vomiting decrease one’s quality of life significantly, and, despite various treatments, they are still uncontrollable, especially in acute illness. Perhaps it would be useful to search for new concepts and therapies for dealing with these issues at other medical schools. The aim of this research was to elucidate the causes of nausea and vomiting in Iranian Traditional Medicine (ITM) based on Avicenna’s viewpoint in The Book of “Canon of medicine”. Methods: We reviewed the Canon of Medicine and other reference textbooks of ITM to get the experts’ viewpoints, such as Kamel-al-Sanaeh, Al-Havi, and Zakhireh-kharazmshahi, and we searched PubMed, Scopus, Embase, ISI and Science Iranian Database (SID) in November and December 2014 using keywords. Results: Basic terms associated with nausea and vomiting in ITM are Gha’y (vomiting), Tahavo’a (retching), Gathayan (nausea), and Taghallob-al-nafs (continuous nausea). Different factors can induce these problems with direct or indirect change in the quantity/quality of humors in the body’s systems or the stomach. Treatments are based on the correction of humors and modifications of lifestyle. ITM has recommended medicinal herbs for severe nausea and vomiting. For example, they may be effective in treating chemotherapy-induced nausea and vomiting (CINV). Conclusion: ITM suggests that almost the nausea and vomiting associated with almost all major diseases originate from abnormalities in either the quantity/quality of humors. The gold standard for managing nausea and vomiting is lifestyle modifications with attention to responsible humors. Some therapeutic protocols in ITM may be applicable today. Perhaps redefining the diseases and updating the expression of these concepts and approaches can lead to the development of complementary and alternative treatments for nausea and vomiting. PMID:26120413

  2. Nausea and vomiting in advanced cancer: the Cleveland Clinic protocol.

    Science.gov (United States)

    Gupta, Mona; Davis, Mellar; LeGrand, Susan; Walsh, Declan; Lagman, Ruth

    2013-03-01

    Nausea and vomiting are common and distressing symptoms in advanced cancer. Both are multifactorial and cause significant morbidity, nutritional failure, and reduced quality of life. Assessment includes a detailed history, physical examination and investigations for reversible causes. Assessment and management will be influenced by performance status, prognosis, and goals of care. Several drug classes are effective with some having the added benefit of multiple routes of administration. It is our institution's practice to recommend metoclopramide as the first drug with haloperidol as an alternative antiemetic. Dexamethasone should be used for patients with central nervous system metastases or bowel obstruction. If your patient is near death, empiric metoclopramide, haloperidol or chlorpromazine is used without further investigation. For patients with a better prognosis, we exclude reversible causes and use the same first-line antiemetics, metoclopramide and haloperidol. For those who do not respond to first-line single antiemetics, olanzapine is second line and ondansetron is third. Rarely do we use combination therapy or cannabinoids. Olanzapine as a single agent has a distinct advantage over antiemetic combinations. It improves compliance, reduces drug interactions and has several routes of administration. Antiemetics, anticholinergics, octreotide and dexamethasone are used in combination to treat bowel obstruction. In opiod-na'ive patients, we prefer haloperidol, glycopyrrolate and an opioid as the first-line treatment and add or substitute octreotide and dexamethasone in those who do not respond. Non-pharmacologic interventions (mechanical stents and percutaneous endoscopic gastrostomy tubes) are used when nausea is refractory to medical management or for home-going management to relieve symptoms, reduce drug costs and rehospitalization.

  3. A longitudinal study on diarrhoea and vomiting in young dogs of four large breeds

    Directory of Open Access Journals (Sweden)

    Sævik Bente K

    2012-02-01

    Full Text Available Abstract Background Prospective studies to document the occurrence of canine diarrhoea and vomiting are relatively scarce in dogs, and the majority of published studies are based on information from clinical records. This study investigates the incidence risk of diarrhoea and vomiting as well as potential risk factors. Methods A cohort study of 585 privately owned dogs of four breeds: Newfoundland, Labrador retriever, Leonberger, and Irish wolfhound. The owners maintained a continuous log regarding housing, exercise, nutrition, and health of their dogs. Episodes of diarrhoea and vomiting were recorded in a consecutive manner in a booklet. The owners completed the questionnaires and reported information at three, four, six, 12, 18, and 24/25 months of age, called observational ages. Associations with potential risk factors for diarrhoea and vomiting were investigated in separate generalized estimating equation analyses. Results The incidence of both diarrhoea and vomiting was influenced by breed. Both diarrhoea and vomiting were relatively common in young dogs, occurring most frequently during the first months of life. After three months of age, the odds of diarrhoea were significantly lower when compared to the observational period seven weeks to three months (OR ranging from 0.31 to 0.70 depending on the period. More males than females suffered from diarrhoea (OR = 1.42. The occurrence of diarrhoea was more common in dogs that also experienced episode(s of vomiting during the study period (OR = 5.43 and vice versa (OR = 5.50. In the majority of dogs episodes of diarrhoea and vomiting did not occur at the same time. Dogs in urban areas had higher odds (OR = 1.88 of getting diarrhoea compared to dogs living in rural areas. The occurrence of both diarrhoea and vomiting demonstrated a seasonal variation with higher incidence during the summer months. Conclusion Both diarrhoea and vomiting occurred most frequently during the first months of life

  4. Neurokinin-1 receptor antagonists for chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Aziz, Fahad

    2012-07-01

    Chemotherapy can be a life-prolonging treatment for many cancer patients, but it is often associated with profound nausea and vomiting that is so distressing that patients may delay or decline treatment to avoid these side effects. The discovery of several NK1 receptor antagonists is a big revolution to dealt this problem. NK1 receptor antagonists prevent both acute and delayed chemotherapy-induced nausea and vomiting (CINV). These agents act centrally at NK-1 receptors in vomiting centers within the central nervous system to block their activation by substance P released as an unwanted consequence of chemotherapy. By controlling nausea and vomiting, these agents help improve patients' daily living and their ability to complete multiple cycles of chemotherapy. They are effective for both moderately and highly emetogenic chemotherapy regimens. Their use might be associated with increased infection rates; however, additional appraisal of specific data from RCTs is needed.

  5. Rolapitant for the treatment of chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Navari, Rudolph M

    2015-01-01

    Chemotherapy-induced nausea and vomiting is a significant clinical issue which affects patient's quality of life and treatment decisions. Significant improvements in the control of chemotherapy-induced nausea and vomiting have occurred in the past 15 years with the introduction of new antiemetic agents 5-HT3, receptor antagonists, neurokinin-1 (NK-1) receptor antagonists, and olanzapine. Aprepitant was the first NK-1 receptor antagonist introduced (2003) for the prevention of chemotherapy-induced nausea and vomiting in combination with a 5-HT3 receptor antagonist and dexamethasone. A second NK-1 receptor antagonist netupitant was approved for use in October 2014. Phase III clinical trials of an additional NK-1 receptor antagonist rolapitant have been completed, and the data have been submitted for regulatory approval. A description of rolapitant and its role in chemotherapy-induced nausea and vomiting will be presented, along with a comparison of the other neurolinin-1 receptor antagonists aprepitant and netupitant.

  6. Gabapentin for Postoperative Vomiting in Children Requiring Posterior Fossa Tumor Resection

    Directory of Open Access Journals (Sweden)

    Ko-Chun Tsai

    2015-10-01

    Full Text Available Gabapentin is well known for its pain control and antiepileptic effect, but its antiemetic effect is poorly investigated. Here we report on effective gabapentin use for refractory vomiting after craniotomy in two children with medulloblastoma in the fourth ventricle. The two pediatric patients (an 11-year-old girl and a 4-year-old boy underwent near-total excision of the tumor via craniotomy. Both patients suffered from refractory postoperative nausea and vomiting, treated with multiple traditional antiemetic drugs but without relief. After gabapentin intake, their nausea and vomiting improved from one to two episodes per day to complete resolution of symptoms. This report suggests that gabapentin may be a novel antiemetic therapeutic intervention for patients with refractory nausea and vomiting after craniotomy.

  7. Breaking the cycle: cognitive behavioral therapy and biofeedback training in a case of cyclic vomiting syndrome.

    Science.gov (United States)

    Slutsker, Barak; Konichezky, Andres; Gothelf, Doron

    2010-12-01

    The present article presents a case of cognitive behavioral therapy (CBT) along with heart rate variability (HRV) biofeedback training for the treatment of a medication unresponsive 13-year-old boy with cyclic vomiting syndrome (CVS). CVS is characterized by recurring stereotypic episodes of vomiting, interspersed with asymptomatic periods. Triggers for vomiting include anticipatory anxiety related to school examinations, family conflicts, and birthday parties as well as infectious diseases, and certain foods. Current treatment design addressed two pivotal etiological factors: autonomic dysregulation and anticipatory anxiety. Treatment outcome suggests that vomiting episodes may be successfully prevented by aiding the patient to identify and manage precipitant psychological stressors, to regulate HRV patterns, and gain a renewed sense of bodily control and self-efficacy. Further research is suggested using a controlled study with pre- and post-behavioral and stress measures to evaluate the effectiveness of CBT and biofeedback training compared to pharmacotherapy and placebo.

  8. Effect of postoperative experiences on willingness to pay to avoid postoperative pain, nausea, and vomiting

    NARCIS (Netherlands)

    J.E. van den Bosch; G.J. Bonsel; K.G. Moons; C.J. Kalkman

    2006-01-01

    Background: The authors assessed the willingness to pay (WTP) for "perfect" prophylactic antiemetics and analgesics in patients who were scheduled to undergo surgery during general anesthesia. Furthermore, they determined whether postoperative experiences of pain and nausea and vomiting (PONV) chang

  9. Expiratory muscle control during vomiting - Role of brain stem expiratory neurons

    Science.gov (United States)

    Miller, A. D.; Tan, L. K.

    1987-01-01

    The neural mechanisms controlling the muscles involved during vomiting were examined using decerebrated cats. In one experiment, the activity of the ventral respiratory group (VRG) expiratory (E) neurons was recorded during induced 'fictive vomiting' (i.e., a series of bursts of coactivation of abdominal and phrenic nerves that would be expected to produce expulsion in unparalyzed animals) and vomiting. In a second, abdominal muscle electromyographic and nerve activity were compared before and after sectioning the axons of descending VRG E neurons as they cross the midline between C1 and the obex (the procedure that is known to abolish expiratory modulation of internal intercostal muscle activity). The results of the study indicate that the abdominal muscles are controlled differently during respiration and vomiting.

  10. Behavioral treatment of psychogenic vomiting in the context of social phobia.

    Science.gov (United States)

    Stravynski, A

    1983-07-01

    A case of psychogenic vomiting in the context of social phobia was treated by a combination of exposure in vivo, social skills training, and cognitive modification. The intervention was not directly aimed at the vomiting, but at aspects of the patient's behavior hypothesized to be instrumental in maintaining it; deficits in prosocial behaviors and associated anxiety. Change was assessed on the basis of patient's records of daily frequency of: vomiting; performance of treated behaviors; and associated anxiety within a single-case multiple baseline design. Change occurred only with the introduction of treatment and not before it, ruling out effects of time or mere contact. Clinically, the vomiting was virtually eliminated after 7 weeks, and the anxiety was substantially reduced in most previously feared (and avoided) social situations; except for a 2-week depressive spell, this outcome has been maintained for an available 2-year follow-up. A general improvement in the patient's personal, social, and vocational life has also occurred.

  11. Vomiting as a Symptom and Transmission Risk in Norovirus Illness: Evidence from Human Challenge Studies.

    Directory of Open Access Journals (Sweden)

    Amy E Kirby

    Full Text Available In the US, noroviruses are estimated to cause 21 million cases annually with economic losses reaching $2 billion. Outbreak investigations frequently implicate vomiting as a major transmission risk. However, little is known about the characteristics of vomiting as a symptom or the amount of virus present in emesis.Emesis samples and symptomology data were obtained from previous norovirus human challenge studies with GI.1 Norwalk virus, GII.2 Snow Mountain virus, and a pilot study with GII.1 Hawaii virus. Viral titers in emesis were determined using strain-specific quantitative RT-PCR. In all four studies, vomiting was common with 40-100% of infected subjects vomiting at least once. However, only 45% of subjects with vomiting also had diarrhea. Most of the emesis samples had detectable virus and the mean viral titers were 8.0 x 105 and 3.9 x 104 genomic equivalent copies (GEC/ml for GI and GII viruses, respectively (p = 0.02. Sample pH was correlated with GII.2 Snow Mountain virus detection.Half of all subjects with symptomatic infection experienced vomiting and the average subject shed 1.7 x 108 GEC in emesis. Unlike shedding through stool, vomiting is more likely to result in significant environmental contamination, leading to transmission through fomites and airborne droplets. This quantitative data will be critical for risk assessment studies to further understand norovirus transmission and develop effective control measures. The correlation between sample pH and virus detection is consistent with a single site of virus replication in the small intestine and stomach contents becoming contaminated by intestinal reflux. Additionally, the frequency of vomiting without concurrent diarrhea suggests that epidemiology studies that enroll subjects based on the presence of diarrhea may be significantly underestimating the true burden of norovirus disease.

  12. Fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting

    DEFF Research Database (Denmark)

    Ruhlmann, Christina H. B.; Herrstedt, Jørn

    2012-01-01

    For patients receiving cancer chemotherapy, the ongoing development of antiemetic treatment is of significant importance. Patients consider nausea and vomiting among the most distressing symptoms of chemotherapy, and as new antiemetics have been very successful in prevention of vomiting, agents...... effective against nausea have become one of the major unmet needs. The neurokinin (NK)(1) receptor antagonist aprepitant potentiates the antiemetic efficacy of the combination of a serotonin receptor antagonist and a corticosteroid. Fosaprepitant (intravenous prodrug of aprepitant) given as a single...

  13. Wirksamkeit von Aromatherapie bei postoperativer Nausea und Vomiting bei Erwachsenen: Systematische Literaturreview

    OpenAIRE

    Schnyder, Samira; Z‘Brun Schnyder, Silvia

    2015-01-01

    Problembeschreibung: Postoperative Nausea und Vomiting (PONV) stellt neben Schmerz eine der häufigsten postoperativen Komplikationen dar. Die Inzidenz beträgt bei gynäkologischen Patientinnen 80%. Symptome und Folgen von PONV können physische, psychische, emotionale und finanzielle Auswirkungen für die Patienten und das Personal haben. Postoperative Nausea und Vomiting wird meistens medikamentös mit Antiemetika behandelt. Diese Medikamente können jedoch viele Nebenwirkungen aufweisen. D...

  14. Possible role of brain stem respiratory neurons in mediating vomiting during space motion sickness

    Science.gov (United States)

    Miller, A. D.; Tan, L. K.

    1987-01-01

    The object of this study was to determine if brain stem expiratory neurons control abdominal muscle activity during vomiting. The activity of 27 ventral respiratory group expiratory neurons, which are known to be of primary importance for control of abdominal muscle activity during respiration, was recorded. It is concluded that abdominal muscle activity during vomiting must be controlled not only by some brain stem expiratory neurons but also by other input(s).

  15. Significantly Elevated Serum Lipase in Pregnancy with Nausea and Vomiting: Acute Pancreatitis or Hyperemesis Gravidarum?

    OpenAIRE

    Amanda Johnson; Bethany Cluskey; Nina Hooshvar; Daphne Tice; Courtney Devin; Elaine Kao; Suhalia Nawabi; Steven Jones; Lihua Zhang; Chi Dola

    2015-01-01

    Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum. However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting bu...

  16. Effect of Acupressure on Nausea-Vomiting in Patients With Acute Myeloblastic Leukemia.

    Science.gov (United States)

    Avc, Hatice Sevil; Ovayolu, Nimet; Ovayolu, Özlem

    2016-01-01

    The aim of this study was to assess the effect of acupressure, applied at P6 (Neiguan) acupuncture point, on chemotherapy-induced nausea and vomiting in patients with acute myeloblastic leukemia. This was a randomized controlled trial conducted on patients with myeloblastic leukemia. A total of 90 patients, who received the same chemotherapy regimen and antiemetic therapy, were included in the study as 30 patients in the control group, 30 patients in the band group, and 30 patients in the pressure group. Although acupressure was applied by placing wristbands at P6 acupuncture point of both wrists in patients of the band group for totally 4 days, acupressure was applied with the use of finger pressure in patients of the pressure group for totally 4 days. No intervention was made in patients of the control group other than the routine antiemetic therapy. The data of the study were collected by using a questionnaire and nausea-vomiting chart. Severity of nausea-vomiting was assessed by using the visual analog scale on this chart. It was determined that the acupressure band applied to the patients included in the study reduced number and severity of nausea-vomiting (P acupressure applied with pressure did not affect number and severity of nausea-vomiting (P > .05). It was found that the acupressure band was effective for reducing the chemotherapy-induced nausea and vomiting.

  17. The Effect of Ondansetron and Dexamethasone on Nausea and Vomiting under Spinal Anesthesia

    Science.gov (United States)

    Kalani, Navid; Zabetian, Hasan; Sanie, Mohammad Sadegh; Deylami, Mansour; Radmehr, Mohammad; Sahraei, Reza; Kargar Jahromi, Hossein; Kooti, Wesam

    2017-01-01

    BACKGROUND During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors. This study compared the effects of ondansetron and dexamethasone on nausea and vomiting under spinal anesthesia. METHODS One hundred and twenty patients of 15 to 35 years old with ASA class I and II were enrolled. Before administering either ondansetron or dexamethasone, blood pressure and heart rate of the patients were recorded. The patients received 70 mg of 5% lidocaine for spinal anesthesia. Patients who received 6 mg of ondansetron were considered as group A, while group B received 8 mg of dexamethasone. The level of nausea and vomiting, blood pressure, heart rate and respiratory rate of each patient was measured at 1, 5, 10, 15 and 30 minutes after spinal anesthesia and during recovery (every 5 minutes). RESULTS There was a significant difference between nausea and vomiting between the two groups after spinal anesthesia within the first and fifth minutes. There was no significant difference between nausea and vomiting between the two groups within 10, 15 and 30 minutes and during recovery at 5, 10, 15 and 30 minutes. CONCLUSION Dexamethasone and ondansetron were shown to equally reduce the incidence of nausea and vomiting under spinal anesthesia and can be recommended as a good choice for prevention of nausea and vomiting during surgeries. PMID:28289619

  18. Value of mink vomit model in study of anti-emetic drugs

    Institute of Scientific and Technical Information of China (English)

    Fang Zhang; Lei Wang; Zhi-Hong Yang; Zhan-Tao Liu; Wang Yue

    2006-01-01

    AIM: To establish a new, reliable vomit model of minks.METHODS: Adult male minks were randomly divided into 8 groups (n=6): cisplatin (7.5 mg/kg)intraperitoneal injection (ip) group, copper sulfate (40mg/kg) intragastric injection (ig) group, apomorphine (1.6 mg/kg) subcutaneous injection (sc) group, and 18Gy whole-body X-irradiation group, ondansetron injection group (2 mg/kg ip) 30 min later followed by cisplatin (7.5 mg/kg) ip, normal saline (NS) ip injection control group, metoclopramide injection group (4 mg/kg ip) 30min later followed by apomorphine (1.6 mg/kg) sc, NS ig control group. The frequency of retching and vomiting was calculated. After behavioral experiment, distribution of 5-HT in the ileum was detected by immunohistologic method.RESULTS: Cisplatin, apomorphine, copper sulfate and X-irradiation administered to minks evoked a profound emetic response in the animals. However, retching and vomiting were significantly inhibited by pretreatment with ondansetron and metoclopramide in cisplatin and copper sulfate groups (P=0.018). Immunohistologic result showed that 5-HT released from enterochromaffin cells (EC cells) was involved in vomiting mechanism.CONCLUSION: Mink vomit model has a great value in studying the vomiting mechanism and screening new antiemetic drugs.

  19. Armed rollers: does nestling's vomit function as a defence against predators?

    Directory of Open Access Journals (Sweden)

    Deseada Parejo

    Full Text Available Chemical defences against predators are widespread in the animal kingdom although have been seldom reported in birds. Here, we investigate the possibility that the orange liquid that nestlings of an insectivorous bird, the Eurasian roller (Coracias garrulus, expel when scared at their nests acts as a chemical defence against predators. We studied the diet of nestling rollers and vomit origin, its chemical composition and deterrent effect on a mammal generalist predator. We also hypothesized that nestling rollers, as their main prey (i.e. grasshoppers do from plants, could sequester chemicals from their prey for their use. Grasshoppers, that also regurgitate when facing to a threat, store the harmful substances used by plants to defend themselves against herbivores. We found that nestling rollers only vomit after being grasped and moved. The production of vomit depended on food consumption and the vomit contained two deterrent chemicals (hydroxycinnamic and hydroxybenzoic acids stored by grasshoppers and used by plants to diminish herbivory, suggesting that they originate from the rollers' prey. Finally, we showed for the first time that the oral secretion of a vertebrate had a deterrent effect on a model predator because vomit of nestling rollers made meat distasteful to dogs. These results support the idea that the vomit of nestling rollers is a chemical defence against predators.

  20. Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents

    Directory of Open Access Journals (Sweden)

    Zbys Fedorowicz

    Full Text Available BACKGROUND: Vomiting is a common manifestation of acute gastroenteritis in children and adolescents. When untreated, it can be a hindrance to oral rehydration therapy, which is the cornerstone in the management of acute gastroenteritis. Evidence is needed concerning the safety and efficacy of antiemetic use for vomiting in acute gastroenteritis in children. OBJECTIVES: To assess the safety and effectiveness of antiemetics on gastroenteritis induced vomiting in children and adolescents. SEARCH STRATEGY: We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register comprising references identified from comprehensive electronic database searches and hand searches of relevant journals and abstract books of conferences. The search was re-run and is up to date as on 20 July 2010. SELECTION CRITERIA: Randomized controlled trials comparing antiemetics with placebo or no treatment, in children and adolescents under the age of 18, for vomiting due to gastroenteritis. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data. MAIN RESULTS: We included seven trials involving 1,020 participants. Mean time to cessation of vomiting in one study was 0.34 days less with dimenhydrinate suppository compared to placebo (P value = 0.036. Pooled data from three studies comparing oral ondansetron with placebo showed: a reduction in the immediate hospital admission rate (RR 0.40, NNT 17, 95% CI 10 to 100 but no difference between the hospitalization rates at 72 hours after discharge from the Emergency Department (ED; a reduction in IV rehydration rates both during the ED stay (RR 0.41, NNT 5, 95% CI 4 to 8, and in follow-up to 72 hours after discharge from the ED stay (worst-best scenario for ondansetron RR 0.57, NNT 6, 95% CI 4 to 13 and an increase in the proportion of patients with cessation of vomiting (RR 1.34, NNT 5, 95% CI 3 to 7. No significant difference was noted in the revisit

  1. Wrist acupressure for post-operative nausea and vomiting (WrAP): A pilot study.

    Science.gov (United States)

    Cooke, Marie; Rapchuk, Ivan; Doi, Suhail A; Spooner, Amy; Wendt, Tameka; Best, Jessica; Edwards, Melannie; O'Connell, Leanda; McCabe, Donna; McDonald, John; Fraser, John; Rickard, Claire

    2015-06-01

    Post-operative nausea and vomiting are undesirable complications following anaesthesia and surgery. It is thought that acupressure might prevent nausea and vomiting through an alteration in endorphins and serotonin levels. In this two-group, parallel, superiority, randomised control pilot trial we aimed to test pre-defined feasibility outcomes and provide preliminary evidence for the efficacy of PC 6 acupoint stimulation vs. placebo for reducing post-operative nausea and vomiting in cardiac surgery patients. Eighty patients were randomly assigned to either an intervention PC 6 acupoint stimulation via beaded intervention wristbands group (n=38) or placebo sham wristband group (n=42). The main outcome was assessment of pre-defined feasibility criteria with secondary outcomes for nausea, vomiting, rescue anti-emetic therapy, quality of recovery and adverse events. Findings suggest that a large placebo-controlled randomised controlled trial to test the efficacy of PC 6 stimulation on PONV in the post-cardiac surgery population is feasible and justified given the preliminary clinically significant reduction in vomiting in the intervention group in this pilot. The intervention was tolerated well by participants and if wrist acupressure of PC 6 acupoint is proven effective in a large trial it is a simple non-invasive intervention that could easily be incorporated into practice.

  2. Does dexamethasone prevent subarachnoid meperidin-induced nausea, vomiting and pruritus after cesarean delivery?

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    Nadia Banihashem

    2013-01-01

    Full Text Available Background: Opioid-induced side effects such as nausea and vomiting and pruritus are common and may be more debilitating than pain itself. We performed a study to assess the efficacy of dexamethasone in reducing postoperative nausea, vomiting, and pruritus in patients receiving neuraxial anesthesia with meperidine. Methods: Fifty-two women undergoing cesarean section were enrolled in the study. The control group and dexamethasone group received intravenously normal saline and dexamethasone, respectively, before spinal anesthesia. The occurrence of postoperative nausea, vomiting, and pruritus was assessed for 24 h in both groups. Results: The overall incidence of nausea and vomiting during the 24 h follow-up period was 37% and 22.2% for group saline and 20% and 12% for group dexamethasone, respectively (P=0.175, 0.469. The incidence of pruritus was not significantly different between the two groups. Pruritus severity was significantly less in the dexamethasone group than in the saline group (P=0.019. Conclusion: Prophylactic dexamethasone does not reduce the incidence of subarachnoid meperidine-induced nausea, vomiting, and pruritus in women undergoing cesarean delivery.

  3. Comparison of vomiting and diarrhoea frequency among dengue-infected patients

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    Gary Low Kim Kuan

    2015-08-01

    Full Text Available Objective: To compare the differences of vomiting and diarrhoea frequency between dengue with warning signs and severe dengue, and to describe the sites of mucosal bleeding among dengue-infected patients. Methods: This was a retrospective cohort study which included patients with laboratory– confirmed dengue infection along with clinical diagnosis of dengue. Exclusion criteria were patients with haematological disorders or any other malignancy. The vomiting and diarrhoea frequency on each day (Day 1 to Day 5 between dengue with warning signs and severe dengue were compared by using Mann-Whitney U test. The different sites of mucosal bleeding were stratified according to the diagnoses and displayed by bar charts. Results: Out of 1700 patients, 1003 (59.0% had vomiting and 587 (34.5% had diarrhoea. Both vomiting and diarrhoea frequency were not statistically different between dengue with warning signs and severe dengue from Day 1 to Day 5. Gum bleeding, hematemesis and menorrhagia were the only sites of mucosal bleeding seen in severe dengue for the first three days of illness. Hematemesis was seen only in severe dengue during the first day of illness but not in dengue with warning signs. Conclusions: The frequency of vomiting and diarrhoea could not differentiate severe dengue from dengue with warning signs. Nevertheless, it is important to have high index of suspicion for dengue when patients are presented with diarrhoea. The different sites of mucosal bleeding could possibly predict severe dengue, especially hematemesis on the first three days of illness.

  4. [Effect of diazepam on delayed nausea and vomiting caused by anticancer agents].

    Science.gov (United States)

    Tong, F Z; Zhang, J Q; Qiao, X M; Mao, Y C; Meng, F Y; Liu, H J; Hui, S; Zhu, F X; Shu, W; Hong, J

    1998-02-01

    We conducted an evaluation of the usefulness of antiemetics (5-Hydroxy-tryptamine 3 receptor antagonism, 5HT3RA) combined with diazepam for delayed nausea and vomiting due to anticancer agents in 17 patients with various malignancies (such as lung Ca, breast Ca, esophagus Ca, gastric Ca, colon Ca, and non Hodgkin's disease) for whom chemotherapy was performed with different regimens in the Dept. of Oncologic Chemotherapy, People's Hospital, Beijing Medical University. Antiemetics (5HT3RA) combined with diazepam were given only to cases that had symptoms of nausea and vomiting induced by anticancer agents in the 1st course and invalidity with antiemetics (5HT3RA) alone in this study. Antiemetic (5HT3RA) agents + Dexamethasone were dosed before chemotherapy and also diazepam 5 mg orally after 24 hours (namely, when nausea was observed). Nausea was reduced and vomiting decreased after the antiemetic treatment with 5HT3RA + Dexamethasone and diazepam. These results indicated that 5HT3RA and diazepam combination therapies were more effective than 5HT3 RA + Dexamethasone alone for delayed nausea and vomiting. Further, the antiemetics had characters that a short adminiter time, few times and a take not over dose. The only side effect related to this antiemetic therapy was light somnolence. Antiemetics combined with diazepam might be a useful therapy against delayed nausea and vomiting induced by anticancer agents.

  5. Comparison of vomiting and diarrhoea frequency among dengue-infected patients

    Institute of Scientific and Technical Information of China (English)

    Gary Low Kim Kuan; Yong Mun Hin; Ridzuan Mohd Isa

    2015-01-01

    Objective: To compare the differences of vomiting and diarrhoea frequency between dengue with warning signs and severe dengue, and to describe the sites of mucosal bleeding among dengue-infected patients. Methods: This was a retrospective cohort study which included patients with laboratory–confirmed dengue infection along with clinical diagnosis of dengue. Exclusion criteria were patients with haematological disorders or any other malignancy. The vomiting and diarrhoea frequency on each day (Day 1 to Day 5) between dengue with warning signs and severe dengue were compared by using Mann-Whitney U test. The different sites of mucosal bleeding were stratified according to the diagnoses and displayed by bar charts. Results: Out of 1700 patients, 1003 (59.0%) had vomiting and 587 (34.5%) had diarrhoea. Both vomiting and diarrhoea frequency were not statistically different between dengue with warning signs and severe dengue from Day 1 to Day 5. Gum bleeding, hematemesis and menorrhagia were the only sites of mucosal bleeding seen in severe dengue for the first three days of illness. Hematemesis was seen only in severe dengue during the first day of illness but not in dengue with warning signs. Conclusions: The frequency of vomiting and diarrhoea could not differentiate severe dengue from dengue with warning signs. Nevertheless, it is important to have high index of suspicion for dengue when patients are presented with diarrhoea. The different sites of mucosal bleeding could possibly predict severe dengue, especially hematemesis on the first three days of illness.

  6. New treatments on the horizon for chemoradiotherapy-induced nausea and vomiting

    DEFF Research Database (Denmark)

    Ruhlmann, Christina H; Herrstedt, Jørn

    2016-01-01

    INTRODUCTION: Antiemetic prophylaxis for the prevention of chemotherapy-induced nausea and vomiting, and the development of new antiemetic drugs are expanding areas of research. However, studies of antiemetic prophylaxis in chemoradiotherapy have not been prioritised, and little is known about...... the proper timing, duration, and combination of antiemetic drugs for the prevention of chemoradiotherapy-induced nausea and vomiting (C-RINV). AREAS COVERED: The article summarises the available antiemetic studies, the evidence for antiemetic prophylaxis of C-RINV, and the future perspectives for antiemetic...... research in chemoradiotherapy. EXPERT OPINION: Antiemetic prophylaxis for patients receiving concomitant chemoradiotherapy has, for many years, been an orphan research area. The distinction between acute and delayed nausea and vomiting does not apply to fractionated radiotherapy, and prophylaxis should...

  7. Incidence and management of chemotherapy-induced nausea and vomiting in women with breast cancer

    Directory of Open Access Journals (Sweden)

    Thais de Oliveira Gozzo

    Full Text Available The objective of this study was to analyze the incidence of chemotherapy-induced nausea and vomiting in women with breast cancer and identify strategies used by them to control these signs and symptoms. Data for this cross-sectional study were collected through interviews during the last cycle of chemotherapy, between August 2011 and March 2012, in a university hospital in the State of São Paulo. The sample consisted of 22 women between the ages of 31 and 70, of whom 77.3% reported nausea and 50% vomiting during treatment. Regarding symptom management, 82% of the women reported having received some information centered on the use of prescribed medication. However, 27.3% did not know what medication they had taken. We concluded that there is a lack of systematic care and institutional protocol to guide professionals in providing standardized information to women so they can better control nausea and vomiting.

  8. Why Can’t Rodents Vomit? A Comparative Behavioral, Anatomical, and Physiological Study

    Science.gov (United States)

    Horn, Charles C.; Kimball, Bruce A.; Wang, Hong; Kaus, James; Dienel, Samuel; Nagy, Allysa; Gathright, Gordon R.; Yates, Bill J.; Andrews, Paul L. R.

    2013-01-01

    The vomiting (emetic) reflex is documented in numerous mammalian species, including primates and carnivores, yet laboratory rats and mice appear to lack this response. It is unclear whether these rodents do not vomit because of anatomical constraints (e.g., a relatively long abdominal esophagus) or lack of key neural circuits. Moreover, it is unknown whether laboratory rodents are representative of Rodentia with regards to this reflex. Here we conducted behavioral testing of members of all three major groups of Rodentia; mouse-related (rat, mouse, vole, beaver), Ctenohystrica (guinea pig, nutria), and squirrel-related (mountain beaver) species. Prototypical emetic agents, apomorphine (sc), veratrine (sc), and copper sulfate (ig), failed to produce either retching or vomiting in these species (although other behavioral effects, e.g., locomotion, were noted). These rodents also had anatomical constraints, which could limit the efficiency of vomiting should it be attempted, including reduced muscularity of the diaphragm and stomach geometry that is not well structured for moving contents towards the esophagus compared to species that can vomit (cat, ferret, and musk shrew). Lastly, an in situ brainstem preparation was used to make sensitive measures of mouth, esophagus, and shoulder muscular movements, and phrenic nerve activity–key features of emetic episodes. Laboratory mice and rats failed to display any of the common coordinated actions of these indices after typical emetic stimulation (resiniferatoxin and vagal afferent stimulation) compared to musk shrews. Overall the results suggest that the inability to vomit is a general property of Rodentia and that an absent brainstem neurological component is the most likely cause. The implications of these findings for the utility of rodents as models in the area of emesis research are discussed. PMID:23593236

  9. Effect of Dexamethasone on Postoperative Vomiting and Oral Intake after Adenotonsillectomy

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    M.R. Fazel

    2007-01-01

    Full Text Available Introduction & Objective: Complications of adenotonsillectomy such as pain, nausea and vomiting, fever, inadequate oral intake, dehydration and bleeding are common and important. In addition of unpleasant feeling for patient, post operative nausea and vomiting will lead to more prolonged hospitalization and intravenous hydration. The purpose of this study was to determine whether a single dose of dexamethasone (0.5mg/kg administered before surgery could decrease postoperative vomiting and improves oral intake in the first 24-hours after adenotonsillectomy procedures.Materials & Methods: In this double-blinded, placebo controlled study, 100 patients age 5-15 years, with ASA physical status I and II were enrolled and they were randomly allocated to receive either dexamethasone (n=50 0.5 mg/kg IV (maximum dose 8 mg or an equivalent volume of saline (n=50 preoperatively. The anesthetic regimen and surgical procedures were standardized for all patients. The incidence of early and late vomiting, the first time oral intake, oral intake adequacy, and duration of IV hydration were compared in both groups. Results: Data from 100 patients were analyzed. The overall incidence of early as well as late vomiting was significantly less in dexamethasone as compared to control group (P=0.001. The time to first oral intake, oral intake adequacy, and duration of IV hydration showed significant difference in both groups (P=0.01.Conclusion: A single dose of dexamethasone was not associated with adverse effects. Dexamethasone significantly decreased the incidence of postoperative vomiting during the first 24 hour, shortened the time to the first oral intake, oral intake adequacy, and duration of IV hydration.

  10. Why can't rodents vomit? A comparative behavioral, anatomical, and physiological study.

    Directory of Open Access Journals (Sweden)

    Charles C Horn

    Full Text Available The vomiting (emetic reflex is documented in numerous mammalian species, including primates and carnivores, yet laboratory rats and mice appear to lack this response. It is unclear whether these rodents do not vomit because of anatomical constraints (e.g., a relatively long abdominal esophagus or lack of key neural circuits. Moreover, it is unknown whether laboratory rodents are representative of Rodentia with regards to this reflex. Here we conducted behavioral testing of members of all three major groups of Rodentia; mouse-related (rat, mouse, vole, beaver, Ctenohystrica (guinea pig, nutria, and squirrel-related (mountain beaver species. Prototypical emetic agents, apomorphine (sc, veratrine (sc, and copper sulfate (ig, failed to produce either retching or vomiting in these species (although other behavioral effects, e.g., locomotion, were noted. These rodents also had anatomical constraints, which could limit the efficiency of vomiting should it be attempted, including reduced muscularity of the diaphragm and stomach geometry that is not well structured for moving contents towards the esophagus compared to species that can vomit (cat, ferret, and musk shrew. Lastly, an in situ brainstem preparation was used to make sensitive measures of mouth, esophagus, and shoulder muscular movements, and phrenic nerve activity-key features of emetic episodes. Laboratory mice and rats failed to display any of the common coordinated actions of these indices after typical emetic stimulation (resiniferatoxin and vagal afferent stimulation compared to musk shrews. Overall the results suggest that the inability to vomit is a general property of Rodentia and that an absent brainstem neurological component is the most likely cause. The implications of these findings for the utility of rodents as models in the area of emesis research are discussed.

  11. Aerosolization of a Human Norovirus Surrogate, Bacteriophage MS2, during Simulated Vomiting.

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    Grace Tung-Thompson

    Full Text Available Human noroviruses (NoV are the leading cause of acute gastroenteritis worldwide. Epidemiological studies of outbreaks have suggested that vomiting facilitates transmission of human NoV, but there have been no laboratory-based studies characterizing the degree of NoV release during a vomiting event. The purpose of this work was to demonstrate that virus aerosolization occurs in a simulated vomiting event, and to estimate the amount of virus that is released in those aerosols. A simulated vomiting device was constructed at one-quarter scale of the human body following similitude principles. Simulated vomitus matrices at low (6.24 mPa*s and high (177.5 mPa*s viscosities were inoculated with low (108 PFU/mL and high (1010 PFU/mL concentrations of bacteriophage MS2 and placed in the artificial "stomach" of the device, which was then subjected to scaled physiologically relevant pressures associated with vomiting. Bio aerosols were captured using an SKC Biosampler. In low viscosity artificial vomitus, there were notable differences between recovered aerosolized MS2 as a function of pressure (i.e., greater aerosolization with increased pressure, although this was not always statistically significant. This relationship disappeared when using high viscosity simulated vomitus. The amount of MS2 aerosolized as a percent of total virus "vomited" ranged from 7.2 x 10-5 to 2.67 x 10-2 (which corresponded to a range of 36 to 13,350 PFU total. To our knowledge, this is the first study to document and measure aerosolization of a NoV surrogate in a similitude-based physical model. This has implications for better understanding the transmission dynamics of human NoV and for risk modeling purposes, both of which can help in designing effective infection control measures.

  12. Comparison on nausea & vomiting between supine and semi fowler position during hemodialysis

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    Azizollahshahreki

    2009-01-01

    Full Text Available (Received 23 Sep, 2008; Accepted 17 Jan, 2009AbstractBackground and purpose: The most common treatment used for end-stage renal disease (ESRD is hemodialysis. Although, this treatment caused may promote longevity, however, many complications may occur, such as nausea & vomiting. Body position during hemodialysis has an effect on nausea & vomiting episodes, patients who may lay in Semi fowler position during hemodialysis are able to communicate with circumstances comfortably, furthermore, with inner organ self arrangement into body in a semi-fowler position, the stomach discharges quickly. In this study, we assessed nausea & vomiting during hemodialysis, in two supine and semi fowler position.Materials and methods: In this quasi-experimental study, one group (pre -post test,45 patients under hemodialysis in Zabol City, were placed in two positions and in each position, which took two sessions, controlled indexes for nausea and vomiting within each half hour and if changes occurred, in that moment controlled appeared.Results: Nausea incidence, during hemodialysis did not have a significant difference within the two positions. Vilkaksons test showed significant difference (P<0/05 in frequency, duration and severity of nausea incidences in two positions, while these indexes in semi- fowler position were reduced. With Vilkaksion and Mac Nemar test, any significant difference between frequency, duration and severity of vomiting incidences did not exist.Conclusion: Regarding the finding that showed majority of nausea & vomiting indexes occurrences was similar in both positions, the other index was reduced in semi- fowler position. Furthermore, since this position has been more comfortable for patients, we would suggest using semi- fowler position with hemodialysis.J Mazand Univ Med Sci 2009; 19(68: 58-63 (Persian

  13. Why can't rodents vomit? A comparative behavioral, anatomical, and physiological study.

    Science.gov (United States)

    Horn, Charles C; Kimball, Bruce A; Wang, Hong; Kaus, James; Dienel, Samuel; Nagy, Allysa; Gathright, Gordon R; Yates, Bill J; Andrews, Paul L R

    2013-01-01

    The vomiting (emetic) reflex is documented in numerous mammalian species, including primates and carnivores, yet laboratory rats and mice appear to lack this response. It is unclear whether these rodents do not vomit because of anatomical constraints (e.g., a relatively long abdominal esophagus) or lack of key neural circuits. Moreover, it is unknown whether laboratory rodents are representative of Rodentia with regards to this reflex. Here we conducted behavioral testing of members of all three major groups of Rodentia; mouse-related (rat, mouse, vole, beaver), Ctenohystrica (guinea pig, nutria), and squirrel-related (mountain beaver) species. Prototypical emetic agents, apomorphine (sc), veratrine (sc), and copper sulfate (ig), failed to produce either retching or vomiting in these species (although other behavioral effects, e.g., locomotion, were noted). These rodents also had anatomical constraints, which could limit the efficiency of vomiting should it be attempted, including reduced muscularity of the diaphragm and stomach geometry that is not well structured for moving contents towards the esophagus compared to species that can vomit (cat, ferret, and musk shrew). Lastly, an in situ brainstem preparation was used to make sensitive measures of mouth, esophagus, and shoulder muscular movements, and phrenic nerve activity-key features of emetic episodes. Laboratory mice and rats failed to display any of the common coordinated actions of these indices after typical emetic stimulation (resiniferatoxin and vagal afferent stimulation) compared to musk shrews. Overall the results suggest that the inability to vomit is a general property of Rodentia and that an absent brainstem neurological component is the most likely cause. The implications of these findings for the utility of rodents as models in the area of emesis research are discussed.

  14. Randomised clinical trial of Levonantradol and Chlorpromazine in the prevention of radiotherapy-induced vomiting

    Energy Technology Data Exchange (ETDEWEB)

    Lucraft, H.H.; Palmer, M.K. (Christie Hospital and Holt Radium Inst., Manchester (UK))

    1982-11-01

    Levonantradol is a cannabis derivative. Cannabinoid anti-emetics are being assessed in cancer chemotherapy but have been little used in radiotherapy to date. A pilot study and randomised trial compared the anti-emetic effect of a standard drug (Chlorpromazine 25 mg) with Levonantradol at two doses (0.5 and 0.75 mg) in patients receiving palliative single fraction radiotherapy to sites likely to cause nausea and vomiting. Most patients were out-patients. Both drugs were well tolerated. The frequency of vomiting was similar in all three groups in both the pilot study and randomised trial.

  15. Chemotherapy-induced nausea and vomiting. Easing patients' fear and discomfort with effective antiemetic regimens.

    Science.gov (United States)

    Bilgrami, S; Fallon, B G

    1993-10-01

    Patients receiving chemotherapy should be given optimal antiemetic therapy to maximize their comfort initially and to prevent development of delayed and anticipatory nausea and vomiting. Understanding the mechanisms of chemotherapy-induced nausea and vomiting allows the healthcare team to design drug regimens capable of avoiding these side effects. Prevention is important, because side effects can be debilitating and sometimes dose-limiting, and up to 10% of patients refuse chemotherapy altogether to avoid them. In general, combination antiemetic therapy is preferred over single-agent therapy for chemotherapeutic regimens that produce moderate to severe adverse effects.

  16. The effect of acupressure on nausea and vomiting after cesarean section under spinal anesthesia.

    Science.gov (United States)

    Noroozinia, Heydar; Mahoori, Alireza; Hasani, Ebrahim; Gerami-Fahim, Mohsen; Sepehrvand, Nariman

    2013-04-06

    Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S) under spinal anesthesia. In a prospective randomized clinical trial, 152 patients who were candidate for elective C/S under spinal anesthesia were evaluated in two groups (acupressure vs control groups). Subjects in the acupressure group received constant pressure by a specific wrist elastic band (without puncture of the skin) on the Nei-Guan acupuncture point, 30 min prior to spinal anesthesia. The incidence of PONV was assessed during the surgery, at recovery room and at 1st, 2nd and 3rd two hours after the surgery. Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure and control groups, with a reduction in the incidence rate of nausea from 35.5% to 13.2%. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the study group. In view of the total absence of side-effects in acupressure, its application is worthy. Our study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting, when applied 30 minutes prior to surgery.

  17. Binge-Eating and Vomiting: A Survey of a High School Population.

    Science.gov (United States)

    Carter, Jo A.; Duncan, Pamela A.

    1984-01-01

    Surveyed 421 high school females to determine the prevalence of bulimia. Teenage vomiters were found to have higher levels of somatic symptoms, anxiety, social dysfunction, depression, and disturbed attitudes toward food, eating, and dieting. The findings provided information useful to school personnel who work with adolescents. (JAC)

  18. Development of Foot Massage Program on Nausea and Vomiting for Cancer Patients: A Literature Review

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    Ni Ketut Guru Prapti

    2012-08-01

    Full Text Available Objective: This study aims to develop a foot massage program to support care activity in reducing nausea and vomiting for cancer patients undergoing chemotherapy. Two phases, a literature review and the development of a foot massage program were conducted. The literature review was to analyze state of the art massage techniques by reviewing problems, related theories and supporting evidence. Method: Eight published studies in the English language were reviewed. A massage can be performed for different durations, from 10 minutes up to 60 minutes for three to six weeks and can be applied on various body areas. We found that the soft stroke/effleurage seems to be the best method and is most suitable for patients with cancer. It is also evident that foot massaging can be applied as a modality to reduce nausea and vomiting for cancer patients undergoing chemotherapy. Result: We developed a foot massage program specifically for patients with cancer. The foot massage program comprised of three sessions, including 1 education session, 2 preparation session, and 3 foot massage session. In the education session, patients obtain brief information about the definition of a foot massage, the benefits and contraindication of foot massaging. During the preparation phase, foot soaking and warming up are performed. Subsequently, the foot massage is applied and should last for 30 minutes. Further research is recommended to test the effectiveness of the proposed foot massage program for nausea and vomiting in cancer patients across countries including Indonesia. Key Words: Foot massage program, chemotherapy, nausea and vomiting

  19. A review of nabilone in the treatment of chemotherapy-induced nausea and vomiting

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    Mark A Ware

    2008-03-01

    Full Text Available Mark A Ware1, Paul Daeninck2, Vincent Maida31Pain Center, McGill University Health Center, Montréal, Quebec, Canada; 2Pain and Symptom Clinic, CancerCare Manitoba, Winnipeg, Manitoba, Canada; 3University of Toronto, Toronto, Ontario, CanadaAbstract: Chemotherapy-induced nausea and vomiting (CINV in cancer patients places a significant burden on patients’ function and quality of life, their families and caregivers, and healthcare providers. Despite the advances in preventing CINV, a substantial proportion of patients experience persistent nausea and vomiting. Nabilone, a cannabinoid, recently received Food and Drug Administration approval for the treatment of the nausea and vomiting in patients receiving cancer chemotherapy who fail to achieve adequate relief from conventional treatments. The cannabinoids exert antiemetic effects via agonism of cannabinoid receptors (CB1 and CB2. Clinical trials have demonstrated the benefits of nabilone in cancer chemotherapy patients. Use of the agent is optimized with judicious dosing and selection of patients.Keywords: nabilone, chemotherapy-induced nausea/vomiting, pain

  20. Patient-practitioner perception gap in treatment-induced nausea and vomiting.

    Science.gov (United States)

    Vidall, Cheryl; Sharma, Sangeeta; Amlani, Bharat

    2016-09-08

    This UK cohort analysis of a European survey evaluated the differences between health professionals and cancer patients regarding the perceived incidence, impact and drug management of chemotherapy/radiotherapy-induced nausea/vomiting (CINV/RINV). The UK healthcare system is unique in that it has dedicated oncology clinical nurse specialists. The analysis found that more patients experienced nausea following their most recent treatment cycle than vomiting. Health professionals overestimated the incidence of CINV/RINV but underestimated its impact on patients' daily lives, particularly in cases of mild and moderate nausea/vomiting. The level of antiemetic cover initiated and degree of symptom control was often suboptimal. Patients under-reported symptoms, primarily because they considered nausea/vomiting an inevitable side effect of treatment. Altogether, 42% of patients reported full adherence to their antiemetic regimen. Leading factors for non-adherence included not having a 'preventive mindset', low symptom severity and a reluctance to increase pill burden. In conclusion, there is a perceptual gap between health professionals and patients around experiences of CINV/RINV. Advances in management depend on enhancing health professional-patient communication, and reporting and understanding nausea as a distinct issue.

  1. Chemotherapy-induced nausea and vomiting in daily clinical practice: a community hospital-based study

    NARCIS (Netherlands)

    Hilarius, D.L; Kloeg, P.H.; van der Wall, E.; van den Heuvel, J.J.G.; Gundy, C.M.; Aaronson, N.K.

    2012-01-01

    Background Chemotherapy-induced nausea and vomiting (CINV) are major adverse effects of cancer chemotherapy. This study investigated: (1) the impact of CINV on patients' health-related quality of life (HRQL) in daily clinical practice; (2) the association between patient characteristics and type of

  2. Palonosetron hydrochloride for the prevention of chemotherapy-induced nausea and vomiting

    DEFF Research Database (Denmark)

    Ruhlmann, Christina; Herrstedt, Jørn

    2010-01-01

    A large number of different 5-hydroxytryptamine (HT)(3) receptor antagonists have been marketed with the indication of preventing nausea and vomiting induced by chemotherapy--palonosetron is the most recently developed of these. Pharmacologic studies have revealed that palonosetron has a long half...

  3. Association study in eating disorders : TPH2 associates with anorexia nervosa and self-induced vomiting

    NARCIS (Netherlands)

    't Landt, M. C. T. Slof-Op; Meulenbelt, I.; Bartels, M.; Suchiman, E.; Middeldorp, C. M.; Houwing-Duistermaat, J. J.; van Trier, J.; Onkenhout, E. J.; Vink, J. M.; van Beijsterveldt, C. E. M.; Brandys, M. K.; Sanders, N.; Zipfel, S.; Herpertz-Dahlmann, B.; Klampfl, K.; Fleischhaker, C.; Zeeck, A.; de Zwaan, M.; Herpertz, S.; Ehrlich, S.; van Elburg, A. A.; Adan, R. A. H.; Scherag, S.; Hinney, A.; Hebebrand, J.; Boomsma, D. I.; van Furth, E. F.; Slagboom, P. E.; Herzog, W.

    2011-01-01

    Twin studies suggest that genetic factors play a substantial role in anorexia nervosa (AN) and self-induced vomiting (SV), a key symptom that is shared among different types of eating disorders (EDs). We investigated the association of 25 single nucleotide polymorphisms (SNPs), capturing 71-91% of t

  4. Multimodal prevention of pain, nausea and vomiting after breast cancer surgery

    DEFF Research Database (Denmark)

    Gärtner, Rune; Kroman, N; Callesen, T

    2010-01-01

    Despite many one- or two-modal attempts to relieve postoperative nausea and vomiting (PONV) and pain, postoperative issues following breast cancer surgery remain a substantial problem. Therefore, the aim of this explorative, hypothesis-generating study was to evaluate the effect of a multimodal, ...

  5. The Effect of Acupressure on Nausea and Vomiting after Cesarean Section Under Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Heydar Noroozinia

    2013-03-01

    Full Text Available Postoperative nausea and vomiting (PONV is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S under spinal anesthesia. In a prospective randomized clinical trial, 152 patients who were candidate for elective C/S under spinal anesthesia were evaluated in two groups (acupressure vs control groups. Subjects in the acupressure group received constant pressure by a specific wrist elastic band (without puncture of the skin on the Nei-Guan acupuncture point, 30 min prior to spinal anesthesia. The incidence of PONV was assessed during the surgery, at recovery room and at 1st, 2nd and 3rd two hours after the surgery. Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure and control groups, with a reduction in the incidence rate of nausea from 35.5% to 13.2%. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the study group. In view of the total absence of side-effects in acupressure, its application is worthy. Our study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting, when applied 30 minutes prior to surgery

  6. Predicting postoperative vomiting among orthopedic patients receiving patient-controlled epidural analgesia using SVM and LR.

    Science.gov (United States)

    Wu, Hsin-Yun; Gong, Cihun-Siyong Alex; Lin, Shih-Pin; Chang, Kuang-Yi; Tsou, Mei-Yung; Ting, Chien-Kun

    2016-06-01

    Patient-controlled epidural analgesia (PCEA) has been applied to reduce postoperative pain in orthopedic surgical patients. Unfortunately, PCEA is occasionally accompanied by nausea and vomiting. The logistic regression (LR) model is widely used to predict vomiting, and recently support vector machines (SVM), a supervised machine learning method, has been used for classification and prediction. Unlike our previous work which compared Artificial Neural Networks (ANNs) with LR, this study uses a SVM-based predictive model to identify patients with high risk of vomiting during PCEA and comparing results with those derived from the LR-based model. From January to March 2007, data from 195 patients undergoing PCEA following orthopedic surgery were applied to develop two predictive models. 75% of the data were randomly selected for training, while the remainder was used for testing to validate predictive performance. The area under curve (AUC) was measured using the Receiver Operating Characteristic curve (ROC). The area under ROC curves of LR and SVM models were 0.734 and 0.929, respectively. A computer-based predictive model can be used to identify those who are at high risk for vomiting after PCEA, allowing for patient-specific therapeutic intervention or the use of alternative analgesic methods.

  7. Multimodal prevention of pain, nausea and vomiting after breast cancer surgery

    DEFF Research Database (Denmark)

    Gärtner, Rune; Kroman, N; Callesen, T

    2010-01-01

    Despite many one- or two-modal attempts to relieve postoperative nausea and vomiting (PONV) and pain, postoperative issues following breast cancer surgery remain a substantial problem. Therefore, the aim of this explorative, hypothesis-generating study was to evaluate the effect of a multimodal...

  8. Self-induced vomiting in X-linked {alpha}-thalassemia/mental retardation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Kenji; Akatsuka, Akira; Ochiai, Yukikatsu [Jikei Univ. School of Medicine, Tokyo (Japan)] [and others

    1996-06-14

    This report poses the question of whether the vomiting observed in X-linked {alpha}-thalassemia/mental retardation syndrome could be self-induced. The authors present a case history which seems to support this hypothesis. 5 refs., 1 fig.

  9. Pneumomediastinum, bilateral pneumothorax, pleural effusion, and surgical emphysema after routine apicectomy caused by vomiting.

    Science.gov (United States)

    Gulati, Archita; Baldwin, Andrew; Intosh, Ian Mc; Krishnan, A

    2008-03-01

    Mediastinal and subcutaneous emphysema may occur after dental and oral surgery as a result of iatrogenic introduction of air or injury to the tracheobronchial tree. We report a patient who developed emphysema and pneumothorax after dentoalveolar surgery, which made diagnosis and management difficult. We suggest that persistent postoperative vomiting caused inhalation of mediastinal and intrathoracic air.

  10. Association study in eating disorders : TPH2 associates with anorexia nervosa and self-induced vomiting

    NARCIS (Netherlands)

    't Landt, M. C. T. Slof-Op; Meulenbelt, I.; Bartels, M.; Suchiman, E.; Middeldorp, C. M.; Houwing-Duistermaat, J. J.; van Trier, J.; Onkenhout, E. J.; Vink, J. M.; van Beijsterveldt, C. E. M.; Brandys, M. K.; Sanders, N.; Zipfel, S.; Herpertz-Dahlmann, B.; Klampfl, K.; Fleischhaker, C.; Zeeck, A.; de Zwaan, M.; Herpertz, S.; Ehrlich, S.; van Elburg, A. A.; Adan, R. A. H.; Scherag, S.; Hinney, A.; Hebebrand, J.; Boomsma, D. I.; van Furth, E. F.; Slagboom, P. E.; Herzog, W.

    2011-01-01

    Twin studies suggest that genetic factors play a substantial role in anorexia nervosa (AN) and self-induced vomiting (SV), a key symptom that is shared among different types of eating disorders (EDs). We investigated the association of 25 single nucleotide polymorphisms (SNPs), capturing 71-91% of t

  11. Gabapentin for post-operative nausea and vomiting: a pilot study

    Directory of Open Access Journals (Sweden)

    Vikram Bhandari

    2014-08-01

    Conclusions: Gabapentin in the doses used was found to ineffective in post-operative nausea and vomiting in patients undergoing planned laparoscopic cholecystectomy with standardized pre-anaesthetic and anaesthetic medication. [Int J Basic Clin Pharmacol 2014; 3(4.000: 627-631

  12. Behavioral interventions for rumination and operant vomiting in individuals with intellectual disabilities: A systematic review

    NARCIS (Netherlands)

    Lang, R.; Mulloy, A.; Giesbers, S.A.H.; Pfeiffer, B.; Delaune, E.; Didden, H.C.M.; Sigafoos, J.; Lancioni, G.E.; O'Reilly, M.F.

    2011-01-01

    We conducted a systematic analysis of studies that involved the treatment of rumination and operant vomiting in individuals with developmental disabilities. A total of 21 studies involving a combined 32 participants were identified and analyzed in terms of (a) participant characteristics, (b) depend

  13. Optimal management of severe nausea and vomiting in migraine: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Láinez MJ

    2013-10-01

    Full Text Available Miguel JA Láinez,1,2 Ana García-Casado,1 Francisco Gascón11Servicio de Neurología, Hospital Clínico Universitario, Valencia, Spain; 2Departamento de Neurología, Universidad Católica de Valencia, Valencia, SpainAbstract: Migraine is a common and potentially disabling disorder for patients, with wide-reaching implications for health care services, society, and the economy. Nausea and vomiting during migraine attacks are common symptoms that affect at least 60% of patients suffering from migraines. These symptoms are often more disabling than the headache itself, causing a great burden on the patient's life. Nausea and vomiting may delay the use of oral abortive medication or interfere with oral drug absorption. Therefore, they can hinder significantly the management and treatment of migraine (which is usually given orally. The main treatment of pain-associated symptoms of migraine (such as nausea and vomiting is to stop the migraine attack itself as soon as possible, with the effective drugs at the effective doses, seeking if necessary alternative routes of administration. In some cases, intravenous antiemetic drugs are able to relieve a migraine attack and associated symptoms like nausea and vomiting. We performed an exhaustive PubMed search of the English literature to find studies about management of migraine and its associated symptoms. Search terms were migraine, nausea, and vomiting. We did not limit our search to a specific time period. We focused on clinical efficacy and tolerance of the various drugs and procedures based on data from human studies. We included the best available studies for each discussed drug or procedure. These ranged from randomized controlled trials for some treatments to small case series for others. Recently updated books and manuals on neurology and headache were also consulted. We herein review the efficacy of the different approaches in order to manage nausea and vomiting for migraine patents

  14. The Effect of Transdermal Scopolamine for the Prevention of Postoperative Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Maria A. Antor

    2014-04-01

    Full Text Available Postoperative nausea and vomiting is one of the most common and undesirable complaints recorded in as many as 70%-80% of high-risk surgical patients. The current prophylactic therapy recommendations for PONV management stated in the Society of Ambulatory Anesthesia guidelines should start with monotherapy and patients at moderate to high risk, a combination of antiemetic medication should be considered. Consequently, if rescue medication is required, the antiemetic drug chosen should be from a different therapeutic class and administration mode than the drug used for prophylaxis. The guidelines restrict the use of dexamethasone, transdermal scopolamine, aprepitant, and palonosetron as rescue medication 6 hours after surgery. In an effort to find a safer and reliable therapy for postoperative nausea and vomiting, new drugs with antiemetic properties and minimal side effects are needed, and scopolamine may be considered an effective alternative. Scopolamine is a belladonna alkaloid, α-(hydroxymethyl benzene acetic acid 9-methyl-3-oxa-9-azatricyclo non-7-yl ester, acting as a nonselective muscarinic antagonist and producing both peripheral antimuscarinic and central sedative, antiemetic, and amnestic effects. The empirical formula is C17H21NO4 and its structural formula is a tertiary amine L-(2-scopolamine (tropic acid ester with scopine; MW = 303.4. Scopolamine became the first drug commercially available as a transdermal therapeutic system used for extended continuous drug delivery during 72 hours. Clinical trials with transdermal scopolamine have consistently demonstrated its safety and efficacy in postoperative nausea and vomiting. Thus, scopolamine is a promising candidate for the management of postoperative nausea and vomiting in adults as a first line monotherapy or in combination with other drugs. In addition, transdermal scopolamine might be helpful in preventing postoperative discharge nausea and vomiting owing to its long

  15. Relationship between Helicobacter pylori infection and vomiting induced by gastrointestinal cancer chemotherapy.

    Science.gov (United States)

    Yao, Yiwei; Ji, Chushu; He, Yifu; Pan, Yueyin

    2017-07-01

    Nausea and vomiting are the most common adverse reactions to chemotherapy. To discuss the relationship between Helicobacter pylori and chemotherapy-induced nausea and vomiting (CINV). A total of 112 patients with malignant tumours of the gastrointestinal tract was selected. Based on the 14C-urea breath test results, the patients were divided into H. pylori-positive (n = 59) and H. pylori-negative (n = 53) groups. Both groups received prophylactic antiemetic treatment during chemotherapy. The incidence of nausea and vomiting and their effects on the patients' life functions was recorded using the Multinational Association of Supportive Care in Cancer (MASCC) Antiemetic Tool (MAT) and the Functional Living Index Emesis (FLIE) from 0-120 h after chemotherapy. Records of the H. pylori-positive and H. pylori-negative groups were compared. The rates of nausea and vomiting remission were higher in the H. pylori -negative group than in the H. pylori -positive group. The proportions of no effect in daily life (NIDL) patients in the nausea and vomiting section were 73.4 and 75.5% in the H. pylori -negative group respectively. There was a higher proportion of NIDL patients in the H. pylori -negative group than in the H. pylori -positive group (P pylori infection was a factor affecting the nausea scores on the FLIE (odds ratio = 0.757, 95% confidence interval 0.597-0.960, P = 0.021). H. pylori infection in patients with cancer may be a factor that increases CINV. © 2017 Royal Australasian College of Physicians.

  16. Experiences with Nausea and Vomiting During Pregnancy in Turkish Women Based on Roy Adaptation Model: A Content Analysis

    Directory of Open Access Journals (Sweden)

    Gözde Gökçe İsbir, BSN, PhD

    2013-12-01

    Conclusion: The study findings help nursing staff detect the stimuli and the behaviors of pregnant women with nausea and vomiting. Further research may evaluate the impact of a counseling program prepared under the guidance of a nursing model on nausea and vomiting in pregnancy.

  17. Dosimetric Predictors of Radiation-induced Acute Nausea and Vomiting in IMRT for Nasopharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Victor H.F., E-mail: vhflee@hku.hk [Department of Clinical Oncology, University of Hong Kong, Queen Mary Hospital (Hong Kong); Ng, Sherry C.Y.; Leung, T.W.; Au, Gordon K.H.; Kwong, Dora L.W. [Department of Clinical Oncology, University of Hong Kong, Queen Mary Hospital (Hong Kong)

    2012-09-01

    Purpose: We wanted to investigate dosimetric parameters that would predict radiation-induced acute nausea and vomiting in intensity-modulated radiation therapy (IMRT) for undifferentiated carcinoma of the nasopharynx (NPC). Methods and Materials: Forty-nine consecutive patients with newly diagnosed NPC were treated with IMRT alone in this prospective study. Patients receiving any form of chemotherapy were excluded. The dorsal vagal complex (DVC) as well as the left and right vestibules (VB-L and VB-R, respectively) were contoured on planning computed tomography images. A structure combining both the VB-L and the VB-R, named VB-T, was also generated. All structures were labeled organs at risk (OAR). A 3-mm three-dimensional margin was added to these structures and labeled DVC+3 mm, VB-L+3 mm, VB-R+3 mm, and VB-T+3 mm to account for physiological body motion and setup error. No weightings were given to these structures during optimization in treatment planning. Dosimetric parameters were recorded from dose-volume histograms. Statistical analysis of parameters' association with nausea and vomiting was performed using univariate and multivariate logistic regression. Results: Six patients (12.2%) reported Grade 1 nausea, and 8 patients (16.3%) reported Grade 2 nausea. Also, 4 patients (8.2%) complained of Grade 1 vomiting, and 4 patients (8.2%) experienced Grade 2 vomiting. No patients developed protracted nausea and vomiting after completion of IMRT. For radiation-induced acute nausea, V40 (percentage volume receiving at least 40Gy) to the VB-T and V40>=80% to the VB-T were predictors, using univariate analysis. On multivariate analysis, V40>=80% to the VB-T was the only predictor. There were no predictors of radiation-induced acute vomiting, as the number of events was too small for analysis. Conclusions: This is the first study demonstrating that a V40 to the VB-T is predictive of radiation-induced acute nausea. The vestibules should be labeled as sensitive OARs

  18. Alexander disease as a cause of nocturnal vomiting in a 7-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Niinikoski, Harri [University of Turku, Department of Paediatrics, Turku (Finland); Haataja, Leena [University of Turku, Department of Paediatrics, Turku (Finland); University of Turku, Department of Pediatric Neurology, Turku (Finland); Brander, Antti [University of Tampere, Department of Radiology, Tampere (Finland); Valanne, Leena [University of Helsinki, Department of Radiology, Helsinki (Finland); Blaser, Susan [Hospital for Sick Children, Department of Radiology, Toronto (Canada)

    2009-08-15

    Alexander disease is a rare form of leukodystrophy with a highly variable clinical course. Occasionally night-time nausea and vomiting are the first symptoms of juvenile Alexander disease. A 7-year-old girl had recurrent night-time vomiting and her growth and weight gain had deteriorated after her sixth birthday. Cranial MRI demonstrated two small, symmetrical focal areas of abnormally high signal intensity in the dorsal medulla oblongata on T2-W and FLAIR images. These were suggestive of juvenile Alexander disease, and subsequent sequencing of the glial fibrillary acidic protein (GFAP) gene revealed a heterogeneous missense mutation in the GFAP gene in exon 6. Alexander disease should be considered in young patients with atypical anorexia nervosa-type symptoms. (orig.)

  19. The Role of Ultrasound in Identifying the Cause of Bilious Vomiting in the Newborn

    Directory of Open Access Journals (Sweden)

    Mehdi Alehossein

    2009-01-01

    Full Text Available "nIntroduction: A standard teaching rule in pediatric surgery, is that bile vomiting in a neonate indicates intestinal obstruction until proven otherwise .However, there are some recent reports that show bilious vomiting was observed in conditions other than intestinal obstruction or malrotation in up to two thirds of cases. Intestinal malrotation can result in midgut volvulus, a condition that is usually fatal if not surgically corrected. The standard diagnostic test for confirming it is upper gastrointestinal contrast study. But there are increasing reports of using ultrasound for diagnosis of midgut volvulus. In this study, we evaluate the role of ultrasound as a complementary or single imaging method for identifying the cause of bilious vomiting. "nMaterials and Methods: All neonates with a history of bilious vomiting referred to the radiology department of Bahrami children’s hospital during a 1-year-period (from November 2007 to December 2008 were prospectively audited .Neonates in whom the cause of vomiting was evident in a plain abdominal film or had a nasogastric tube in the duodenum were excluded. Sonography was performed with a Sonoline G50 Ultrasound scanner (Siemens medical solutions, Erlangen, Germany with 7.5 -MHz convex and 10-MHz linear transducers. Some neonates had follow-up UGI and/or contrast enema .However, the final outcome of the neonates was measured by surgery or with clinical follow-up during hospitalization in a few cases. "nResults: Twenty three consecutive neonates (15 boys, 8 girls were enrolled in this study .Their median age was 8.2 days (1-27 days. A surgical etiology of bilious vomiting was identified in 18 ( 78%: duodenal stenosis or atresia ( n=5, jejunal atresia ( n=4, intestinal malrotation with or without volvulus ( n=4 in concordance with sonographic diagnosis . Hirschprung‘s disease (n=2, bowel stenosis (n=1 and imperforate anus (n=1 presented sonographically with a suspicious lower obstruction .There

  20. The prevention of postoperative vomiting following strabismus surgery in children with using Promethazine and Droperidol

    Directory of Open Access Journals (Sweden)

    Shaigh al Islam V

    1996-07-01

    Full Text Available Children undergoing general anesthesia for strabismus surgery have a higher incidence of postoperative vomiting than those receiving the same anaesthesia for other types of ambulatory surgical procedures. Droperidol (0/0 75 mg/kg IV and promethazine (0.05-1.0 mg/kg were used in 100 children between 2-15 years old. Promethazine which has sedative property, anticholinergic antihistaminic, antiemetic and anti-motion sickness effects is recommended for children 0.05 mg-1.0 mg/kg of body weight IV. After induction of anesthesia and before operation and manipulation of the eye and combined with 0.5 mg/kg IM promethazine after operation. The incidence of vomiting following strabismus surgery might be reduced more than with intravenous droperidol

  1. Neuromyelitis Optica: An Often Forgotten Cause of Intractable Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Chijioke Enweluzo

    2013-07-01

    Full Text Available Neuromyelitis optica, also known as Devic's disease, is a rare autoimmune disorder in which a patient's immune system affects the optic nerves and the spinal cord, leading to loss of vision and spinal cord dysfunction. We present our experience with a 38-year-old female who presented to our facility with complaints of intractable nausea and vomiting. After extensive evaluation, she was found to have neuromyelitis optica. Her symptoms completely resolved following institution of appropriate therapy. She made a significant recovery and has since been placed on chronic immunosuppressive therapy. Through this article we hope to bring attention to a significant cause of intractable nausea and vomiting that may often be forgotten in general medicine or gastroenterology services.

  2. Duodenal Duplication Cyst: A Rare Differential Diagnosis in a Neonate with Bilious Vomiting

    Science.gov (United States)

    Župančić, Božidar; Gliha, Andro; Fuenzalida, Jose Varas; Višnjić, Stjepan

    2015-01-01

    Bilious vomiting is a relevant sign in neonates that requires immediate evaluation and diagnosis. A duplication of the intestinal tract is a possible cause of obstruction if located distally to the major duodenal papilla of Vater and most of them involve the jejunum, stomach, or colon. Duodenal duplications are very rare and can have an endoscopic or surgical treatment after diagnosis. We present a case of a 16-day-old term newborn that consulted because of bilious vomiting and after evaluation with imaging and upper endoscopy, a duodenal duplication cyst was found at the level of the third portion causing compression of the intestinal lumen that required surgical resolution with duodenocystostomy. PMID:26788454

  3. Economic and clinical burden of opioid-induced nausea and vomiting.

    Science.gov (United States)

    Nicholson, Bruce D

    2017-01-01

    Opioids are the standard of care for treating moderate-to-severe pain; however, their efficacy can be limited by adverse events (AEs), including nausea and vomiting. Opioid-induced nausea and vomiting (OINV) is an inherent adverse effect of opioid treatment, exerting effects centrally and peripherally. Opioid-related AEs can impact treatment adherence and discontinuation, which can result in inadequate pain management. OINV may persist long-term, negatively affecting patient functional outcomes, physical and mental health, patient satisfaction, and overall costs of treatment. Multiple factors may contribute to OINV, including activation of opioid receptors in the chemoreceptor trigger zone, vestibular apparatus, and gastrointestinal tract. Prophylactic or early treatment with antiemetics may be appropriate for patients who are at high risk for OINV.

  4. An assessment of chemotherapy-induced nausea and vomiting direct costs in three EU countries

    OpenAIRE

    Turini, Marco; Piovesana, Vittoria; Ruffo, Pierfrancesco; Ripellino,Claudio; Cataldo, Nazarena

    2015-01-01

    Background: chemotherapy-induced nausea and vomiting (CINV) has been commonly reported as one of the most distressing adverse effects among treated patients with cancer. Inadequately treated, CINV can lead to increased resource utilization and severely impair patients’ daily functioning and quality of life. Direct costs include acquisition cost of antiemetic drugs and rescue medication, administration devices, add-on treatments, such as hydration, and additional patient care, that is, nursing...

  5. Novel Airway Training Tool that Simulates Vomiting: Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) System.

    Science.gov (United States)

    DuCanto, James; Serrano, Karen D; Thompson, Ryan J

    2017-01-01

    We present a novel airway simulation tool that recreates the dynamic challenges associated with emergency airways. The Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) simulation system trains providers to use suction to manage emesis and bleeding complicating intubation. We modified a standard difficult-airway mannequin head (Nasco, Ft. Atkinson, WI) with hardware-store equipment to enable simulation of vomiting or hemorrhage during intubation. A pre- and post-survey was used to assess the effectiveness of the SALAD simulator. We used a 1-5 Likert scale to assess confidence in managing the airway of a vomiting patient and comfort with suction techniques before and after the training exercise. Forty learners participated in the simulation, including emergency physicians, anesthesiologists, paramedics, respiratory therapists, and registered nurses. The average Likert score of confidence in managing the airway of a vomiting or hemorrhaging patient pre-session was 3.10±0.49, and post-session 4.13±0.22. The average score of self-perceived skill with suction techniques in the airway scenario pre-session was 3.30±0.43, and post-session 4.03±0.26. The average score for usefulness of the session was 4.68±0.15, and the score for realism of the simulator was 4.65±0.17. A training session with the SALAD simulator improved trainee's confidence in managing the airway of a vomiting or hemorrhaging patient. The SALAD simulation system recreates the dynamic challenges associated with emergency airways and holds promise as an airway training tool.

  6. Case-control study of food intake, nausea and vomiting of pregnant women

    OpenAIRE

    2014-01-01

    Background: Severe pregnancy induced nausea and vomiting, also known as Hyperemesis gravidarum (HG), can lead to significant reduced quality of life (QOL) and of food intake. Untreated this can potentially harm both mother and foetus. An English questionnaire, PUQE, identifies women severely affected with HG. Our aim in present study was to investigate whether scores from a Norwegian translated version of PUQE; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of na...

  7. International Patterns of Practice in the Management of Radiation Therapy-induced Nausea and Vomiting

    Energy Technology Data Exchange (ETDEWEB)

    Dennis, Kristopher; Zhang Liying [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Lutz, Stephen [Blanchard Valley Health Systems, Findlay, Ohio (United States); Baardwijk, Angela van [Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Linden, Yvette van der [Leiden University Medical Center, Leiden (Netherlands); Holt, Tanya [Radiation Oncology Mater Centre, Princess Alexandra Hospital, Brisbane (Australia); Arnalot, Palmira Foro [Parc de Salut Mar. Universitat Pompeu Fabra Barcelona (Spain); Lagrange, Jean-Leon [AP-HP Hopital Henri-Mondor, Universite Paris Est Creteil, Creteil (France); Maranzano, Ernesto [' S. Maria' Hospital, Terni (Italy); Liu, Rico [Queen Mary Hospital, Hong Kong (China); Wong, Kam-Hung [Queen Elizabeth Hospital, Hong Kong (Hong Kong); Wong, Lea-Choung [National University Cancer Institute (Singapore); Vassiliou, Vassilios [Bank of Cyprus Oncology Centre, Nicosia (Cyprus); Corn, Benjamin W. [Tel Aviv Medical Center, Tel Aviv (Israel); De Angelis, Carlo; Holden, Lori; Wong, C. Shun [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To investigate international patterns of practice in the management of radiation therapy-induced nausea and vomiting (RINV). Methods and Materials: Oncologists prescribing radiation therapy in the United States, Canada, The Netherlands, Australia, New Zealand, Spain, Italy, France, Hong Kong, Singapore, Cyprus, and Israel completed a Web-based survey that was based on 6 radiation therapy-only clinical cases modeled after the minimal-, low-, moderate-, and high-emetic risk levels defined in the antiemetic guidelines of the American Society of Clinical Oncology and the Multinational Association of Supportive Care in Cancer. For each case, respondents estimated the risks of nausea and vomiting separately and committed to an initial management approach. Results: In total, 1022 responses were received. Risk estimates and management decisions for the minimal- and high-risk cases varied little and were in line with guideline standards, whereas those for the low- and moderate-risk cases varied greatly. The most common initial management strategies were as follows: rescue therapy for a minimal-risk case (63% of respondents), 2 low-risk cases (56% and 80%), and 1 moderate-risk case (66%); and prophylactic therapy for a second moderate-risk case (75%) and a high-risk case (95%). The serotonin (5-HT){sub 3} receptor antagonists were the most commonly recommended prophylactic agents. On multivariate analysis, factors predictive of a decision for prophylactic or rescue therapy were risk estimates of nausea and vomiting, awareness of the American Society of Clinical Oncology antiemetic guideline, and European Society for Therapeutic Radiology and Oncology membership. Conclusions: Risk estimates and management strategies for RINV varied, especially for low- and moderate-risk radiation therapy cases. Radiation therapy-induced nausea and vomiting are under-studied treatment sequelae. New observational and translational studies are needed to allow for individual patient risk

  8. Pericardium-6 Acupressure for the Prevention of Postoperative Nausea and Vomiting

    Science.gov (United States)

    1999-10-01

    conducted to provide information to the anesthesia community on the use of acupressure for the prevention of postoperative nausea and vomiting. It was...that is expected in this study (Dr. Levine, personal communication , Feb 13, 1998). An attempt was made to recruit approximately 50 subjects into the...background . Journal of Nurse- Midwifery , 37(4), 254-259. Beal, M. (1992b). Acupuncture and related treatment modalities part II: Applications to

  9. Vomiting Blood

    Science.gov (United States)

    ... Accessed Jan. 26, 2017. Rockey DC. Causes of upper gastrointestinal bleeding in adults. http://www.uptodate.com/home. Accessed Jan. 26, 2017. Villa X. Approach to upper gastrointestinal bleeding in children. http://www.uptodate.com/home. Accessed ...

  10. Infant Vomiting

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  11. Significantly Elevated Serum Lipase in Pregnancy with Nausea and Vomiting: Acute Pancreatitis or Hyperemesis Gravidarum?

    Directory of Open Access Journals (Sweden)

    Amanda Johnson

    2015-01-01

    Full Text Available Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum. However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting but without abdominal pain. They were found to have severely elevated lipase levels over 1,000 units/liter. In the absence of other findings of pancreatitis, they were treated with conservative measures for hyperemesis gravidarum, with eventual resolution to normal lipase levels. Although significantly elevated lipase level in pregnant patients with nausea and vomiting is a concern for acute pancreatitis, these two cases of significantly elevated serum lipase without other clinical findings of pancreatitis led to this report that serum lipase could be quite elevated in hyperemesis gravidarum and that it might not be an accurate biochemical marker for acute pancreatitis. Imaging studies are thus necessary to establish the diagnosis of acute pancreatitis.

  12. Gastric Ollulanus tricuspis infection identified in captive cheetahs (Acinonyx jubatus with chronic vomiting : case report

    Directory of Open Access Journals (Sweden)

    M.G. Collett

    2000-07-01

    Full Text Available Gastritis, vomition and weight loss are common in captive cheetahs (Acinonyx jubatus. Gastric spiral bacteria (Helicobacter spp. and the very small, viviparous nematode Ollulanus tricuspis, a stomach worm of cats, are believed to be important causes. Three sibling cheetahs at Wellington Zoo, New Zealand, developed chronic vomiting, diarrhoea and debility. Their parents were both South African-born. Response to antibacterial treatment was poor. Endoscopic examinations revealed chronic lymphoplasmacytic gastritis and Ollulanus infection. Treatment with oxfendazole and pyrantel embonate resulted in clinical improvement; however, 1 cheetah, which died 7 months later as a result of a ruptured liver due to hepatic amyloidosis, still had Ollulanus worms present in her stomach. Ollulanus tricuspis is a significant cause of gastritis and vomiting in captive cheetahs, lions and tigers, as well as wild cougars and tigers. The parasite has not yet been found in sub-Saharan Africa. Because of the unusual characteristics of this parasite, the literature on its life history and techniques for diagnosis is reviewed.

  13. Chemotherapy-Induced Nausea and Vomiting: A Narrative Review to Inform Dietetics Practice.

    Science.gov (United States)

    Marx, Wolfgang; Kiss, Nicole; McCarthy, Alexandra L; McKavanagh, Dan; Isenring, Liz

    2016-05-01

    Chemotherapy-induced nausea and vomiting (CINV) are common symptoms experienced by patients with cancer that influence nutrition. They exert a detrimental effect on dietary intake, risk of malnutrition, and quality of life. Whereas CINV are primarily managed with medication, nutrition and dietetics practitioners play an important role in the management of CINV-related complications such as reduced dietary intake. This review discusses the burden of nausea and vomiting that patients with cancer can experience, including the effect on quality of life, nutritional status, and treatment outcomes. Implications for dietetics practice include the need to explore the nature of reported symptoms, identify predisposing risk factors, and to consider the use of a variety of interventions that are individualized to a patient's symptoms. There are little clinical data regarding effective dietetic interventions for nausea and vomiting. In summary, this review discusses dietetics-related issues surrounding CINV, including the pathophysiology, risk factors, prevalence, and both pharmacologic and dietetic treatment options. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  14. Carbamazepine for prevention of chemotherapy-induced nausea and vomiting: a pilot study

    Directory of Open Access Journals (Sweden)

    Thaiana Aragão Santana

    Full Text Available CONTEXT AND OBJECTIVE: Nausea and vomiting are major inconveniences for patients undergoing chemotherapy. Despite standard preventive treatment, chemotherapy-induced nausea and vomiting (CINV still occurs in approximately 50% of these patients. In an attempt to optimize this treatment, we evaluated the possible effects of carbamazepine for prevention of CINV.DESIGN AND LOCATION: Prospective nonrandomized open-label phase II study carried out at a Brazilian public oncology service. METHODS: Patients allocated for their first cycle of highly emetogenic chemotherapy were continuously recruited. In addition to standard antiemetic protocol that was made available, they received carbamazepine orally, with staggered doses, from the third day before until the fifth day after chemotherapy. Considering the sparseness of evidence about the efficacy of anticonvulsants for CINV prevention, we used Simon's two-stage design, in which 43 patients should be included unless overall complete prevention was not achieved in 9 out of the first 15 entries. The Functional Living Index-Emesis questionnaire was used to measure the impact on quality of life.RESULTS:None of the ten patients (0% presented overall complete prevention. In three cases, carbamazepine therapy was withdrawn because of somnolence and vomiting before chemotherapy. Seven were able to take the medication for the entire period and none were responsive, so the study was closed. There was no impact on the patients' quality of life.CONCLUSION: Carbamazepine was not effective for prevention of CINV and also had a deleterious side-effect profile in this population.

  15. Refractory nausea and vomiting in the setting of well-controlled idiopathic intracranial hypertension.

    Science.gov (United States)

    Barnett, Dennis L; Rosenbaum, Rachel A; Diaz, Jonathan R

    2014-06-03

    Summary A 27-year-old woman with a history of recurrent nausea and vomiting in the setting of idiopathic intracranial hypertension (IIH) was admitted for control of unremitting nausea and vomiting. Initial antiemetic therapy included optimisation of IIH therapy by titrating acetazolamide, in addition to using ondansetron and metoclopramide as needed, with minimal relief. She was ultimately treated with palonosetron with complete resolution of her acute nausea. Nausea, often treated with 5-hydroxytryptamine (5-HT3) receptor antagonists, approved for perioperative and chemotherapy-induced nausea, are used off-label to treat nausea and vomiting outside of those settings. The efficacy of different regimens has been compared in the literature and continues to remain controversial. When choosing from different 5-HT3 antagonists there are other considerations, in addition to efficacy to consider: dosing schedule, half-life, time of onset, duration and cost-to-benefit ratio, and although one 5-HT3 antagonist may not have been effective, another one may be. In our case palonosetron, with a significantly longer half-life than other 5-HT3 antagonists, was effective in resolving nausea when compared with the more commonly used ondansetron.

  16. Investigation of the Effects of Preoperative Hydration on the Postoperative Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    M. Selçuk Yavuz

    2014-01-01

    Full Text Available Introduction. Postoperative nausea and vomiting (PONV after laparoscopic cholecystectomy operations still continue to be a serious problem. Intravenous fluid administration has been shown to reduce PONV. Some patients have higher risk for PONV described by APFEL score. In this study, our aim was to determine the effects of preoperative intravenous hydration on postoperative nausea and vomiting in high Apfel scored patients undergoing laparoscopic cholecystectomy surgery. Patients and Methods. This study is performed with 50 female patients who had APFEL score 3-4 after ethics committee approval and informed consent was taken from patients. The patients were divided into 2 groups: group 1 (P1: propofol + preoperative hydration and group 2 (P2: propofol + no preoperative hydration. Results. When the total nausea VAS scores of groups P1 and P2 to which hydration was given or not given were compared, a statistically significant difference was detected at 8th and 12th hours (P=0.001 and P=0.041. It was observed that in group P1, which was given hydration, the nausea VAS score was lower. When the total number of patients who had nausea and vomiting in P1 and P2, more patients suffered nausea in P2 group. Discussion. Preoperative hydration may be effective in high Apfel scored patients to prevent postoperative nausea.

  17. Nausea and vomiting in pregnancy: a review of the pathology and compounding opportunities.

    Science.gov (United States)

    Zur, Eyal

    2013-01-01

    Nausea and vomiting in pregnancy can have serious adverse effects on the quality of a woman's life, affecting her occupational, social, and domestic functioning, and her general well-being; therefore, it is very important to treat this condition appropriately and effectively. Evidence-based algorithms support the use of oral pyridoxine alone or combined with doxylamine as first-line treatment. Promethazine or dimenhydrinate, known as a second-line treatment, should be added to the first-line treatment or should be added only to pyridoxine according to different algorithms. In most of the world, there is a lack of approved medicines using this combination approach known as the first-line treatment. Therefore, compounding pharmacists should supply the demand by compounding 10-mg pyridoxine hydrochloride and 10-mg doxylamine succinate slow-release capsules. Since transdermal promethazine does not exist world wide, and, since this medicine has significant added values compared to the oral/rectal dosage forms, compounding pharmacists should offer physicians transdermal promethazine as a second-line therapy in nausea and vomiting in pregnancy. This review summarizes the nausea and vomiting in pregnancy problems and discusses the compounding opportunities that exist in this common and wide-spread pathology in order to improve a woman's quality of life.

  18. Prevention of acute chemotherapy-induced nausea and vomiting: the role of palonosetron

    Directory of Open Access Journals (Sweden)

    Emilio Bajetta

    2009-08-01

    Full Text Available Emilio Bajetta, Sara Pusceddu, Valentina Guadalupi, Monika Ducceschi, Luigi CelioMedical Oncology Unit 2, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, ItalyAbstract: Prevention of nausea and vomiting is the main goal of antiemetic treatment in cancer patients scheduled to receive chemotherapy. To prevent acute emesis, antiemetics should be administered just before chemotherapy and patients should be protected for up to 24 hours after chemotherapy initiation. The emetogenic potential of chemotherapeutic agents guides clinicians towards the most appropriate antiemetic prophylaxis. Current guidelines recommend the use of 5-HT3 receptor antagonist (RA either alone or in combination with dexamethasone and/or a neurokinin-1 RA both in the acute and delayed phases. The second-generation 5-HT3RA palonosetron exhibits a longer half-life and a higher binding affinity than older antagonists. Palonosetron has been approved by the FDA for the prevention of chemotherapy-induced nausea and vomiting (CINV in patients scheduled to receive either moderately (MEC or highly emetogenic chemotherapy (HEC and for the prevention of delayed CINV in patients receiving MEC. The present review will discuss the role of palonosetron in the prevention of acute CINV.Keywords: antiemetics, chemotherapy, nausea, vomiting, serotonin-receptor antagonists, palonosetron

  19. Ginger-Mechanism of action in chemotherapy-induced nausea and vomiting: A review.

    Science.gov (United States)

    Marx, Wolfgang; Ried, Karin; McCarthy, Alexandra L; Vitetta, Luis; Sali, Avni; McKavanagh, Daniel; Isenring, Liz

    2017-01-02

    Despite advances in antiemetic therapy, chemotherapy-induced nausea and vomiting (CINV) still poses a significant burden to patients undergoing chemotherapy. Nausea, in particular, is still highly prevalent in this population. Ginger has been traditionally used as a folk remedy for gastrointestinal complaints and has been suggested as a viable adjuvant treatment for nausea and vomiting in the cancer context. Substantial research has revealed ginger to possess properties that could exert multiple beneficial effects on chemotherapy patients who experience nausea and vomiting. Bioactive compounds within the rhizome of ginger, particularly the gingerol and shogaol class of compounds, interact with several pathways that are directly implicated in CINV in addition to pathways that could play secondary roles by exacerbating symptoms. These properties include 5-HT3, substance P, and acetylcholine receptor antagonism; antiinflammatory properties; and modulation of cellular redox signaling, vasopressin release, gastrointestinal motility, and gastric emptying rate. This review outlines these proposed mechanisms by discussing the results of clinical, in vitro, and animal studies both within the chemotherapy context and in other relevant fields. The evidence presented in this review indicates that ginger possesses multiple properties that could be beneficial in reducing CINV.

  20. Granisetron versus tropisetron in the prevention of postoperative nausea and vomiting after total thyroidectomy

    Directory of Open Access Journals (Sweden)

    Artemisia Papadima

    2013-01-01

    Full Text Available Background: Postoperative nausea and vomiting (PONV are frequently encountered after thyroidectomy. For PONV prevention, selective serotonin 5-hydroxytryptamine type 3 (5-HT 3 receptor antagonists are considered one of the first-line therapy. We report on the efficiency of granisetron and tropisetron, with that of placebo on the prevention of PONV in patients undergoing total thyroidectomy. Methods: One hundred twenty-seven patients were divided into three groups and randomized to receive intravenously, prior to induction of anesthesia, tropisetron 5 mg, or granisetron 3 mg, or normal saline. All patients received additionally 0.625 mg droperidol. All episodes of postoperative PONV during the first 24 h after surgery were evaluated. Results: Nausea visual analogue scale (VAS score was lower in tropisetron and granisetron groups than the control group at all measurements ( P<0.01 except for the 8-h measurement for tropisetron ( P=0.075. Moreover, granisetron performed better than tropisetron ( P<0.011 at 4 h and P<0.01 at all other points of time apart from the 2-h measurement. Vomiting occurred in 22.2%, 27.5%, and 37.5% in granisetron, tropisetron, and control groups, respectively ( P=0.43. Conclusions: The combination of the 5-HT 3 antagonists with droperidol given before induction of anesthesia is well tolerated and superior to droperidol alone in preventing nausea but not vomiting after total thyroidectomy.

  1. Antiemetic Therapy With or Without Olanzapine in Preventing Chemotherapy-Induced Nausea and Vomiting in Patients With Cancer Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies antiemetic therapy with olanzapine to see how well they work compared to antiemetic therapy alone in preventing chemotherapy-induced nausea and vomiting in patients with cancer receiving highly emetogenic (causes vomiting) chemotherapy. Antiemetic drugs, such as palonosetron hydrochloride, ondansetron, and granisetron hydrochloride, may help lessen or prevent nausea and vomiting in patients treated with chemotherapy. |

  2. Control of abdominal and expiratory intercostal muscle activity during vomiting - Role of ventral respiratory group expiratory neurons

    Science.gov (United States)

    Miller, Alan D.; Tan, L. K.; Suzuki, Ichiro

    1987-01-01

    The role of ventral respiratory group (VRG) expiratory (E) neurons in the control of abdominal and internal intercostal muscle activity during vomiting was investigated in cats. Two series of experiments were performed: in one, the activity of VRG E neurons was recorded during fictive vomiting in cats that were decerebrated, paralyzed, and artificially ventilated; in the second, the abdominal muscle activity during vomiting was compared before and after sectioning the axons of descending VRG E neurons in decerebrate spontaneously breathing cats. The results show that about two-thirds of VRG E neurons that project at least as far caudally as the lower thoracic cord contribute to internal intercostal muscle activity during vomiting. The remaining VRG E neurons contribute to abdominal muscle activation. As shown by severing the axons of the VRG E neurons, other, as yet unidenified, inputs (either descending from the brain stem or arising from spinal reflexes) can also produce abdominal muscle activation.

  3. Development of aprepitant, the first neurokinin-1 receptor antagonist for the prevention of chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Hargreaves, Richard; Ferreira, Juan Camilo Arjona; Hughes, David; Brands, Jos; Hale, Jeff; Mattson, Britta; Mills, Sandy

    2011-03-01

    Chemotherapy can be a life-prolonging treatment for many cancer patients, but it is often associated with profound nausea and vomiting that is so distressing that patients may delay or decline treatment to avoid these side effects. EMEND (aprepitant) is the first and only neurokinin-1 (NK-1) receptor antagonist available on the market for the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Aprepitant acts centrally at NK-1 receptors in vomiting centers within the central nervous system to block their activation by substance P released as an unwanted consequence of chemotherapy. By controlling nausea and vomiting, EMEND helps improve patients' daily living and their ability to complete multiple cycles of chemotherapy. The development of aprepitant included a novel nanoparticle formulation to optimize oral absorption and innovative chemistry to discover a prodrug form suitable for intravenous administration to improve compliance and convenience for healthcare professionals and cancer patients.

  4. Palonosetron Hydrochloride in Preventing Nausea and Vomiting Caused by Radiation Therapy in Patients With Primary Abdominal Cancer

    Science.gov (United States)

    2016-08-11

    Anal Cancer; Carcinoma of the Appendix; Colorectal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Gastrointestinal Carcinoid Tumor; Liver Cancer; Nausea and Vomiting; Pancreatic Cancer; Primary Peritoneal Cavity Cancer; Small Intestine Cancer

  5. Epidemiology of nausea and vomiting of pregnancy: prevalence, severity, determinants, and the importance of race/ethnicity

    National Research Council Canada - National Science Library

    Lacasse, Anaïs; Rey, Evelyne; Ferreira, Ema; Morin, Caroline; Bérard, Anick

    2009-01-01

    ... the multidimensional associations. The objectives of this study were to: 1) Estimate the prevalence and the severity of nausea and vomiting of pregnancy during the 1st and the 2nd trimester of pregnancy, and 2...

  6. Control of abdominal and expiratory intercostal muscle activity during vomiting - Role of ventral respiratory group expiratory neurons

    Science.gov (United States)

    Miller, Alan D.; Tan, L. K.; Suzuki, Ichiro

    1987-01-01

    The role of ventral respiratory group (VRG) expiratory (E) neurons in the control of abdominal and internal intercostal muscle activity during vomiting was investigated in cats. Two series of experiments were performed: in one, the activity of VRG E neurons was recorded during fictive vomiting in cats that were decerebrated, paralyzed, and artificially ventilated; in the second, the abdominal muscle activity during vomiting was compared before and after sectioning the axons of descending VRG E neurons in decerebrate spontaneously breathing cats. The results show that about two-thirds of VRG E neurons that project at least as far caudally as the lower thoracic cord contribute to internal intercostal muscle activity during vomiting. The remaining VRG E neurons contribute to abdominal muscle activation. As shown by severing the axons of the VRG E neurons, other, as yet unidenified, inputs (either descending from the brain stem or arising from spinal reflexes) can also produce abdominal muscle activation.

  7. Biopsychosocial approaches to a patient with vomiting of 10 years' duration – a case of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Kitamura Kana

    2009-01-01

    Full Text Available Abstract Background Vomiting is commonly encountered in clinical medicine. When organic gastrointestinal, metabolic, and brain diseases are ruled out, many cases are considered to be functional. We experienced an adult patient with epilepsy whose main symptom was vomiting. Biopsychosocial approaches were needed to control the symptoms. Case presentation A 26-year-old female with a 10-year history of persistent vomiting was found to have temporal lobe epilepsy (TLE. Throughout this time, during which the vomiting had become part of a vicious cycle, her epilepsy was poorly controlled by medication. Biopsychosocial approaches were employed successfully and the patient subsequently undertook training to become a home-helper, started a job, and was able to leave her parents' house and live independently. All of her symptoms resolved after she became self-sufficient. Discussion Vomiting without impaired consciousness is seldom considered to be a manifestation of epilepsy. Difficulty in recording an electroencephalogram (EEG because of the presence of persistent vomiting delayed the diagnosis. The improvement of symptoms was thought to have been due to the patient's emotional stabilization and physical improvement, which may have stabilized the limbic system. Conclusion When an illness persists for many years and conditioning and a vicious cycle occur secondarily, systematic biopsychosocial approaches are needed in addition to general treatment. Also, secondary symptoms make the diagnosis more difficult when efforts at treatment are ineffective.

  8. The Effect of Ginger Extract on the Incidence and Severity of Nausea and Vomiting After Cesarean Section Under Spinal Anesthesia.

    Science.gov (United States)

    Zeraati, Hossein; Shahinfar, Javad; Imani Hesari, Shiva; Masrorniya, Mahnaz; Nasimi, Fatemeh

    2016-10-01

    Nausea and vomiting are one of the most common complications of cesarean sections under spinal anesthesia. Recently, the use of drugs to treat nausea and vomiting has decreased, and nonpharmaceutical and alternative traditional medicine are often preferred. This study aimed to determine the effect of ginger extract on the incidence and severity of nausea and vomiting after cesarean section under spinal anesthesia. In this double-blind randomized clinical trial, 92 pregnant women, each of whom underwent a cesarean section under spinal anesthesia, were divided in two groups: a control group and an intervention group. The intervention group received 25 drops of ginger extract in 30 cc of water, and the control group received 30 cc of water one hour before surgery. The incidence and severity of nausea and vomiting were assessed during the surgery and two and four hours after the surgery using a self-report scale. Data analysis was performed using SPSS software and statistical tests. There was no statistically significant difference between the two groups in terms of maternal age, duration of fasting, duration of surgery, and confounding factors (P > 0.05). According to an independent t-test, there was a significant relationship between the two groups in terms of the incidence and mean severity score of nausea and vomiting during the cesarean section (P 0.05). The findings of this study showed that ginger extract can be used for the prevention of nausea and vomiting during cesarean section under spinal anesthesia.

  9. Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

    Directory of Open Access Journals (Sweden)

    Brian R. Sharp

    2016-09-01

    Full Text Available Introduction: Nausea and vomiting in pregnancy (NVP is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods: We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results: There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6% had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06-1.61], high parity (OR 1.50 95% CI [1.12-2.00], and early gestational age (OR 0.74 95% CI [0.60-0.90] were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59-0.91] was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002. Conclusion: NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition.

  10. Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

    Science.gov (United States)

    Sharp, Brian R.; Sharp, Kristen M.; Patterson, Brian; Dooley-Hash, Suzanne

    2016-01-01

    Introduction Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06–1.61]), high parity (OR 1.50 95% CI [1.12–2.00]), and early gestational age (OR 0.74 95% CI [0.60–0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59–0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002). Conclusion NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition. PMID:27625723

  11. Prevention of chemotherapy-induced nausea and vomiting in elderly cancer patients

    DEFF Research Database (Denmark)

    Jakobsen, Jan Nyrop; Herrstedt, Jørn

    2009-01-01

    There is a global and continuing increase in the population of elderly people. This is particularly true among patients with cancer including those receiving chemotherapy. There are no guidelines that in particular address prophylaxis of chemotherapy-induced nausea and vomiting (CINV) in the elde......, use of poly-pharmacy with increased risk of drug-drug interactions and due to co-morbidity. Compliance needs to be carefully evaluated, particularly in patients with high risk of non-compliance, such as elderly with dementia and impaired vision....

  12. A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia.

    Science.gov (United States)

    Mutreja, Deepti; Sivasami, Kartik; Tewari, Vanmalini; Nandi, Bhaskar; Nair, G Lakhsmi; Patil, Sunita D

    2015-01-01

    Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.

  13. A New Guidelines For Using Erythromycin In Management Of Childhood Cyclic Vomiting Syndrome

    Directory of Open Access Journals (Sweden)

    Mahmood Haghighat

    2016-11-01

    Full Text Available Cyclic vomiting syndrome (CVS is a functional disorder without any determined cause, though some motility disorders are considered in stream of this syndrome. There is no clear treatment for CVS and all treatments are borrowed from treatment of other similar diseases such as migraine. Clinical practice guideline instructs the pediatricians and pediatric gastroenterologists for treatment of CVS in both inpatient and outpatient settings. Since there is no practical guideline for the empirical management of CVS, this guideline was prepared for framing the treatments in a scienti­c and simple way for this disorder.

  14. Preventing nausea and vomiting in women undergoing regional anesthesia for cesarean section: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Jelting Y

    2017-08-01

    Full Text Available Yvonne Jelting,1 Christian Klein,1 Thomas Harlander,1 Leopold Eberhart,2 Norbert Roewer,1 Peter Kranke1 1Department of Anesthesia and Critical Care, University Hospitals of Wuerzburg, Wuerzburg, 2Department of Anesthesiology and Critical Care Medicine, Philipps-University Marburg, Marburg, Germany Background: Intraoperative nausea and vomiting (IONV or postoperative nausea and vomiting (PONV affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids. Methods: Given the high and even increasing rate of cesarean sections and the sparse information on the etiology, incidence and severity of nausea and vomiting and the impact of prophylactic measures on the incidence of PONV/IONV, this article aims to review the available information and provide pragmatic suggestions on how to prevent nausea and vomiting in this patient cohort. Current literature and guidelines were identified by electronic database searching (MEDLINE via PubMed and Cochrane database of systematic reviews up to present, searching through reference lists of included literature and personal contact with experts. Discussion and conclusion: Taking into account the current guidelines and literature as well as everyday clinical experience, the first step for decreasing the incidence of IONV and PONV is a comprehensive management of circulatory parameters. This management includes liberal perioperative fluid administration and the application of vasopressors as the circumstances require. By using low

  15. Should doxylamine-pyridoxine be used for nausea and vomiting of pregnancy?

    Science.gov (United States)

    Persaud, Navindra; Chin, Jessica; Walker, Mark

    2014-04-01

    Doxylamine-pyridoxine is the first-line agent for the treatment of nausea and vomiting of pregnancy (NVP) according to Canadian guidelines, and this combination is commonly prescribed to pregnant women. There is limited evidence that doxylamine-pyridoxine is more effective than pyridoxine alone. There is stronger support for the safety of pyridoxine monotherapy than for the combination of doxylamine-pyridoxine during pregnancy, and some conflicting evidence links doxylamine-pyridoxine use to pyloric stenosis and childhood malignancies. The role of doxylamine-pyridoxine as the first-line pharmacological treatment for NVP in Canada should be reconsidered.

  16. Olanzapine as an antiemetic in refractory nausea and vomiting in advanced cancer.

    Science.gov (United States)

    Srivastava, Manish; Brito-Dellan, Norman; Davis, Mellar P; Leach, Marie; Lagman, Ruth

    2003-06-01

    Nausea and vomiting are difficult symptoms to manage in patients with advanced cancer. Several classes of antiemetics are available, including phenothiazines, butyrophenones, substituted benzamides and selective serotonin antagonists, as well as corticosteroids. Most patients will respond to either single agents or combinations that frequently include corticosteroids. A minority of patients will have nausea that fails to respond. The atypical antipsychotic, olanzapine, relieves nausea in some patients failing to respond to the usual antiemetics. Two case reports are presented and the rationale for olanzapine's benefit is discussed.

  17. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum--a 2013 update.

    Science.gov (United States)

    Maltepe, Caroline; Koren, Gideon

    2013-01-01

    Nausea and vomiting of pregnancy (NVP) affects up to 85% of all pregnancies, yet many physicians are uncertain as to how to best treat their patients in the presence of controversial data on fetal risks. This review provides an update on the management of NVP, including pharmacological and non pharmacological approaches Due to a high rate of recurrent symptoms, it is important for women to receive early treatment to reduce the severity of symptoms with the aim of preventing hospitalization and improving quality of life.

  18. DEXAMETHASONE PROPHYLAXIS ON INCIDENCES OF POST-OPERATIVE NAUSEA AND VOMITING (PONV IN PATIENTS UNDERGOING GYNECOLOGICAL SURGERIES UNDER SPINAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Chandrashekharappa

    2014-05-01

    Full Text Available BACK GROUND: Nausea and vomiting are the most common distressing symptom in the post-operative period. It can result in delayed hospital discharge and increased hospital cost. The present study was done to assess the effect of dexamethasone prophylaxis on the incidences of nausea and vomiting in post-operative period in patients undergoing gynecological surgeries. MATERIAL AND METHODS: A total number of 66 patients, aged between 20 to 65 years, posted for elective gynecological surgeries under spinal anesthesia were included in the study. Patients were randomized into two groups of 33 patients each, and the study group (group-D received Inj. Dexamethasone 8 mg intravenously as prophylactic antiemetic 1 hour before surgery whereas control group (group-N received normal saline. Post-operatively, the frequency of nausea and vomiting were observed and its influences on postoperative analgesia were also noted. RESULTS: In our study, 4(12.1% patients in group-D and 8(24.2% patients in group-N had nausea and vomiting in the intraoperative period (p value=0.202. 24.2% patients in group-D had vomiting in the postoperative period as compared to 72.7% in group-N and group D patients had significant reduction in incidences of nausea and vomiting in immediate post-operative period compared to group N (p-value 0.016. Accordingly, the mean requirement of rescue antiemetic was less in group- D compared to Group-N. Further, patients in group-D had better VAS scores compared to patients in group-N in post-operative period. CONCLUSION: Use of Dexamethasone prior to subarachnoid block in patients undergoing gynecological surgeries reduces the incidence of nausea and vomiting and the requirement of antiemetic in the postoperative period, and better post-operative analgesia.

  19. Dronabinol for chemotherapy-induced nausea and vomiting unresponsive to antiemetics

    Directory of Open Access Journals (Sweden)

    May MB

    2016-05-01

    Full Text Available Megan Brafford May,1 Ashley E Glode2 1Department of Pharmacy, Baptist Health Lexington, Lexington, KY, USA; 2Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA Abstract: Chemotherapy-induced nausea and vomiting (CINV is one of the most common symptoms feared by patients, but may be prevented or lessened with appropriate medications. Several antiemetic options exist to manage CINV. Corticosteroids, serotonin receptor antagonists, and neurokinin receptor antagonists are the classes most commonly used in the prevention of CINV. There are many alternative drug classes utilized for the prevention and management of CINV such as antihistamines, benzodiazepines, anticonvulsants, cannabinoids, and dopamine receptor antagonists. Medications belonging to these classes generally have lower efficacy and are associated with more adverse effects. They are also not as well studied compared to the aforementioned agents. This review will focus on dronabinol, a member of the cannabinoid class, and its role in CINV. Cannabis sativa L. (also known as marijuana contains naturally occurring delta-9-tetrahydrocannibinol (delta-9-THC. The synthetic version of delta-9-THC is the active ingredient in dronabinol that makes dronabinol an orally active cannabinoid. Evidence for clinical efficacy of dronabinol will be analyzed in this review as monotherapy, in combination with ondansetron, and in combination with prochlorperazine. Keywords: dronabinol, cannabinoids, antiemetic, chemotherapy-induced nausea and vomiting

  20. Lighter Ingestion as an Uncommon Cause of Severe Vomiting in a Schizophrenia Patient

    Directory of Open Access Journals (Sweden)

    Yahya Atayan

    2016-01-01

    Full Text Available Background. Foreign bodies in the gastrointestinal tract are important morbid and mortal clinical conditions. Particularly, emergency treatment is required for cutting and drilling bodies. The majority of ingested foreign bodies (80–90% leave gastrointestinal tract without creating problems. In 10–20% of cases, intervention is absolutely required. Less than 1% of cases need surgery. In this paper, we present a schizophrenia patient who swallowed multiple lighters. Case. A 21-year-old male schizophrenic patient who uses psychotic drugs presented to the emergency department with the complaints of abdominal pain, severe vomiting, and inability to swallow for a week. His physical examination revealed epigastric tenderness. A plain radiograph of the abdomen revealed multiple tiny metallic densities. Gastroscopy was performed. The lighters were not allowing the passage, and some of them had penetrated the gastric mucosa, and bezoars were observed. One lighter was extracted with the help of the polypectomy snare. Other lighters as a bezoar were removed by surgery. Conclusion. Excessive vomiting of swallowed foreign bodies in the etiology of psychotic patients should be kept in mind. Endoscopic therapy can be performed in the early stages in these patients, but in the late stage surgery is inevitable.

  1. Finding evidences on oncohematological patients (3rd part: nutrition assessment, nauseas and vomiting

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    Natalia Lorenzo García

    2009-07-01

    Full Text Available Introduction: It would be advisable to change cares based in tradition for evidence-based ones. So diffusion of investigation result should be the first step to get this change. Frequently oncologic patients suffer from nauseas and vomiting due to chemotherapy. These symptoms are frequently underestimated by health professionals. Another significant problem is under nourishment, because the relationship between that and worse prognosis is well known. Consequently, our objective has been: to find and summarize the evidences about nauseas and vomiting and the nutrition assessment. Method: Databases as CINAHL, MEDLINE, Cochrane Library, EMBASE, Pascal Biomed, LILACS, CUIDEN, CUIDEN qualitative y CUIDATGE were revised in Spanish, French and English. No time restrictions were applied.Results: The main findings and recommendations were synthesised on a poster, next to suggestions for practical changes to implement, evidence levels used, and the clinic problem significance. The suggested changes arose from nursing staff based on evidences found that includes behaviours and attitudes changes, which should facilitate more rapid innovations diffusion.

  2. Oral Clonidine Premedication Reduces Nausea and Vomiting in Children after Appendectomy

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    Reza Alizadeh

    2012-09-01

    Full Text Available Objective: Clonidine is an α2-agonist which is used as a sedative premedication in children. There are conflicting results in the published literature about the effect of clonidine on the incidence of post operative nausea and vomiting (PONV. We therefore decided to evaluate the effect of oral clonidine given preoperatively on the incidence of PONV in children after appendectomy.Methods: sixty children, 5-12 years old, classified as American Society of Anesthesiologists physical status I and II, who were scheduled for appendecectomy were enrolled in this randomized double blinded clinical trial. Patients were randomly assigned into two groups of 30 patients. Patients in clonidine group were given4 μg.kg -1 clonidine in 20 cc of apple juice and patients in control group were given only 20 cc of apple juice 1 hour before transporting to operating room. The protocol of general anesthesia and postoperative analgesia was the same for two groups. Incidence of PONV and antiemetic usage of patients were assessed during 0-24hours after anesthesia.Findings: The patients' characteristics were similar in two groups. Patients who had received clonidine had significantly less episodes of PONV and also less rescue antiemetic usage than patients in control group.Conclusion: we showed that oral clonidine at a dose of 4 μg.kg -1 administered preoperatively is associated with a reduced incidence of postoperative vomiting in children who have undergone appendectomy.

  3. Hypnosis and Therapy for a Case of Vomiting, Nausea, and Pain.

    Science.gov (United States)

    Lankton, Stephen R

    2015-07-01

    In this case study the author illustrates the treatment of idiopathic gastrointestinal (GI) symptoms that practitioners sometimes encounter and for which none of the usual medical explanations apply. In this case, the symptoms have deeply personal and intricate causes that are explicated for the reader. A 20-year old female was vomiting six to eight times a day, accompanied with pain and nausea, for 2 years. She had medical intervention for almost that same duration. She had numerous uneventful medical tests, her gall bladder removed, and had exhausted hope for a medical cure. Working with a resource-building approach in therapy her vomiting was stopped within 6 weeks and her nausea in the following 7th week (or 13th session). Hypnosis was used during each session along with a protocol referred to as Self-Image Thinking (Lankton & Lankton, 1983/2008, 1986/2007; Lankton, 2008) to rehearse novel experiences and behaviors that she would implement in her social environment each week. She provided yearly follow-up phone contacts for 3 years and the latest contact was 1 month before this article was written. She remains symptom-free.

  4. Comparison of sugammadex and conventional reversal on postoperative nausea and vomiting: a randomized, blinded trial.

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    Koyuncu, Onur; Turhanoglu, Selim; Ozbakis Akkurt, Cagla; Karcıoglu, Murat; Ozkan, Mustafa; Ozer, Cahit; Sessler, Daniel I; Turan, Alparslan

    2015-02-01

    To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting (PONV) than the cholinesterase inhibitor neostigmine. Prospective, randomized, double-blinded study. University-affiliated hospital. One hundred American Society of Anesthesiologists physical status 1 and 2 patients scheduled for extremity surgery. Patients were randomly assigned to neostigmine (70 μg/kg) and atropine (0.4 mg per mg neostigmine) or sugammadex 2 mg/kg for neuromuscular antagonism at the end of anesthesia, when 4 twitches in response to train-of-four stimulation were visible with fade. We recorded PONV, recovery parameters, antiemetic consumption, and side effects. Nausea and vomiting scores were lower in the sugammadex patients upon arrival in the postanesthesia care unit (med: 0 [min-max, 0-3] vs med: 0 [min-max, 0-3]; P sugammadex. Postoperative heart rates were significantly lower in all measured times patients given neostigmine. Nondepolarizing neuromuscular blocking antagonism with sugammadex speeds recovery of neuromuscular strength but only slightly and transiently reduces PONV compared with neostigmine and atropine. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting

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    Özgür Yağan

    Full Text Available Abstract Background and objectives: The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV. Methods: Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly divided into two groups given 2 mg kg-1 sugammadex (Group S or 50 µg kg-1 neostigmine plus 0.2 mg kg-1 atropine (Group N. Monitoring and recording times were set as 1 hour postoperative and from 1-6, 6-12, and 12-24 hours. The anti-emetic amounts administered were recorded. Results: In the first hour postoperative 13 patients in Group N (27% and 4 in Group S (8% were observed to have nausea and/or vomiting and the difference was statistically significant (p = 0.0016. During the 24 hours of monitoring there was no significant difference in the incidence and severity of PONV (p > 0.05, however the number of patients given ondansetron for PONV treatment in Group N was statistically significantly higher than the number in Group S (16 in Group N, 6 in Group S, p < 0.011. Conclusions: At the end of our study comparing neostigmine with sugammadex for neuromuscular blockage antagonism, we found use of sugammadex had lower incidence of PONV in the postoperative 1st hour and less anti-emetic use in 24 hours of monitoring.

  6. Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting.

    Science.gov (United States)

    Yağan, Özgür; Taş, Nilay; Mutlu, Tuğçe; Hancı, Volkan

    The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV). Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly divided into two groups given 2mgkg(-1) sugammadex (Group S) or 50μgkg(-1) neostigmine plus 0.2mgkg(-1) atropine (Group N). Monitoring and recording times were set as 1 hour postoperative and from 1-6, 6-12, and 12-24hours. The anti-emetic amounts administered were recorded. In the first hour postoperative 13 patients in Group N (27%) and 4 in Group S (8%) were observed to have nausea and/or vomiting and the difference was statistically significant (p=0.0016). During the 24 hours of monitoring there was no significant difference in the incidence and severity of PONV (p>0.05), however the number of patients given ondansetron for PONV treatment in Group N was statistically significantly higher than the number in Group S (16 in Group N, 6 in Group S, psugammadex for neuromuscular blockage antagonism, we found use of sugammadex had lower incidence of PONV in the postoperative 1st hour and less anti-emetic use in 24 hours of monitoring. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  7. Determinants of women's decision making on whether to treat nausea and vomiting of pregnancy pharmacologically.

    Science.gov (United States)

    Baggley, Anne; Navioz, Yvette; Maltepe, Caroline; Koren, Gideon; Einarson, Adrienne

    2004-01-01

    Nausea and vomiting of pregnancy (NVP) affects up to 80% of all women to some degree during their pregnancies. Diclectin (doxylamine and pyridoxine [vitamin B6]) has been on the Canadian market for many years and is indicated as the drug of choice for the treatment of NVP. However, some women choose not to treat NVP with pharmacologic measures, perhaps due to a persistent fear of teratogenic risk. The objective of this study was to determine the factors that influence a woman's decision not to treat NVP with pharmacologic measures. Fifty-nine women recruited from the Motherisk Nausea and Vomiting Helpline completed a questionnaire. All were informed that Diclectin was considered safe for use during pregnancy. At a follow-up telephone call, 34% were not using any pharmacologic treatment, and of those who were taking the drug, 26% were using less than the recommended dose. Reasons cited for not using the medication were insufficient safety data, preference for non-pharmacologic methods, and being made to feel uncomfortable by the physician. Of the women who did use Diclectin, the most convincing reassuring information that it was safe to use came from friends and family. Many other factors play a large role in a women's decision making.

  8. Postoperative vomiting in pediatric oncologic patients: prediction by a fuzzy logic model.

    Science.gov (United States)

    Bassanezi, Betina S B; de Oliveira-Filho, Antônio G; Jafelice, Rosana S M; Bustorff-Silva, Joaquim M; Udelsmann, Artur

    2013-01-01

    To report a fuzzy logic mathematical model to predict postoperative vomiting (POV) in pediatric oncologic patients and compare with preexisting scores. Although POV has a high incidence in children and may decrease parental satisfaction after surgeries, there is only one specific score that predicts POV in children: the Eberhart's score. In this study, we report a fuzzy model that intends to predict the probability of POV in pediatric oncologic patients. Fuzzy logic is a mathematical theory that recognizes more than simple true and false values and takes into account levels of continuous variables such as age or duration of the surgery. The fuzzy model tries to account for subjectiveness in the variables. Preoperative potential risk factors for POV in 198 children (0-19 year old) with malignancies were collected and analyzed. Data analysis was performed with the chi-square test and logistic regression to evaluate probable risk factors for POV. A system based on fuzzy logic was developed with the risk factors found in the logistic regression, and a computational interface was created to calculate the probability of POV. The model showed a good performance in predicting POV. After the analysis, the model was compared with Eberhart's score in the same population and showed a better performance. The fuzzy score can predict the chance of POV in children with cancer with good accuracy, allowing better planning for postoperative prophylaxis of vomiting. The computational interface is available for free download at the internet and is very easy to use. © 2012 Blackwell Publishing Ltd.

  9. The efficacy of ginger added to ondansetron for preventing postoperative nausea and vomiting in ambulatory surgery

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    Pragnadyuti Mandal

    2014-01-01

    Full Text Available Background: Post-operative nausea and vomiting (PONV frequently hampers implementation of ambulatory surgery in spite of so many costly antiemetic drugs and regimens. Objective: The study was carried out to compare the efficacy of ginger (Zingiber officinale added to Ondansetron in preventing PONV after ambulatory surgery. Materials and Methods: It was a prospective, double blinded, and randomized controlled study. From March 2008 to July 2010, 100 adult patients of either sex, aged 20-45, of ASA physical status I and II, scheduled for day care surgery, were randomly allocated into Group A[(n = 50 receiving (IV Ondansetron (4 mg and two capsules of placebo] and Group B[(n = 50 receiving IV Ondansetron (4 mg and two capsules of ginger] simultaneously one hour prior to induction of general anaesthesia (GA in a double-blind manner. One ginger capsule contains 0.5 gm of ginger powder. Episodes of PONV were noted at 0.5h, 1h, 2h, 4h, 6h, 12h and 18h post- operatively. Statistical Analysis and Results: Statistically significant difference between groups A and B (P < 0.05, was found showing that ginger ondansetron combination was superior to plain Ondansetron as antiemetic regimen for both regarding frequency and severity. Conclusion: Prophylactic administration of ginger and ondansetron significantly reduced the incidence of postoperative nausea and vomiting compared to ondansetron alone in patients undergoing day care surgery under general anaesthesia.

  10. Establishment of an animal model for radiation-induced vomiting in rats using pica

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    Yamamoto, Kouichi; Yamatodani, Atsushi [Osaka Univ., Suita (Japan). Medical School; Takeda, Noriaki [Tokushima Univ. (Japan). School of Medicine

    2002-06-01

    We investigated whether radiation-induced pica, a behavior characterized by the eating of a non-food substance, such as kaolin, can be used as an index of radiation-induced vomiting in rats. Since there was an individual difference in the susceptibility to pica, we selected rats that actually ate kaolin following X-ray irradiation, and used them for the experiment. The total-body irradiation (TBI) increased kaolin consumption in a dose-dependent manner (sham, 0.05{+-}0.03 (SEM) g; 2 Gy, 0.38{+-}0.11 g; 4 Gy, 1.54{+-}0.28 g; 8 Gy, 3.55{+-}0.67 g), and the increased kaolin consumption after 4 Gy of TBI was inhibited by a pretreatment with the serotonin 5-HT{sub 3} receptor antagonist ondansetron (2 mg/kg, i.p.) (saline, 1.49{+-}0.33 g; ondansetron, 0.75{+-}0.11 g). Furthermore, 4 Gy of abdominal irradiation was more effective to induce pica than that of head irradiation (abdomen: 0.37{+-}0.05 g, head: 0.06{+-}0.01 g). These findings suggested that peripheral serotonergic pathway is predominantly involved in the development of radiation-induced pica in rats and that the radiation-induced pica could be useful as a behavioral index for the severity of radiation-induced vomiting in rats. (author)

  11. Ictal vomiting as a sign of temporal lobe epilepsy confirmed by stereo-EEG and surgical outcome.

    Science.gov (United States)

    Pietrafusa, Nicola; de Palma, Luca; De Benedictis, Alessandro; Trivisano, Marina; Marras, Carlo Efisio; Vigevano, Federico; Specchio, Nicola

    2015-12-01

    Vomiting is uncommon in patients with epilepsy and has been reported in both idiopathic and symptomatic epilepsies. It is presumed to originate in the anterior part of the temporal lobe or insula. To date, 44 cases of nonidiopathic focal epilepsy and seizures associated with ictal vomiting have been reported. Of the 44 cases, eight were studied using invasive exploration (3 stereo-EEG/5 subdural grids). Here, we report a 4-year-and-7-month-old patient with a history of febrile convulsion in the second year of life and who developed episodes of vomiting and complex partial seizures at 3 years of age. Scalp EEG showed no electrical modification during vomiting while the complex partial seizure displayed a clear right temporal origin. Brain MR showed hippocampal volume reduction with mild diffuse blurring of the temporal lobe. Stereoelectroencephalography study confirmed the mesiotemporal origin of the seizures and showed that the episodes of vomiting were strictly related to an ictal discharge originating in the mesial temporal structures without insular diffusion. The patient is now seizure-free (18 months) after removal of the right anterior and mesial temporal structures. In all the reported patients, seizures seemed to start in mesial temporal structures. The grid subgroup is more homogeneous, and the most prominent characteristic (4/5) is the involvement of both mesial and lateral temporal structures at the time of vomiting. In the S-EEG group, there is evidence of involvement of either the anterior temporal structures alone (2/3) or both insular cortices (1/3). Our case confirms that vomiting could occur when the ictal discharge is limited to the anterior temporal structure without insular involvement. Regarding the pathophysiology of vomiting, the role of subcortical structures such as the dorsal vagal complex and the central pattern generators (CPG) located in the reticular area is well established. Vomiting as an epileptic phenomenon seems to be related to

  12. Changes in oral cavity during period of intensive vomiting in patient with somatoform autonomic dysfunction – description of the case.

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    Elżbieta Maria Paszyńska

    2016-06-01

    Full Text Available Introduction. The most important endogenous causes of erosion are eating disorders, gastro-oesophageal reflux (GERD, alcoholism and syndromes involving lowered saliva secretion. Aim. The aim of this work is to study a patient with symptoms of somatoform autonomic dysfunction, in which significant erosive loss occurred through chemical influence of gastric acid on oral cavity. Methods. Seventeen years old girl was sent to Department of Child and Adolescent Psychiatry due to persistent nausea and vomiting, which occurred over a period of about 10 months. Because of this she was repeatedly admitted to a paediatric hospital. Nausea and vomiting led to fear of going out of the house and of being in public places. In addition dental clinical examination was performed. Results. Somatoform Disorders, during which there has been intense vomiting, can be seen as an unusual example of purging-type eating disorders. Erosion of enamel was the most common. In examination of oral mucosa, keratinisation, tongue covered with removable coating and exfoliative cheilitis associated with drying and cracking of lips, were detected. Conclusions. Observed erosion of teeth and changes in macroscopic construction of oral mucosa seem to be symptoms caused mainly by induced intense and prolonged vomiting. Those changes may be a serious problem not only for the patient’s health but also their aesthetics. The described case of patient with intense and long-term vomiting indicates the need of multidisciplinary medical care, including systematic dental assessment.

  13. A comparison of different severities of nausea and vomiting during pregnancy relative to stress, social support, and maternal adaptation.

    Science.gov (United States)

    Kuo, Shih-Hsien; Wang, Ruey-Hsia; Tseng, Hui-Chen; Jian, Shu-Yuan; Chou, Fan-Hao

    2007-01-01

    A cross-sectional and comparative research design with convenience sampling was used to recruit pregnant women from prenatal clinics in southern Taiwan between 2002 and 2003 to examine the differences in perceived stress, social support, and maternal psychosocial adaptation among women with different severities (mild or less than mild, moderate, and severe) of nausea and vomiting during pregnancy. A total of 150 pregnant women participated in this study. One-way analysis of variance indicated that perceived stress was significantly different among the 3 groups. The least significant difference post-hoc test revealed that pregnant women with mild nausea and vomiting had significantly lower stress than did pregnant women with severe nausea and vomiting. The severity of nausea and vomiting was significantly associated with the Prenatal Self Evaluation Questionnaire subscales for "acceptance of pregnancy" and "fear of helplessness and loss of control in labor." Social support and maternal psychosocial adaptation were not significantly different among these three groups. The degree of perceived stress and maternal psychosocial adaptation may be related to the severity of nausea and vomiting during pregnancy.

  14. The Impact of Sucking Bits of Ice Containing Mint on Nausea and Vomiting During Chemotherapy in Patients with Breast Cancer

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    Mohammad Haddadi

    2016-06-01

    Full Text Available Background: Cancer remains as one of the most challenging diseases to be tackled in today’s world. Improving treatment methods can contribute to fighting cancer better than before. Breast cancer is one of the most common and significant diseases which problematizes a large number of women. Various methods are used in order to cure breast cancer, including surgery, radiotherapy and chemotherapy. Chemotherapy is one of the oldest and most common treatments for cancer. Nausea and vomiting are the most common side effects of chemotherapy. Due to its limited effect and the risk of anti-nausea medications, one of the critical and relatively safe measures is to use CAM (Complementary and Alternative Medicine. Ice therapy is one of the methods in this regard. Materials and Methodology: This study is a clinical trial in which 60 patients were divided randomly into intervention and control groups (each group containing 30 people based on inclusion criteria. In the control and experimental groups, 30 cc tap water and 30 cc ice containing mint extract were used, respectively, during chemotherapy. First, in both groups, nausea was examined through VAS, and vomiting was examined through the number of incidences. At the end of chemotherapy, nausea and vomiting levels were recorded in both groups. Finally, the data obtained (nausea and vomiting levels from both groups were compared. Results: The results showed that the level of nausea became significantly lower in the intervention group compared to the same rate in control group (P-value: 0.022, but the difference in the number of vomiting incidences in the intervention group and the control group was not significant (P -value: 0.770. Conclusion: According to the results, the use of ice containing mint is effective in healing feelings of nausea caused by chemotherapy, while it is not effective in treating vomiting caused by chemotherapy.

  15. Diffuse abdominal pain, nausea and vomiting due to retroperitoneal fibrosis: a rare but often missed diagnosis.

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    Netzer, P; Binek, J; Hammer, B

    1997-10-01

    Retroperitoneal fibrosis is a rare chronic inflammatory disease usually involving the ureters, retroperitoneal vessels and nerves; however, any intestinal organ may also be involved. In recent years, a few successful immunosuppressive treatments of this disease have been described and surgery can, therefore, probably be avoided in most cases. We report here on a case of secondary retroperitoneal fibrosis with compression and midline deviation of the ureters and impaired renal function which was probably caused by ergotamine abuse because of migraine. The patient complained of diffuse abdominal pain, nausea and vomiting. After immunosuppressive treatment with azathioprine and prednisone for a year, we observed a complete resolution of the retroperitoneal mass on computed tomography, although renal function remained impaired. Eleven months after the cessation of treatment, the patient had not relapsed.

  16. A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia

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    Deepti Mutreja

    2015-01-01

    Full Text Available Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.

  17. Preemptive Treatment of Nausea and Vomiting of Pregnancy: Results of a Randomized Controlled Trial

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    Caroline Maltepe

    2013-01-01

    Full Text Available Objectives. To determine whether the initiation of treatment (preemptive treatment before the symptoms of nausea and vomiting of pregnancy (NVP versus when the symptoms begin can improve the outcome in patients at a high risk for recurrence of severe NVP. Study Design. Prospective, randomized controlled trial. Results. Preemptive therapy conferred a significant reduction in HG as compared to the previous pregnancy (P=0.047. In the preemptive arm, there were 2.5-fold fewer cases of moderate-severe cases of NVP than those in the control group (15.4% versus 39.13% in the first 3 weeks of NVP (P=0.05. In the preemptive group, significantly more women had their NVP resolved before giving birth (78.2% versus 50% (P<0.002. Conclusions. Preemptive treatment with antiemetics is superior to the treatment that starts only when the symptoms have already occurred in decreasing the risk of severe forms of NVP.

  18. Malignancy-associated gastroparesis: an important and overlooked cause of chronic nausea and vomiting.

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    Kelly, Dearbhla

    2014-01-01

    A 69-year-old woman was referred to a gastroenterology clinic with a 1-year history of protracted nausea and postprandial vomiting. She had a background of gastro-oesophageal reflux disease, irritable bowel syndrome and chronic obstructive pulmonary disease with a significant smoking history. Her laboratory work-up including autoimmune screen, coeliac serology and synacthen test were unremarkable. Upper gastrointestinalendoscopy and CT imaging ruled out mucosal and obstructive causes. Gastric emptying studies demonstrated a delayed gastric emptying consistent with diagnosis of gastroparesis. Concurrently, she underwent a CT of the thorax for unresolved consolidation on her chest X-ray. This revealed a locally advanced primary lung carcinoma. In this context, with all other causes excluded, her gastroparesis was deemed to represent a paraneoplastic phenomenon. Gastroparesis is a frequent, under-recognised and important complication of cancer.

  19. Non-analgesic effects of opioids: opioid-induced nausea and vomiting: mechanisms and strategies for their limitation.

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    Coluzzi, Flaminia; Rocco, Alessandra; Mandatori, Ilenia; Mattia, Consalvo

    2012-01-01

    Nausea and vomiting are common gastrointestinal symptoms following opioid administration, for either chronic or acute pain management. As a consequence, patients' dissatisfaction has a negative impact on treatment efficacy. A number of mechanisms have been identified, involving both central and peripheral sites. This article will review the pathophysiology of opioid-induced nausea and vomiting and the various pharmacological treatments currently available for its management. Preventive strategies and therapeutic approaches are evaluated in the perioperative setting and in chronic pain. Newer drugs include second generation serotonin receptor antagonists (palonosetron) and neurokinin-1 (NK-1) antagonists (aprepitant).

  20. A patient presenting with metabolic acidosis despite severe vomiting--correct diagnosis by use of the physical-chemical approach.

    Science.gov (United States)

    Lindner, Gregor; Pfortmüller, Carmen; Exadaktylos, Aristomenis K

    2013-06-01

    We describe the case of a 28-year-old otherwise healthy woman who presents to our emergency department with nausea for 2 days and severe vomiting for 1 day. She has no history of travel, and her medical history is unremarkable. The physical examination shows a soft and nontender abdomen. Laboratory examinations reveal the presence of significant metabolic alkalosis despite the severe vomiting of the patient. Hypochloremic alkalosis would be expected to be present in this patient. We explain how to correctly identify the rare cause of metabolic acidosis present in this patient using the physicochemical approach (Stewarts approach) for the analysis of human acid-base disorders.

  1. Management of chemotherapy-induced nausea and vomiting by risk profile: role of netupitant/palonosetron

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    Lorusso V

    2016-06-01

    Full Text Available Vito Lorusso National Cancer Research Centre, Istituto Tumori Giovanni Paolo II, Bari, Italy Abstract: As recommended by most recent antiemetic guidelines, the optimal prophylaxis of chemotherapy-induced nausea and vomiting (CINV requires the combination of 5-HT3 receptor antagonist (RA with an NK1-RA. Moreover, the major predictors of acute and delayed CINV include: young age, female sex, platinum- or anthracycline-based chemotherapy, nondrinker status, emesis in the earlier cycles of chemotherapy, and previous history of motion/morning sickness. Despite improved knowledge of the pathophysiology of CINV and advances in the availability of active antiemetics, an inconsistent compliance with their use has been reported, thereby resulting in suboptimal control of CINV in several cases. In this scenario, a new antiemetic drug is now available, which seems to be able to guarantee better prophylaxis of CINV and improvement of adherence to guidelines. In fact, netupitant/palonosetron (NEPA is a ready-to-use single oral capsule, combining an NK1-RA (netupitant and a 5-HT3-RA (palonosetron, which is to be taken 1 hour before the administration of chemotherapy, ensuring the coverage from CINV for 5 days. We reviewed the role of NEPA in patients at high risk of CINV receiving highly emetogenic chemotherapy. In these patients, NEPA plus dexamethasone, as compared to standard treatments, achieved superior efficacy in all primary and secondary end points during the acute, delayed, and overall phases, including nausea assessment. Moreover, these results were also achieved in female patients receiving anthracycline plus cyclophosphamide-based chemotherapy. NEPA represents a real step forward in the prophylaxis of CINV. Keywords: NEPA, netupitant, NK1, CINV, vomiting, risk factors

  2. Palonosetron for the prevention of chemotherapy-induced nausea and vomiting: approval and efficacy

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    Rudolph M Navari

    2009-12-01

    Full Text Available Rudolph M NavariIndiana University School of Medicine South Bend, South Bend, IN USAAbstract: Chemotherapy-induced nausea and vomiting (CINV is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles, and patient characteristics (female gender, younger age, low alcohol consumption, history of motion sickness are the major risk factors for CINV. This review provides a detailed description of palonosetron, a second-generation 5-hydroxytryptamine 3 (5-HT3 receptor antagonist. The chemistry and pharmacology of palonosetron are described, as well as the initial and recent clinical trials. Palonosetron has a longer half-life and a higher binding affinity than the first-generation 5-HT3 receptor antagonists. Palonosetron has been approved for the prevention of acute CINV in patients receiving either moderately or highly emetogenic chemotherapy and for the prevention of delayed CINV in patients receiving moderately emetogenic chemotherapy. In recent studies, compared to the first-generation 5-HT3 receptor antagonists, palonosetron in combination with dexamethasone demonstrated better control of delayed CINV in patients receiving highly emetogenic chemotherapy. There were no clinically relevant adverse reactions reported in the palonosetron clinical trials which were different from the common reactions reported for the 5-HT3 receptor antagonist class. Due to its efficacy in controlling both acute and delayed CINV, palonosetron may be very effective in the clinical setting of multiple-day chemotherapy and bone marrow transplantation.Keywords: anti-emetics, chemotherapy-induced nausea and vomiting, serotonin receptor antagonists, palonosetron

  3. Activity-based cost analysis of opioid-related nausea and vomiting among inpatients.

    Science.gov (United States)

    Eberhart, Leopold; Koch, Tilo; Kranke, Peter; Rüsch, Dirk; Torossian, Alexander; Nardi-Hiebl, Stefan

    2014-01-01

    Nausea and/or vomiting (N/V) are frequent side effects of opioid drugs. These are of major concerns to patients and caregivers and only few studies have focused on their economical costs. This is a prospective, nonproduct-related, activity-based evaluation of personnel and material costs of opioid-related N/V among inpatients. Data were obtained from surgical, general medicine, and palliative care wards at 16 German hospitals of different size, healthcare mandate, and ownership. According to predefined criteria, of 462 documented N/V events, 340 were diagnosed as opioid related. Elicited activities and pharmacological interventions for N/V episodes followed local standards. Both materials used and the time engaged to treat patients with N/V were documented on an "ad hoc" activity recording form. The total cost of an opioid-related N/V episode was calculated based on standard wages of the involved personnel and standard costs of the inherent materials used. Mean staff tenure time for handling an episode of N/V was 26.2 ± 19.8 minutes (nausea 16.9 ± 28.7 minutes; nausea + vomiting: 33.4 ± 26.8 minutes). In the German context, this corresponds to average personnel costs of €18.06 ± 13.64. Material cost contributes to another €13.49 ±13.38 of costs mainly depending on acquisition costs of antiemetic drugs. N/V showed to have impact on workload of nurses and (to lesser extent) physicians and economic burden of €31 ± 22 for each N/V episode. In view of these results, the potential costs of strategies to minimize the incidence of N/V (use of antiemetics and/or the use of new analgesics) should be outweighed against the incurred costs of N/V.

  4. Treatment of cyclic vomiting syndrome with co-enzyme Q10 and amitriptyline, a retrospective study

    Directory of Open Access Journals (Sweden)

    Preston Amy

    2010-01-01

    Full Text Available Abstract Background Cyclic vomiting syndrome (CVS, which is defined by recurrent stereotypical episodes of nausea and vomiting, is a relatively-common disabling condition that is associated with migraine headache and mitochondrial dysfunction. Co-enzyme Q10 (Co-Q is a nutritional supplement that has demonstrated efficacy in pediatric and adult migraine. It is increasingly used in CVS despite the complete lack of studies to demonstrate its value in treatment Methods Using an Internet-based survey filled out by subjects with CVS or their parents, the efficacy, tolerability and subject satisfaction in CVS prophylaxis were queried. Subjects taking Co-Q (22 subjects were compared against those taking amitriptyline (162 subjects, which is the general standard-of-care. Results Subjects/parents reported similar levels of efficacy for a variety of episode parameters (frequency, duration, number of emesis, nausea severity. There was a 50% reduction in at least one of those four parameters in 72% of subjects treated with amitriptyline and 68% of subjects treated Co-Q. However, while no side effects were reported on Co-Q, 50% of subjects on amitriptyline reported side effects (P = 5 × 10-7, resulting in 21% discontinuing treatment (P = 0.007. Subjects/parents considered the benefits to outweigh the risks of treatment in 47% of cases on amitriptyline and 77% of cases on Co-Q (P = 0.008. Conclusion Our data suggest that the natural food supplement Co-Q is potentially efficacious and tolerable in the treatment of CVS, and should be considered as an option in CVS prophylaxis. Our data would likely be helpful in the design of a double-blind clinical trial.

  5. Olanzapine and Betamethasone Are Effective for the Treatment of Nausea and Vomiting due to Metastatic Brain Tumors of Rectal Cancer

    Directory of Open Access Journals (Sweden)

    M. Suzuki

    2014-01-01

    Full Text Available Brain lesions originating from metastasis of colorectal cancer represent 3-5% of all brain metastases and are relatively rare. Of all distant metastases of colorectal cancer, those to the liver are detected in 22-29% of cases, while those to the lungs are detected in 8-18% of cases. In contrast, brain metastasis is quite rare, with a reported incidence ranging from 0.4 to 1.8%. Treatments for metastatic brain tumors include surgery, radiotherapy, chemotherapy and supportive care with steroids, etc. Untreated patients exhibit a median survival of only approximately 1 month. The choice of treatment for brain metastasis depends on the number of lesions, the patient's general condition, nerve findings and presence of other metastatic lesions. We herein report the case of a 78-year-old male who presented with brain metastases originating from rectal carcinoma. He suffered from nausea, vomiting, anorexia and vertigo during body movement. He received antiemetics, glycerol and whole brain radiation therapy; however, these treatments proved ineffective. Olanzapine therapy was started at a dose of 1.25 mg every night. The persistent nausea disappeared the next day, and the frequency of vomiting subsequently decreased. The patient was able to consume solid food. Olanzapine is an antipsychotic that has recently been used as palliative therapy for refractory nausea and vomiting in patients receiving chemotherapy. We consider that olanzapine was helpful as a means of supportive care for the treatment of nausea and vomiting due to brain metastasis.

  6. Impact of adding therapeutic recommendations to risk assessments from a prediction model for postoperative nausea and vomiting

    NARCIS (Netherlands)

    Kappen, T. H.; Vergouwe, Y.; van Wolfswinkel, L.; Kalkman, C. J.; Moons, K. G. M.; van Klei, W. A.

    2015-01-01

    Background. In a large cluster-randomized trial on the impact of a prediction model, presenting the calculated risk of postoperative nausea and vomiting (PONV) on-screen (assistive approach) increased the administration of risk-dependent PONV prophylaxis by anaesthetists. This change in therapeutic

  7. Evaluation of Transcutaneous Electroacupoint Stimulation with the Train-of-four Mode for Preventing Nausea and Vomiting after Laparoscopic Cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    LIU Yu-yong; DUAN Shan-e; CAI Ming-xue; ZOU Peng; LAI Yong; LI Ya-lan

    2008-01-01

    Obiectve:To evaluate the efficacy of transcutaneous electroacupoint stimulation with a train-of-four(TOF)mode for the prevention of postoperative nausea and vomiting(PONV)in the patients undergoing laparoscopic cholecystectomy.Methods:Ninety-six ASA Grade Ⅰ-Ⅱ patients scheduled for laparoscopic cholecystectomy were randomized into Neiguan(P6)electroacupoint stimulation group(treated group)and a placebo control group(placement of electrodes without electroacupoint stimulation).The anesthetic regimen was standardized by needling at Neiguan on the left side and connecting the TOF peripheral nerve stimulator.The incidence of nausea,vomiting,severity,antiemetic dosage and the degree of pain were assessed at 0,60,120 min,and 24 h after surgery.Results:The incidence of nausea and vomiting,the dose of antiemetics and the occurrence of severe nausea were all significantly lower in the treated group compared with the control group and the score for pain was obviously reduced in patients of the treated group at 24 h post-operation (P<0.05 or P<0.01).Conclusion:Transcutaneous electroacupoint stimulation at P6 with the TOF mode could reduce the incidence and severity of nausea and vomiting with analgesic effects.

  8. Gastric malpositioning and chronic, intermittent vomiting following prophylactic gastropexy in a 20-month-old great Dane dog

    OpenAIRE

    Sutton, Jessie S.; Steffey, Michele A.; Bonadio, Cecily M.; Marks, Stanley L

    2015-01-01

    A 20-month-old castrated male great Dane dog was presented for evaluation of chronic intermittent vomiting of 2 months’ duration. A prophylactic incisional gastropexy performed at 6 mo of age resulted in gastric malpositioning and subsequent partial gastric outflow tract obstruction.

  9. Singapore General Hospital Experience on Ethnicity and the Incidence of Postoperative Nausea and Vomiting after Elective Orthopaedic Surgeries

    Directory of Open Access Journals (Sweden)

    Xin Yu Adeline Leong

    2015-01-01

    Full Text Available Introduction. We explored how ethnicity affects the risk of postoperative nausea and vomiting (PONV and established the correlation of suggested risk factors of PONV in the multiethnic population of Singapore. Methods. 785 patients who underwent orthopaedic surgery were recruited. These comprised 619 Chinese (78.9%, 76 Malay (9.7%, 68 Indian (8.7%, and 22 other (2.8% cases. The presence of possible risk factors of PONV and nausea and/or vomiting within 24 h after surgery was studied. Univariate and multivariate logistic regression analyses were performed. Results. The incidence of PONV was 33.2% (261 patients. There was no statistically significant difference of PONV incidence between Chinese, Malay, and Indian cases (34.6% versus 34.2% versus 29.4%, p=0.695. Indian females younger than 50 years were found to have a higher incidence of vomiting (p=0.02. The significant risk factors for this population include females, use of nitrous oxide, and a history of PONV. Conclusion. In the groups studied, ethnicity is not a significant risk factor for PONV except for young Indian females who have a higher risk of postoperative vomiting. We suggest the selective usage of antiemetic for young Indian females as prophylaxis and avoiding nitrous oxide use in high-risk patients.

  10. Scared to lose control? General and health locus of control in females with a phobia of vomiting.

    Science.gov (United States)

    Davidson, Angela L; Boyle, Christopher; Lauchlan, Fraser

    2008-01-01

    The term emetophobia (i.e., a fear of vomiting) exists as rather an elusive predicament, often eluding conventional treatment. The present study involved 149 participants, consisting of 51 emetophobics, 48 phobic controls (i.e. those who suffered from a different phobia), and 50 nonphobic controls. Participants were administered the Rotter (1966) Locus of Control Scale and the Health Locus of Control Scale by B.S. Wallston, Wallston, Kaplan, and Maides (1976). Significant differences were found among the three groups; specifically, that emetophobics had a significantly higher internal Locus of Control Scale score with regard to both general and health-related issues than did the two control groups. It is suggested that vomiting phobics may have a fear of losing control, and that their vomiting phobia is reflective of this alternative, underlying problem. More research is required to explore the association between emetophobia and issues surrounding control; however, the current study suggests that it may be helpful for therapists to consider this aspect when treating a patient with vomiting phobia.

  11. The Effects of Acupressure on Meridian Energy as well as Nausea and Vomiting in Lung Cancer Patients Receiving Chemotherapy.

    Science.gov (United States)

    Shen, Chi-Hsiang; Yang, Li-Yu

    2017-03-01

    Nausea and vomiting are the most common side effects of antineoplastic chemotherapy. However, only a small number of studies have been conducted in Taiwan to determine the efficacy of acupressure in treating these side effects in cancer patients receiving chemotherapy. In this quasi-experimental study, we aimed to explore the effects of acupressure on meridian energy as well as nausea and vomiting in 70 lung cancer patients receiving chemotherapy. Patients were assigned to the experimental or control group based on order of hospital admission. The experimental group received acupressure on "Neiguan (PC6)" and "Gongsun (SP4)" points, and the control group received sham acupoint patches on "Houxi (SI3)" point. The results showed that the mean meridian energy in the experimental group after acupressure was significantly higher than in the control group ( F = 28.71, p energy and effectively decreased the severity of nausea and vomiting in lung cancer patients undergoing chemotherapy. We recommend that clinical nurses provide acupressure as an intervention to relieve nausea and vomiting in patients receiving chemotherapy.

  12. The effects of acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting in healthy dogs.

    Science.gov (United States)

    Scallan, Elizabeth M; Simon, Bradley T

    2016-09-01

    To evaluate the effect of needling at acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting. Randomized controlled clinical study. Eighty-one mixed-breed, healthy dogs aged 1.8 ± 1.6 years and weighing 14.5 ± 5.6 kg, admitted for elective ovariohysterectomy (n = 75) or castration (n = 6). Dogs were randomly assigned to one of three groups: acupuncture at Pericardium 6 (AT, n = 27); alternative acupuncture at Lung 5 (ST, n = 27), and no acupuncture (CT, n = 27). During time 0-30 minutes (baseline), occurrences of hypersalivation, vomiting and licking were recorded. At 30 minutes, subjects were administered hydromorphone (0.1 mg kg(-1) ) in combination with acepromazine (0.03 mg kg(-1) ) intramuscularly. During time 30-45 minutes (post-injection), occurrences of hypersalivation, vomiting and licking were recorded by an observer unaware of group assignment. Groups were compared using a Kruskal-Wallis test followed by a Dunn's post-test, or Fisher's exact tests when appropriate. There were no significant differences in age, weight or baseline observations among groups. Vomiting incidence post-injection was higher in the CT (20/27, 74.1%) and ST (22/27, 81.5%) groups than in the AT (10/27, 37.0%) group (p = 0.0129 and p = 0.002, respectively). The number of vomiting episodes [median (range)] after opioid administration was higher in the ST [1 (1-6)] than the AT [0 (0-2)] group (p = 0.0040). There were no differences in the median number of vomiting episodes between the ST and CT [1 (0-3)] or AT and CT groups. There were no differences in hypersalivation or licking among groups after hydromorphone-acepromazine administration. Pericardium 6 acupuncture reduced the incidence of hydromorphone-induced vomiting in healthy dogs. This cost-effective technique can improve patient well-being and comfort during the perioperative period. © 2016 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia

  13. Effect of concord grape juice on chemotherapy-induced nausea and vomiting: results of a pilot study.

    Science.gov (United States)

    Ingersoll, Gail L; Wasilewski, Amy; Haller, Michele; Pandya, Kishan; Bennett, John; He, Hua; Hoffmire, Claire; Berry, Cynthia

    2010-03-01

    To determine the feasibility of administering a flavonoid-rich adjunctive treatment (Concord grape juice) for the management of chemotherapy-induced nausea and vomiting (CINV); to evaluate the usefulness of existing measures for assessing CINV frequency and severity, quality of life, control over life events, and psychological state; to identify any actual or potential adverse events associated with frequent grape juice intake; and to provide preliminary data concerning the effect of Concord grape juice on CINV, quality of life, perceived control over life events, and psychological state. Double-blind, randomized clinical trial. A cancer center in an academic health science center in the northeastern United States. 77 adult patients with cancer receiving moderately or highly emetogenic chemotherapy agents. Participants drank 4 oz. of grape juice or placebo prior to meals for one week following each of four chemotherapy treatment cycles. They recorded frequency, duration, and distress of nausea, vomiting, and retching daily, beginning the evening of chemotherapy administration and continuing for seven days. Data were analyzed with generalized estimating equations methodology to model differences between groups over time. Nausea and vomiting frequency, duration, and distress; quality of life; control over decision making; and psychological state. Nausea and vomiting frequency, duration, and distress were lower for experimental group members, although a high attrition rate (50%) resulted in insufficient power to detect statistically significant differences over time. Greater levels of anxiety, depression, and hostility at baseline were related to nausea and vomiting, quality of life, and perceived control over decision making. The effect of grape juice flavonoids on CINV should be investigated further with a larger sample to determine whether preliminary findings are supported. Alterations to the study protocol will be necessary to decrease attrition. Flavonoid

  14. Impact of nausea/vomiting on quality of life as a visual analogue scale-derived utility score.

    Science.gov (United States)

    Grunberg, S M; Boutin, N; Ireland, A; Miner, S; Silveira, J; Ashikaga, T

    1996-11-01

    Pharmacoeconomic analysis is often based upon incremental cost per increase in survival (cost-effectiveness). Using this definition supportive care measures, which increase quality but not quantity of life, generate a zero denominator and cannot be directly compared with other components of health care cost. Cost-utility analysis, which measures incremental cost per increase in quality-adjusted life-years (QALY), where QALY = utility score x time at risk, addresses this problem, since successful supportive intervention increases the utility score and thus provides a finite denominator in QALY even when absolute survival is unchanged. However, utility scores for various supportive care modalities have not been well defined. As a pilot study to generate a first approximation of a utility score for nausea/vomiting, we used a rating scale technique and administered two visual analogue scale questions to 30 patients completing a cycle of chemotherapy. Patients rated their global quality of life during their previous cycle of chemotherapy with hypothetical absence or presence of nausea/vomiting as the only variable. The study population included 8 male and 22 female patients, with a median age of 56 years. The most common malignancies were breast cancer (8 patients), lung cancer (7 patients), and hematologic malignancies (7 patients). On a 100 mm visual analogue scale, the mean score for overall quality of life during chemotherapy was 79 mm without nausea/vomiting and 27 mm with nausea/vomiting (P < 0.001, paired t-test). The implied marked increase in utility with relief of nausea/vomiting suggests a significant impact on cost-utility analysis. Similar methodology could be used to estimate utility scores in other areas of supportive care.

  15. 格拉司琼预防化疗后呕吐65例分析%Effect of granisetron in preventing vomiting after chemiotherapy

    Institute of Scientific and Technical Information of China (English)

    王中华; 陈冬波

    2003-01-01

    BACKGROUND:During the therapy of cencers,it is difficult to continue chemiotherapy due to frequent vomiting,especially commonly used drugs such as side effects of cisplatin.Although new pharmacy appeared in greatly relieve vomiting effect of the chemiotherapy, there were no satisfied drugs to settle this problem.

  16. A Systematic Review and Meta-Analysis of Intravenous Palonosetron in the Prevention of Chemotherapy-Induced Nausea and Vomiting in Adults

    OpenAIRE

    2011-01-01

    A systematic review and meta-analysis was performed to compare treatment effectiveness and adverse effects in cancer patients receiving chemotherapy with palonosetron to prevent chemotherapy-induced nausea and vomiting (CINV). The use of palonosetron should be considered an integral part of adjuvant therapy for prevention of the acute, delayed, and overall phases of chemotherapy-induced nausea and vomiting.

  17. Reviewing the evidence for using continuous subcutaneous metoclopramide and ondansetron to treat nausea & vomiting during pregnancy.

    Science.gov (United States)

    Reichmann, James P; Kirkbride, Michael S

    2012-05-01

    To examine the medical evidence regarding the clinical efficacy and cost-effectiveness of the application of continuous subcutaneous metoclopramide and ondansetron to treat nausea and vomiting during pregnancy. All of the published peer-reviewed articles on the subject were assembled and assigned a level of evidence based on research design. The search uncovered one level II matched, controlled trial and three level III uncontrolled, retrospective case series published in peer review journals, as well as a book chapter. The book chapter, although not subjected to the peer-review process, is included in this review due to the paucity of other evidence. The matched cohort trial showed that continuous subcutaneous metoclopramide is significantly less-tolerated than continuous subcutaneous ondansetron (31.8% vs. 4.4%; P < 0.001). The four case series reported complete symptom resolution for 63.9% to 75% of the patients. Complications arose in 24.9% to 30.5% of the selected cases that were severe enough to require discontinuation of therapy. Complications included side effects of a worsening of symptoms. All of the trials are retrospective and observational in nature and, therefore, subject to the limitations inherent in the research design. Absent the benefit of meaningful cohort controls, comparative statements effectiveness cannot be substantiated with the available data. Randomized, controlled trials of sufficient power are necessary before long-term continuous subcutaneous metoclopramide or ondansetron can be used on a widespread basis to treat nausea and vomiting during pregnancy. Cost approximations in the case series are reported and, when compared to the cost of other methods of treatment previously published in the medical literature, the therapy appears to be cost-prohibitive. However, definitive statements cannot be made regarding cost-effectiveness until clinical efficacy is demonstrated through a sufficiently powered, well-designed, randomized control

  18. Visual diagnosis: an 11-month-old with nausea, vomiting, and an abdominal mass.

    Science.gov (United States)

    Whittington, Laura A; Stevens, David C; Jones, Sarah A; Mayo, Julie M

    2013-12-01

    Children with intussusception can present with a wide variety of symptoms, including vomiting, fever,lethargy, and abdominal pain. The classic triad of abdominal pain, hematochezia, and palpable abdominal mass is seen in a few patients.• Early diagnosis of intussusception depends on a high level of clinical suspicion in any child with non specific abdominal findings followed by appropriate radiographic or ultrasonographic evaluation and confirmation with a contrast enema.• Abdominal radiography, although an appropriate component of the initial workup for gastrointestinal symptoms, lacks the sensitivity to reliably exclude the presence of intussusception.• Because ultrasonography is a safe, sensitive, and specific test for the diagnosis of intussusceptions, it should be performed early whenever there is clinical suspicion of intussusception.• Contrast enema is the gold standard for diagnosis and first-line treatment of intussusception. There is an increasing trend for pneumatic reduction of intussusception compared with hydrostatic reduction.Intravenous placement, fluid resuscitation, and notification of the pediatric surgeon should be completed before contrast enema.

  19. The use of CAM by women suffering from nausea and vomiting during pregnancy

    Directory of Open Access Journals (Sweden)

    Smith Michael

    2002-05-01

    Full Text Available Abstract Background Nausea and vomiting during pregnancy (NVP affects two-thirds of pregnant women to varying degrees and over the years many modalities have been used to try to alleviate this often debilitating condition. There is a paucity of information in the literature about the use or efficacy of complementary and alternative medicine (CAM for the treatment of this condition that affects so many women. Our primary objective was to examine the prevalence of CAM usage by women suffering from NVP. Our secondary objective was to ascertain if women had any supervision in the use of these treatments. Methods Women who called The Motherisk NVP helpline, were asked after the counseling session to complete a questionnaire, which included demographic data as well as information about their CAM use. Results Seventy women completed the questionnaire. 61% reported using CAM therapies, of which the three most popular were: ginger, vitamin B6 and acupressure. 21% of those who reported using CAM, had consulted CAM practitioners, 8% their physicians or pharmacists and 71% discussed the usage with family, friends and other allied health professionals. Women who did not use CAM stated they would probably use these modalities if there was more information about the safety in pregnancy. Conclusion Pregnant women with NVP are mirroring the trend in the general population of the use of CAM. They are also using CAM therapies with little supervision from practitioners experienced in the use of these modalities.

  20. Olanzapine for the prevention and treatment of chronic nausea and chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Navari, Rudolph M

    2014-01-05

    Olanzapine is an atypical antipsychotic agent of the thiobenzodiazepine class. It blocks multiple neurotransmitter receptors including dopaminergic at D1, D2, D3, D4 brain receptors, serotonergic at 5-HT2a, 5-HT2c, 5-HT3, 5-HT6 receptors, catecholamines at alpha1 adrenergic receptors, acetylcholine at muscarinic receptors, and histamine at H1 receptors. Olanzapine has five times the affinity for 5-HT2 receptors than D2 receptors and has been used to treat schizophrenia and delirium. Olanzapine's activity at multiple receptors, particularly at the D2, 5-HT2c, and 5-HT3 receptors which appear to be involved in nausea and emesis, has prompted its use in the treatment of nausea and vomiting refractory to standard antiemetics. Case reports and formal clinical trials have demonstrated its efficacy in the treatment of chronic nausea, the prevention of chemotherapy-induced nausea and emesis, and the treatment of breakthrough chemotherapy-induced nausea and emesis. Phase II and phase III clinical trials have demonstrated that there is a significant improvement in nausea when olanzapine is added to guideline directed prophylactic antiemetic agents 5-HT3 receptor antagonists and tachykinin NK1 receptor antagonists in patients receiving moderately or highly emetogenic chemotherapy Common side effects of olanzapine when used over a period of months include weight gain as well as an association with the onset of diabetes mellitus, but these effects have not been seen with short term use of daily doses of less than one week.

  1. Effects of professional support on nausea, vomiting, and quality of life during early pregnancy.

    Science.gov (United States)

    Liu, Mei-Chun; Kuo, Shih-Hsien; Lin, Chao-Po; Yang, Yung-Mei; Chou, Fan-Hao; Yang, Yi-Hsin

    2014-10-01

    The purpose of this study was to examine the effectiveness of a professional support (PS) intervention (including individualized health education and supportive phone calls) in reducing the severity of nausea and vomiting (NV) and improving the quality of life (QOL) of women in early pregnancy. An experimental pretest/posttest design with a control group was used. Participants were recruited from a regional teaching hospital in southern Taiwan. The women in the experimental group (n = 40) received the PS intervention, while those in the control group (n = 39) only received routine nursing care. Analysis of covariance and mixed models were used to compare the experimental and control groups while adjusting for covariates. The severity of NV and the perceived level of symptom distress were significantly lower in the experimental group than in the control group during weeks 2 and 4, and the women in the experimental group showed a significant improvement in their QOL in week 4 (p < .05). However, there was no significant difference between the two groups in body weight at week 4 (p = .501). These findings provide empirical evidence in support of the effectiveness of PS in reducing the severity of NV and improving QOL for women during early pregnancy. This intervention could be routinely applied in prenatal nursing health education. Future studies could apply the concept of PS to different populations and health issues.

  2. Clinical roundtable monograph: New data in emerging treatment options for chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Morrow, Gary R; Navari, Rudolph M; Rugo, Hope S

    2014-03-01

    Chemotherapy-induced nausea and vomiting (CINV) has long been one of the most troublesome adverse effects of chemotherapy, leading to significant detriments in quality of life and functioning, increased economic costs, and, in some cases, the discontinuation of effective cancer therapy. The past 2 decades have witnessed a dramatic increase in the number of effective antiemetic agents, with the introduction of the serotonin (5-hydroxytryptamine [5-HT₃]) receptor antagonists (ondansetron, granisetron, and palonosetron), the neurokinin-1 (NK₁) receptor antagonists (aprepitant and fosaprepitant), and the identification of other agents that have demonstrated efficacy against CINV, including corticosteroids. These agents often provide excellent control of emesis. Nausea, however, has proven more intractable, particularly in the days after administration of chemotherapy. Newer antiemetic agents under study may provide additional CINV control, particularly against delayed nausea. New agents undergoing review by the US Food and Drug Administration for the prevention of CINV include the novel NK₁ receptor antagonist rolapitant and a fixed-dose combination consisting of the novel NK₁ receptor antagonist netupitant and palonosetron (NEPA). Adherence to clinical practice guidelines has been shown to significantly improve CINV control. As antiemetic therapy continues to evolve, it will be important for clinicians to stay informed of new developments and changes in guidelines.

  3. The Leading Concerns of American Women with Nausea and Vomiting of Pregnancy Calling Motherisk NVP Helpline

    Directory of Open Access Journals (Sweden)

    Svetlana Madjunkova

    2013-01-01

    Full Text Available Background. Nausea and vomiting of pregnancy (NVP is the most common medical condition of pregnancy, affecting up to 85% of expecting mothers. In the USA, there is no FDA-approved medication for the treatment of NVP. Objective. To identify the primary concerns of American women leading them to contact the Motherisk NVP Helpline and to characterize the severity of their symptoms and therapy offered in order to develop improved and customized counseling for them. Methods. We reviewed the intake forms of the American women who called the NVP Helpline from 2008 to 2012. We extracted their state of residence, demographic data, severity of NVP symptoms, and other available clinical characteristics. Results. A total of 195 forms were reviewed. Of these, 86% called for information on management of NVP with/without questions about fetal drug safety, while 14% called solely about drug safety during pregnancy/breastfeeding. The majority of women were Caucasian, in their thirties, educated, employed, married and in their second pregnancy. Of them 95% were suffering from moderate-to-severe condition with 13% having hyperemesis gravidarum. Conclusion. American women need more information on the management of NVP and on a variety of its aspects in addition to the safety and effectiveness of antiemetic medications. Their leading concern was the use of doxylamine and vitamin B6 combination for NVP treatment followed by the use of ondansetron.

  4. Re-analysis of safety data supporting doxylamine use for nausea and vomiting of pregnancy.

    Science.gov (United States)

    Chin, Jessica W S; Gregor, Sarah; Persaud, Navindra

    2014-09-01

    Antihistamines are commonly used to treat nausea and vomiting of pregnancy (NVP). We re-analyzed the 24 primary studies cited in a 1997 meta-analysis that concluded antihistamine use for NVP was safe as they had been studied in more than 200,000 participating women and the pooled odds ratio for congenital malformations was 0.76 (95% confidence interval [CI]: 0.60-0.94). Our analysis of this meta-analysis showed that 139,414 women were included in 22 original studies involving antihistamines, 129,108 of which were in studies involving doxylamine. In these studies, 23,485 women were exposed to antihistamines, 14,624 of which were exposed to doxylamine. The summary relative risk (cohort studies) and odds ratio (case-control studies) for congenital malformations from antihistamine exposure were 1.09 (95% CI: 1.01-1.18) and 1.04 (95% CI: 0.91-1.19), and for doxylamine exposure, the summary relative risk and odds ratio were 0.94 (95% CI: 0.80-1.10) and 1.07 (95% CI: 0.93-1.23), respectively. Although not a new systematic review, our re-analysis demonstrates that the safety data for antihistamines, and doxylamine in particular, are based on many fewer than 200,000 participating women and exposures, and that doxylamine use is not associated with a decreased risk of malformations as previously reported.

  5. A Report of Nausea and Vomiting with Discontinuation of Chronic Use of Salvia divinorum

    Directory of Open Access Journals (Sweden)

    C. R. Travis

    2012-01-01

    Full Text Available Introduction. This is the first reported case of gastrointestinal symptoms associated with withdrawal after chronic use of this substance. Case Presentation. A 51-year-old Caucasian woman was referred to a hospital with a 3-day history of nausea, vomiting, diarrhea, and abdominal discomfort. She reported no sick family members or contact with anyone who was ill. She did report smoking 3–5 cigarettes of the herb “Salvia” consistently for 3-4 months and quit approximately 48 hours before symptoms appeared. Her use of the herb had been consistent; she smoked several cigarettes each day. Laboratory results were essentially normal including the white blood cell count. She received symptomatic treatment and was released after one day. Discussion. Salvinorin A, a kappa-opioid receptor agonist, is the major active ingredient of S. divinorum. The unique opioid properties of this herb may explain its ability to cause changes in intestinal transit time. Conclusion. A 51-year-old woman possibly developed gastrointestinal manifestations suggestive of withdrawal from Salvia divinorum after smoking the substance consistently for 3 to 4 months. The widespread use of this herb will make the potential for withdrawal syndromes more commonplace.

  6. A Report of Nausea and Vomiting with Discontinuation of Chronic Use of Salvia divinorum.

    Science.gov (United States)

    Travis, C R; Ray, G A; Marlowe, K F

    2012-01-01

    Introduction. This is the first reported case of gastrointestinal symptoms associated with withdrawal after chronic use of this substance. Case Presentation. A 51-year-old Caucasian woman was referred to a hospital with a 3-day history of nausea, vomiting, diarrhea, and abdominal discomfort. She reported no sick family members or contact with anyone who was ill. She did report smoking 3-5 cigarettes of the herb "Salvia" consistently for 3-4 months and quit approximately 48 hours before symptoms appeared. Her use of the herb had been consistent; she smoked several cigarettes each day. Laboratory results were essentially normal including the white blood cell count. She received symptomatic treatment and was released after one day. Discussion. Salvinorin A, a kappa-opioid receptor agonist, is the major active ingredient of S. divinorum. The unique opioid properties of this herb may explain its ability to cause changes in intestinal transit time. Conclusion. A 51-year-old woman possibly developed gastrointestinal manifestations suggestive of withdrawal from Salvia divinorum after smoking the substance consistently for 3 to 4 months. The widespread use of this herb will make the potential for withdrawal syndromes more commonplace.

  7. Chemotherapy-induced nausea and vomiting: an overview and comparison of three consensus guidelines.

    Science.gov (United States)

    Tageja, Nishant; Groninger, Hunter

    2016-01-01

    Chemotherapy-induced nausea and vomiting (CINV) remains one of the most debilitating toxicities associated with cancer treatment. In recent decades, significant strides have been made in our understanding of the pathophysiology of CINV, making way to more effective targeted pharmacotherapies, especially 5-hydroxytryptamine3 receptor antagonists and neurokinin-1 (NK-1) receptor antagonists. As much as 70%-80% of CINV can be prevented with appropriate administration of available antiemetics. Nevertheless, fear of CINV still may diminish cancer treatment adherence. To assimilate and summarise the rapidly growing body of clinical research literature on CINV, three professional organisations-the Multinational Association of Supportive Care in Cancer/European Society for Medical Oncology, the American Society of Clinical Oncology and the National Comprehensive Cancer Network-have created CINV management guidelines. While these respective guidelines are developed from similar consensus processes using similar clinical research literature, their results demonstrate several key differences in recommended strategies. This article aims to provide an overview of CINV pathophysiology, compare and contrast three expert guidelines and offer considerations for future clinical and research challenges.

  8. Does measurement of preoperative anxiety have added value for predicting postoperative nausea and vomiting?

    Science.gov (United States)

    Van den Bosch, Jolanda E; Moons, Karel G; Bonsel, Gouke J; Kalkman, Cor J

    2005-05-01

    Preoperative anxiety has been suggested as a predictor of postoperative nausea and vomiting (PONV), but supporting data are lacking. We quantified the added predictive value of preoperative anxiety to established predictors of PONV in 1389 surgical inpatients undergoing various procedures, by using multivariate logistic regression analysis. Investigated predictors were a history of PONV or motion sickness, smoking, sex, age, ethnicity, body mass index, ASA physical status, surgery type, duration of anesthesia, anesthetic technique, and postoperative opioid analgesia. Anxiety was measured by the Spielberger State-Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information Scale. The outcome was the occurrence of PONV in the first 24 h after surgery. The area under the receiver operating characteristic curve of a multivariate (logistic regression) model including sex, age, smoking, history of PONV or motion sickness, surgery type, and anesthetic technique was 0.72 (95% confidence interval, 0.70-0.74). There was a weak but significant association of anxiety with PONV, but the addition of anxiety to the model did not further increase the area under the receiver operating characteristic curve. Therefore, routine preoperative measurement of anxiety does not seem warranted, provided that the other predictors are already considered.

  9. A Comparison of Dysautonomias Comorbid with Cyclic Vomiting Syndrome and with Migraine

    Directory of Open Access Journals (Sweden)

    Gisela Chelimsky

    2009-01-01

    Full Text Available Cyclic vomiting syndrome (CVS shares many features with migraine headache, including auras, photophobia, and antimigrainous treatment response being traditionally viewed as a migraine variant. Aims. To determine whether CVS is associated with the same disorders as migraine headache, and compare these associations to those in healthy control subjects. Methods. Cross-sectional study of patients utilizing the ODYSA instrument, evaluating the probability of 12 functional/autonomic diagnoses, CVS, migraine, orthostatic intolerance (OI, reflex syncope, interstitial cystitis, Raynaud's syndrome, complex regional pain syndrome (CRPS, irritable bowel syndrome, functional dyspepsia, functional abdominal pain, fibromyalgia, and chronic fatigue syndrome. Control subjects were age-matched gender-matched friends. Patients had to fulfill criteria for CVS or migraine, while control subjects could not. Results. 103 subjects were studied, 21 with CVS, 46 with migraine and 36 healthy controls. CVS and migraine did not differ in the relative frequencies of fibromyalgia, OI, syncope, and functional dyspepsia. However, CVS patients did demonstrate a significantly elevated frequency of CRPS. Conclusions. Although CVS and migraine clearly share many of the same comorbidities, they do differ in one important association, suggesting that they may not be identical in pathophysiology. Since OI is common in CVS, treatment strategies could also target this abnormality.

  10. Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy.

    Science.gov (United States)

    Ansari, Mansour; Porouhan, Pezhman; Mohammadianpanah, Mohammad; Omidvari, Shapour; Mosalaei, Ahmad; Ahmadloo, Niloofar; Nasrollahi, Hamid; Hamedi, Seyed Hasan

    2016-01-01

    Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the frst 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (±1.31) and 1.46 (±1.28) with no statistically significant difference. After the 2nd chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After 3rd chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (±1.14), versus 1.42 (±1.30)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (±0.96) and in control arm it was 1.40 (±0.92). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (±1.03), 0.68 (±1.00) and 0.77 (±1.18). In control arm, mean vomiting was 0.983 (±1.23), 1.03 (±1.22) and 1.15 (±1.27). In all sessions, ginger decreased vomiting severity from 1.4 (±1.04) to 0.71 (±0.86). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe (0.64±0.87) compared to those who received placebo (1.13±1.12), which was statistically significant (p-value <0.05). Further and larger studies are needed to draw conclusions.

  11. Humanistic and economic burden of nausea and vomiting among migraine sufferers

    Directory of Open Access Journals (Sweden)

    Gajria K

    2017-03-01

    Full Text Available Kavita Gajria,1 Lulu K Lee,2 Natalia M Flores,2 Ernesto Aycardi,1 Sanjay K Gandhi1 1Global Health Economics Research, Teva Pharmaceuticals, New York, NY, USA; 2Health Outcomes Practice, Kantar Health, Foster City, CA, USA Background: While studies have demonstrated the economic burden of migraines in terms of quality of life, health care resource use (HRU, and costs, there exists a notable paucity of data comparing such outcomes among migraineurs with nausea and vomiting (N/V and those without. The current study aimed to address this gap.Methods: This was a retrospective study using data from the 2013 US National Health and Wellness Survey, a cross-sectional, internet-based survey. Respondents self-reported their migraine with or without N/V along with demographics and outcomes including depression (Patient Health Questionnaire total score; PHQ-9, sleep problems (11-item total score of sleep problems, HRU (number of physician visits, emergency room [ER] visits, and hospitalizations and Work Productivity and Activity Impairment-General Health Scale (WPAI-GH, and associated mean annual costs. Generalized linear models, adjusting for covariates, assessed the burden of N/V on all outcomes.Results: Among all migraineurs (N=7,855, 73.4% were female, mean age was 41.82 years old, and 57.6% reported experiencing N/V. Adjusting for covariates, migraineurs with N/V vs without N/V had higher mean PHQ-9 scores (7.91 vs 7.02, p<0.001 and mean sleep problems (3.29 vs 2.64, p<0.001. Mean ER visits were more frequent among migraineurs with N/V than those without N/V (0.48 vs 0.38, p=0.001. This difference translated into a 26.3% increase in estimated mean ER costs (N/V=US$1,499 vs without N/V=US$1,187, p=0.002. Mean percentage activity impairment was higher in migraineurs with N/V than in those without N/V (37.73% vs 35.12%, p=0.002 and migraineurs with N/V had higher work productivity loss costs (N/V=US$10,344 vs without N/V=US$9,218, p=0.016.Conclusion

  12. The Effect of Pharyngeal Packing during Nasal Surgery on the Incidence of Post Operative Nausea, Vomiting, and Sore Throat

    Directory of Open Access Journals (Sweden)

    Ali Karbasfrushan

    2014-10-01

    Full Text Available Introduction: Nausea and vomiting after ear, nose and throat (ENT surgery is one of the most common and notable problems facing anesthesiologists in this area. This study was conducted to determine the effect of a pharyngeal pack on the severity of nausea, vomiting, and sore throat among patients after ear, pharynx, and throat surgeries.   Materials and Methods: This randomized clinical study was performed in 140 patients (61 men and 79 women; age range, 20–40 years who had undergone nasal surgery in 2010. Patients were divided into two groups: the first group were treated using a pharyngeal pack (case group and the second group were managed without a pharyngeal pack (control group. Statistical analysis was performed using the Chi-square test and the Mann-Whitney U test. SPSS software was used for data analysis.   Results: The mean severity of nausea and vomiting in the two groups was 2.057, 1.371 and 1.100, respectively, with no significant differences between groups. However, the mean severity of sore throat was 1.714 in the group with the pharyngeal pack and 1.385 in the group without pharyngeal pack (P=0.010.   Conclusion:  Not only does a pharyngeal pack in ENT surgery not reduce the extent and severity of nausea and vomiting, but it also increases the severity of sore throat in patients when leaving the recovery room and discharging hospital.

  13. Palonosetron for the prevention of nausea and vomiting in children with acute lymphoblastic leukemia treated with high dose methotrexate

    DEFF Research Database (Denmark)

    Nadaraja, Sambavy; Mamoudou, Aissata Diop; Thomassen, Harald;

    2012-01-01

    High dose methotrexate (HD-MTX), used in the treatment of children with acute lymphoblastic leukemia (ALL), is moderately emetogenic. First generation 5-HT(3) receptor antagonists are effective prophylactic agents but require multiple administrations. Palonosetron has a half life of 36-42 hours a...... of palonosetron (5 µg/kg) for the prevention of chemotherapy-induced nausea and vomiting in children 18 years of age with ALL treated with HD-MTX, 5 g/m(2)....

  14. Choice of study endpoint significantly impacts the results of breast cancer trials evaluating chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Ng, Terry; Mazzarello, Sasha; Wang, Zhou; Hutton, Brian; Dranitsaris, George; Vandermeer, Lisa; Smith, Stephanie; Clemons, Mark

    2016-01-01

    Multiple endpoints can be used to evaluate chemotherapy-induced nausea and vomiting (CINV). These endpoints reflect the various combinations of vomiting, nausea and rescue antiemetic use in the acute (0-24 h), delayed (>24-120 h) and overall (0-120 h) periods after chemotherapy. As the choice of outcome measure could potentially change the interpretation of clinical trial results, we evaluated CINV rates using different endpoints on a single dataset from a prospective cohort. Data from 177 breast cancer patients receiving anthracycline and cyclophosphamide-based chemotherapy was used to calculate CINV control rates using the 15 most commonly reported CINV endpoints. As nausea remains such a significant symptom, we explored the frequency at which pharmaceutical and non-pharmaceutical company-funded studies included measures of nausea in their primary study endpoint. CINV control rates ranged from 12.5 %, 95 % (CI 7.6-17.4 %) for total control (no vomiting, no nausea and no rescue medication) in the overall period to 77.4 %, 95 % (CI 71.2-83.6 %) for no vomiting in the overall period. Similar differences were found in the acute and delayed periods. Non-pharmaceutical company-funded trials were more likely to include a measure of nausea in the primary study outcome (9/18, 50 %) than pharmaceutical-funded trials (1/12, 8.3 %). The choice of trial endpoint has an important impact on reported CINV control rates and could significantly impact on interpretation of the results. Primary endpoints of studies, including those mandated by regulatory bodies, should account for nausea to reflect patient experience. Reporting of endpoints should be more comprehensive to allow for cross-trial comparisons.

  15. Content Analysis of Vomit and Diarrhea Cleanup Procedures To Prevent Norovirus Infections in Retail and Food Service Operations.

    Science.gov (United States)

    Chao, Morgan G; Dubé, Anne-Julie; Leone, Cortney M; Moore, Christina M; Fraser, Angela M

    2016-11-01

    Human noroviruses are the leading cause of foodborne disease in the United States, sickening 19 to 21 million Americans each year. Vomit and diarrhea are both highly concentrated sources of norovirus particles. For this reason, establishing appropriate cleanup procedures for these two substances is critical. Food service establishments in states that have adopted the 2009 or 2013 U.S. Food and Drug Administration Food Code are required to have a program detailing specific cleanup procedures. The aim of our study was to determine the alignment of existing vomit and diarrhea cleanup procedures with the 11 elements recommended in Annex 3 of the 2011 Supplement to the 2009 Food Code and to determine their readability and clarity of presentation. In July 2015, we located vomit and diarrhea cleanup procedures by asking Norovirus Collaborative for Outreach, Research, and Education stakeholders for procedures used by their constituency groups and by conducting a Google Advanced Search of the World Wide Web. We performed content analysis to determine alignment with the recommendations in Annex 3. Readability and clarity of presentation were also assessed. A total of 38 artifacts were analyzed. The mean alignment score was 7.0 ± 1.7 of 11 points; the mean clarity score was 6.7 ± 2.5 of 17 points. Only nine artifacts were classified as high clarity, high alignment. Vomit and diarrhea cleanup procedures should align with Annex 3 in the Food Code and should, as well, be clearly presented; yet, none of the artifacts completely met both conditions. To reduce the spread of norovirus infections in food service establishments, editable guidelines are needed that are aligned with Annex 3 and are clearly written, into which authors could insert their facility-specific information.

  16. Doxylamine succinate–pyridoxine hydrochloride (Diclegis) for the management of nausea and vomiting in pregnancy: an overview

    OpenAIRE

    Nuangchamnong N; Niebyl J

    2014-01-01

    Nina Nuangchamnong, Jennifer Niebyl Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa, IA, USA Abstract: Nausea and vomiting in pregnancy (NVP) is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA) approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog) 10 mg as a delayed-release combination pill ...

  17. 8-Way Randomized Controlled Trial of Doxylamine, Pyridoxine and Dicyclomine for Nausea and Vomiting during Pregnancy: Restoration of Unpublished Information

    OpenAIRE

    Zhang, Rujun; Persaud, Navindra

    2017-01-01

    Objectives We report information about an unpublished 1970s study (“8-way” Bendectin Study) that aimed to evaluate the relative therapeutic efficacy of doxylamine, pyridoxine, and dicyclomine in the management of nausea and vomiting during pregnancy. We are publishing the trial's findings according to the restoring invisible and abandoned trials (RIAT) initiative because the trial was never published. Design Double blinded, multi-centred, randomized placebo-controlled study. Setting 14 clinic...

  18. Cyclic vomiting syndrome in children: Experience with 181 cases from southern Iran

    Institute of Scientific and Technical Information of China (English)

    Mahmood Haghighat; Seyed Mohammad Rafie; Seyed Mohsen Dehghani; Gholam Hossein Fallahi; Marzieh Nejabat

    2007-01-01

    AIM:To evaluate the clinical presentation,response to prophylactic therapy and outcome of children with cyclic vomiting syndrome (CVS) in Shiraz,Iran.METHODS:During a period of 11 years (March 1994 to March 2005),181 consecutive children with a final diagnosis of CVS were evaluated,treated and followed in our center. Patients were randomized to receive either amitriptyline or propranolol as prophylactic treatments.RESULTS:There were 88 boys and 93 girls with mean age of onset of symptoms of 4.9 ± 3.3 years(range,neonatal period to 14 years),the mean age at final diagnosis was 6.9 years (range, 1.5 to 14),and the mean duration between the onset of the first attack and the final diagnosis of CVS was 2 ± 1.81 years(range,1/6 to 8).The mean duration of each attack was 4.26 days(range,from few hours to 10 d)and the mean interval between the attacks was 1.8 mo(range,1 wk to 12 mo).The time of onset of the attacks was midnight to early morning in about 70% of cases. Amitriptyline was effective in 46 out of 81 (56%) patients (P<0.001). Propranolol appeared to have a superior action and was effective in 74 out of 83 (92%) patients (P<0.0001). CONCLUSION:There is a significant lag time between the onset of clinical symptoms and the final diagnosis of CVS in our area. In patients with typical clinical presentationsof CVS,who are examined by an experienced physician,invasive workup is not necessary. Propranolol appears more effective than amitriptyline for prophylactic use in children with CVS.

  19. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting

    Science.gov (United States)

    Navari, Rudolph M.; Qin, Rui; Ruddy, Kathryn J.; Liu, Heshan; Powell, Steven F.; Bajaj, Madhuri; Dietrich, Leah; Biggs, David; Lafky, Jacqueline M.; Loprinzi, Charles L.

    2016-01-01

    BACKGROUND We examined the efficacy of olanzapine for the prevention of nausea and vomiting in patients receiving highly emetogenic chemotherapy. METHODS In a randomized, double-blind, phase 3 trial, we compared olanzapine with placebo, in combination with dexamethasone, aprepitant or fosaprepitant, and a 5-hydroxytryptamine type 3–receptor antagonist, in patients with no previous chemotherapy who were receiving cisplatin (≥70 mg per square meter of body-surface area) or cyclophosphamide–doxorubicin. The doses of the three concomitant drugs administered before and after chemotherapy were similar in the two groups. The two groups received either 10 mg of olanzapine orally or matching placebo daily on days 1 through 4. Nausea prevention was the primary end point; a complete response (no emesis and no use of rescue medication) was a secondary end point. RESULTS In the analysis, we included 380 patients who could be evaluated (192 assigned to olanzapine, and 188 to placebo). The proportion of patients with no chemotherapy-induced nausea was significantly greater with olanzapine than with placebo in the first 24 hours after chemotherapy (74% vs. 45%, P = 0.002), the period from 25 to 120 hours after chemotherapy (42% vs. 25%, P = 0.002), and the overall 120-hour period (37% vs. 22%, P = 0.002). The complete-response rate was also significantly increased with olanzapine during the three periods: 86% versus 65% (P<0.001), 67% versus 52% (P = 0.007), and 64% versus 41% (P<0.001), respectively. Although there were no grade 5 toxic effects, some patients receiving olanzapine had increased sedation (severe in 5%) on day 2. CONCLUSIONS Olanzapine, as compared with placebo, significantly improved nausea prevention, as well as the complete-response rate, among previously untreated patients who were receiving highly emetogenic chemotherapy. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT02116530.) PMID:27410922

  20. Critical appraisal of drug therapy for nausea and vomiting of pregnancy: II. Efficacy and safety of diclectin (doxylamine-B6).

    Science.gov (United States)

    Bishai, R; Mazzotta, P; Atanackovic, G; Levichek, Z; Pole, M; Magee, L A; Koren, G

    2000-01-01

    Nausea and vomiting of pregnancy is the most common condition in pregnancy and affects up to 80% of all pregnant women. There are a large number of pharmacological agents that are effective for the treatment of nausea and vomiting associated with conditions such as motion sickness and gastrointestinal conditions; however, their use in pregnancy is limited by the lack of sufficient data on their potential teratogenic effects. The efficacy of the delayed-release combination of doxylamine and pyridoxine (Bendectin, Diclectin) has been shown in several randomized, controlled trials. The present review aims to refute the unsubstantiated beliefs that Diclectin is unsafe when used in the treatment of nausea and vomiting of pregnancy.

  1. Acupoint Sticking at Shenque (CV 8) with Ginger-preparedBan Xia (Rhizoma Pinelliae) for Nausea and Vomiting Induced by Amifostine

    Institute of Scientific and Technical Information of China (English)

    Wang Li-na; Hu Hong-yan; Qiu Yi-ling; Zhou Yu-hong

    2014-01-01

    Objective: To observe the treatment effect of acupoint sticking at Shenque (CV 8) with ginger-preparedBan Xia (Rhizoma Pinelliae) on nausea and vomiting induced by Amifostine for myelodysplastic syndromes (MDS). Methods: Totally 124 eligible subjects intervened by Amifostine were randomized into 2 groups by the visiting order,an observation group and a control group,62 in each group. The control group was intervened by conventional treatment, while the observation group was by acupoint sticking at Shenque (CV 8) with ginger-preparedBan Xia (Rhizoma Pinelliae) in addition to the same conventional treatment. The occurrence rate of nausea and vomiting in the two groups were observed. Results: After intervention, the occurrence rate of nausea and vomiting in the observation group was significantly lower than that in the control group (P Conclusion: Acupoint sticking at Shenque (CV 8) with ginger-prepared Ban Xia (Rhizoma Pinelliae)can produce a content effect on nausea and vomiting induced by Amifostine for MDS.

  2. An assessment of chemotherapy-induced nausea and vomiting direct costs in three EU countries

    Directory of Open Access Journals (Sweden)

    Marco Turini

    2015-07-01

    Full Text Available Background: Chemotherapy-induced nausea and vomiting (CINV has been commonly reported as one of the most distressing adverse effects among treated patients with cancer. Inadequately treated, CINV can lead to increased resource utilization and severely impair patients’ daily functioning and quality of life. Direct costs include acquisition cost of antiemetic drugs and rescue medication, administration devices, add-on treatments, such as hydration, and additional patient care, that is, nursing and physician time, unscheduled office visits, emergency room admissions, and, in some cases, extended hospitalization or readmission. There are many reports on the cost-effectiveness of antiemetic drugs, but information on the total cost per patient associated with CINV is limited. The costs associated with severe CINV episodes are considered responsible for the most significant part of the expenditures. Scope: The aim of this study was to investigate the management of CINV episodes in three European health-care environments and to estimate direct costs associated with severe CINV episodes. Methods: An online survey addressed to Italian, German, and French oncologists and oncology nurses was performed. The survey included 41 questions about the management and the resource utilization for patients experiencing any CINV episode during the 6-month period preceding the survey. Furthermore, the cost associated with severe CINV episode management was estimated by adopting the National Health Service’s perspective. Findings: A large proportion of patients receiving chemotherapy experienced a CINV episode (34.4% in Italy, 50.2% in France, and 40.4% in Germany; among those, 8.8% in Italy, 11.6% in France, and 19.2% in Germany experienced a severe CINV episode. Compared with Italy, Germany and France presented a greater hospitalization rate following an unplanned visit to the oncology ward or an emergency room access due to CINV. In Italy, the mean cost per

  3. Cyclic Vomiting Syndrome (CVS: is there a difference based on onset of symptoms - pediatric versus adult?

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    Kumar Nilay

    2012-05-01

    Full Text Available Abstract Background Cyclic Vomiting Syndrome (CVS is a well-recognized functional gastrointestinal disorder in children but its presentation is poorly understood in adults. Genetic differences in pediatric-onset (presentation before age 18 and adult-onset CVS have been reported recently but their clinical features and possible differences in response to therapy have not been well studied. Methods This was a retrospective review of 101 CVS patients seen at the Medical College of Wisconsin between 2006 and 2008. Rome III criteria were utilized to make the diagnosis of CVS. Results Our study population comprised of 29(29% pediatric-onset and 72 (71% adult-onset CVS patients. Pediatric-onset CVS patients were more likely to be female (86% vs. 57%, p = 0.005 and had a higher prevalence of CVS plus (CVS + neurocognitive disorders as compared to adult-onset CVS patients (14% vs. 3%, p = 0.05. There was a longer delay in diagnosis (10 ± 7 years in the pediatric-onset group when compared to (5 ± 7 years adult-onset CVS group (p = 0.001. Chronic opiate use was less frequent in the pediatric-onset group compared to adult-onset patients (0% vs. 23%, p = 0.004. Aside from these differences, the two groups were similar with regards to their clinical features and the time of onset of symptoms did not predict response to standard treatment. The majority of patients (86% responded to treatment with tricyclic antidepressants, anticonvulsants (topiramate, coenzyme Q-10, and L-carnitine. Non-response to therapy was associated with coalescence of symptoms, chronic opiate use and more severe disease as characterized by longer episodes, greater number of emergency department visits in the year prior to presentation, presence of disability and non-compliance on univariate analysis. On multivariate analysis, only compliance to therapy was associated with a response. (88% vs. 38%, Odds Ratio, OR 9.6; 95% Confidence Interval [CI], 1.18-77.05. Conclusion Despite reported

  4. Pre-emptive therapy for severe nausea and vomiting of pregnancy and hyperemesis gravidarum.

    Science.gov (United States)

    Koren, G; Maltepe, Caroline

    2004-08-01

    Nausea and vomiting of pregnancy (NVP) affects 80% of pregnancies. Its severe form, hyperemesis gravidarum (HG), results in dehydration, electrolyte imbalance, the need for hospitalisation and can, rarely, be fatal. This was a prospective, open-labelled, controlled, interventional study to evaluate the effectiveness of pre-emptive treatment of NVP symptoms in women who experienced severe NVP or HG in their previous pregnancy. Twenty-five women who reported severe symptoms of NVP with or without HG in their previous pregnancy were recruited and counselled to commence the use of antiemetics as soon as they became aware of the present pregnancy, and no later than the beginning of symptoms. They were followed-up prospectively through the index pregnancy for symptoms of NVP, and were counselled continuously as to how to modify antiemetic doses based on symptoms. A comparison group consisted of randomly selected women also counselled by us for NVP, who had also had severe NVP in the previous pregnancy, but who did not call before a planned pregnancy and thus could not be offered pre-emptive therapy. The recruited women commenced pre-emptive drug therapy for NVP before conception or up to 7 weeks' gestation, before the appearance of NVP symptoms in all cases. In comparison to the previous pregnancy, only eight of these 18 women experienced a HG again in the index pregnancy (P = 0.01). The majority of study the women had an improvement in severity of NVP symptoms compared to the previous pregnancy. In the comparison group (n = 35), symptoms in the index pregnancy remained severe in 28 cases (80%), decreased to moderate in six (16.6%) and decreased to mild in five cases (13.9%). There were five cases of HG in the previous pregnancy and three in the index pregnancy. The pre-emptive group was improved significantly compared to the control group (P = 0.01). Pre-emptive symptom management appears to be effective in preventing severe NVP in general, and HG in particular. Women

  5. TREATMENT EFFICACY OF GINGER V/S P YRIDOXIN IN THE FIRST TRIMESTER NAUSEA & VOMITINGS OF PREG NANCY-A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Kaliki.Hymavathi

    2013-02-01

    Full Text Available Nausea and vomiting are the main symptoms in 1sttrimester of pregnancy. Ginger is safe and highly effective in the treatment of pregnancy induced nausea and vomitings. The present study aimed to evaluate the effectiveness of Ginger and Pyridoxine in the treatmentof pregnancy induced nausea and vomitings (First trimester.100 pregnant women attending the out patient department of Obstetrics and Gynecology of Narayana medical college hospital, Nellore with complaints of nausea and vomitings in 1sttrimester of pregnancy are recruited into the study after obtaining informed consent. These100 were divided into two groups. 50 were given Ginger administration and another 50 were given Pyridoxine for a period of 35 days. During the period of treatment the symptom relief in both the groups are assessed periodically by visual analog scales .The results have shown that nausea and vomiting scores reduction was found to be much better in Ginger group compared to Pyridoxine group. Ginger administration is proved to bea better treatment in treating 1sttrimester pregnancy induced nausea and vomitings

  6. A physiological perspective for utility or futility of alcohol-based hand rub gel against nausea-vomiting: is it P-6 acupoint or transnasal aroma?

    Science.gov (United States)

    Gupta, Deepak; Mazumdar, Ashish; Stellini, Michael

    2014-09-01

    Nausea-vomiting is a common and unpleasant phenomenon with numerous underlying mechanisms and pathways that are not always well elucidated. In clinical practice, refractory nausea-vomiting is encountered in several settings. Antiemetic medications may reduce these symptoms but are not always effective in all patients. In the absence of a well-defined optimal strategy for management of nausea-vomiting, the search for better approaches to treat this distressing symptom continues. One of the alternative treatment approaches is a compounded formulation called ABHR gel that is comprised of multiple antiemetic medications and has been shown to be useful for symptomatic relief in some patients with refractory nausea-vomiting. It has been suggested that alternative mechanisms should be explored to explain the perceived efficacy of ABHR gel, because transdermal absorption leading to nil-to-minimal or subtherapeutic blood concentrations of active ingredients does not explain the role of ABHR gel in the treatment of nausea-vomiting. In the current paper, we discuss possible mechanisms that may explain ABHR transdermal gel's efficacy. Compounded ABHR transdermal gel formulation's efficacy in antagonizing nausea-vomiting that has been recently questioned may be explained by alternative mechanisms mediated through the P-6 acupoint stimulation and facial-nasal, cooling-related counterstimulation.

  7. A randomized crossover trial on the effect of compression stockings on nausea and vomiting in early pregnancy.

    Science.gov (United States)

    Mendoza, Erika; Amsler, Felix

    2017-01-01

    This study aimed to assess the impact of wearing compression stockings on women's quality of life (QoL) associated with nausea and vomiting in early pregnancy (NVP). In this randomized, open, single-center, crossover study, 74 women were assigned 1:1 to 2 weeks with compression stockings followed by 2 weeks without or vice versa. The main outcomes were NVP-associated QoL, leg-related QoL, and dizziness, as assessed by the Nausea and Vomiting in Pregnancy Quality of Life (NVPQOL) questionnaire, Chronic Venous Disease Quality of Life (CIVIQ) questionnaire, and questions on dizziness at baseline and after each 2-week period, respectively. Daily NVP was assessed using the modified Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) questionnaire. Data were analyzed using Pearson's chi-square and independent t-tests. Fifty-eight women completed the study. QoL scores improved with compression treatment; changes in mean total scores were as follows: NVPQOL, -36.7 with compression vs -21.7 without (P<0.0001); and CIVIQ, -4.5 with compression vs +1.4 without (P=0.001). Mean dizziness scores were -3.2 with compression vs -0.4 without (P<0.0001). PUQE mean total score (standard deviation) was 4.9 (2.3) with compression vs 5.5 (2.2) without (P=0.042). Wearing of compression stockings in early pregnancy may improve nausea and vomiting-associated symptoms in addition to improving QoL factors.

  8. Effect of Acupressure on Nausea, Vomiting, Anxiety and Pain among Post-cesarean Section Women in Taiwan

    Directory of Open Access Journals (Sweden)

    Huei-Mein Chen

    2005-08-01

    Full Text Available The purpose of this study was to examine the effectiveness of acupressure for controlling post-cesarean section (CS symptoms, such as nausea and vomiting, anxiety perception and pain perception. A total of 104 eligible participants were recruited by convenience sampling of operating schedules at two hospitals. Participants assigned to the experimental group received acupressure, and those assigned to the control group received only postoperative nursing instruction. The experimental group received three acupressure treatments before CS and within the first 24 hours after CS. The first treatment was performed the night before CS, the second was performed 2-4 hours after CS, and the third was performed 8-10 hours after CS. The measures included the Rhodes Index of Nausea and Vomiting, Visual Analog Scale for Anxiety, State-Trait Anxiety Inventory, Visual Analog Scale for Pain, and physiologic indices. Statistical methods included percentages, mean value with standard deviation, t test and repeated measure ANOVA. The use of acupressure reduced the incidence of nausea, vomiting or retching from 69.3% to 53.9%, compared with control group (95% confidence interval = 1.65-0.11; p = 0.040 2-4 hours after CS and from 36.2% to 15.4% compared with control group (95% confidence interval = 0.59-0.02; p = 0.024 8-10 hours after CS. Results indicated that the experimental group had significantly lower anxiety and pain perception of cesarean experiences than the control group. Significant differences were found in all physiologic indices between the two groups. In conclusion, the utilization of acupressure treatment to promote the comfort of women during cesarean delivery is strongly recommended.

  9. COMPARATIVE STUDY OF PROPHYLACTIC METOCLOPRAMIDE VERSUS ONDANSETRON FOR CONTROL OF POSTOPERATIVE NAUSEA AND VOMITING (PONV ASSOCIATED WITH IV TRAMADOL

    Directory of Open Access Journals (Sweden)

    Anjali P.

    2015-10-01

    Full Text Available AIMS AND OBJECTIVE: This prospective double blind randomized study was conducted to compare: 1. The efficacy and safety of prophylactic administration of Metoclopramide versus Ondansetron in the control of postoperative nausea and vomiting in patients receiving intravenous Tr amadol as postoperative analgesic. 2. To study the incidence of post operative nausea and vomiting with IV bolus Tramadol. METHODS: 90 patients ASA grade I and II, age 18 - 60 years, posted for hernia, hydrocele and other peripheral lower limb surgeries under subarachnoid block were selected . Patients were randomly allocated into three groups of thirty each. All surgeries were performed under subarachnoid block and received IV Tramadol 100 m g 8 hourly for 24 hours as post - operative analgesic. Group N received no prophylactic antiemetic. Group M received 10 mg Metoclopramide 12 hourly. Group O received 4 mg Ondansetron 12 hourly. Vital signs, nausea, vomiting, pain, sedation, need for rescue a ntiemetic, rescue analgesic and adverse effects were recorded for 24 hours. RESULTS: Ondansetron group (Group O significantly reduced the incidence of PONV as compared to Metoclopramide (Group M and no antiemetic group (Group N .But Metoclopramide was fo und to be not significantly effective in controlling PONV in patients receiving Tramadol as analgesic. None of the patients in Group O required rescue antiemetic as compared to 13.3% patients in Group M and 26.7% patients in Group N. There was statisticall y no significant difference between the 3 groups with respect to requirement of rescue analgesic. No major adverse effects were observed which can be attributed to either Metoclopramide or Ondansetron. CONCLUSION: Ondansetron was more effective than Metoclopramide in controlling PONV, in patients receiving IV Tramadol as post-operative analgesia

  10. Comparison of palanosetron with ondansetron for postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia

    Directory of Open Access Journals (Sweden)

    Jyoti Bhalla

    2015-01-01

    Full Text Available Background: Post-operative nausea and vomiting (PONV is a ′big little′ problem especially after laparoscopic surgeries. Palanosetron is a new potent 5 hydroxy tryptamine 3 antagonists. In this randomized double blind clinical study we compared the effects of i.v. ondansetron and palanosetron administered at the end of surgery in preventing post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia. Materials and Methods: A total of 100 subjects between 18-60 years with Apfel score ≥2, were randomly assigned into one of the two groups, containing 50 patients each. Group A received ondansetron 4 mg i.v. and Group B received palanosetron 0.07 5mg i.v. both as bolus before induction. The incidence of nausea, retching and vomiting, incidence of total PONV, requirement of rescue antiemetics and adverse effects were evaluated during the first 24 h following end of surgery. Results: The incidence of nausea was significantly lower in patients who had received palanosetron (16% as compared to ondansetron (24%. Need of rescue antiemetics was significantly higher in patients receiving ondansetron (32% as compared to palanosetron (16%. The incidence of total PONV was also significantly lower in group receiving palanosetron (20% as compared to ondansetron (50%. Among the side effects, headache was noted significantly higher with ondansetron (20% as compared to palanosetron (6%. Conclusion: Palanosetron has got better anti-nausea effect, less need of rescue antiemetics, favourable side effect profile and a decrease in the incidence of total PONV as compared to ondansetron in 24 h post operative period in patients undergoing laproscopic cholecystectomy under general anesthesia.

  11. Computational prediction of state anxiety in Asian patients with cancer susceptible to chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Yap, Kevin Yi-Lwern; Low, Xiu Hui; Chui, Wai Keung; Chan, Alexandre

    2012-04-01

    State anxiety, a risk factor for chemotherapy-induced nausea and vomiting (CINV), is a subjective symptom and difficult to quantify. Clinicians need appropriate anxiety measures to assess patients' risks of CINV. This study aimed to determine the anxiety characteristics that can predict CINV based on computational analysis of an objective assessment tool. A single-center, prospective, observational study was carried out between January 2007 and July 2010. Patients with breast, head and neck, and gastrointestinal cancers were recruited and treated with a variety of chemotherapy protocols and appropriate antiemetics. Chemotherapy-induced nausea and vomiting characteristics and antiemetic use were recorded using a standardized diary, whereas patients' anxiety characteristics were evaluated using the Beck Anxiety Inventory. Principal component (PC) analysis was performed to analyze the anxiety characteristics. A subset known as principal variables, which had the highest PC weightings, was identified for patients with and without complete response, complete protection, and complete control. Chemotherapy-induced nausea and vomiting events and anxiety characteristics of 710 patients were collated; 51%, 30%, and 20% were on anthracycline-, oxaliplatin-, and cisplatin-based therapies, respectively. Most patients suffered from delayed CINV, with decreasing proportions achieving complete response (58%), complete protection (42%), and complete control (27%). Seven symptoms (fear of dying, fear of the worst, unable to relax, hot/cold sweats, nervousness, faintness, numbness) were identified as potential CINV predictors. This study demonstrates the usefulness of PC analysis, an unsupervised machine learning technique, to identify 7 anxiety characteristics that are useful as clinical CINV predictors. Clinicians should be aware of these characteristics when assessing CINV in patients on emetogenic chemotherapies.

  12. Betahistine as an add-on: The magic bullet for postoperative nausea, vomiting and dizziness after middle ear surgery?

    Directory of Open Access Journals (Sweden)

    Sandip Mukhopadhyay

    2013-01-01

    Full Text Available Purpose: Patients undergoing middle ear surgery experience variable degrees of postoperative nausea and vomiting (PONV despite prophylaxis and treatment with ondansetron or other 5HT 3 receptor antagonists. Furthermore vertigo or dizziness are not well controlled perioperatively. Role of betahistine was tested as an add-on to ondansetron in control of PONV and vertigo in middle ear surgery cases. Materials and Methods: We conducted a prospective, randomized, double-blind, placebo controlled study, enrolling one hundred patients undergoing middle ear surgery under local anesthesia into two groups consisting of fifty (n = 50 patients each. Group A patients were given betahistine 16 mg plus ondansetron 8 mg and placebo plus ondansetron 8 mg were given to group B or placebo group, orally 3 hours before starting operation. The incidence of nausea, vomiting, and dizziness was noted during the intraoperative and postoperative 24 hours period. Chi-square test, unpaired ′t′ test, and Fisher′s exact tests were performed for statistical analysis using SPSS version 16 and Open Epi version 2.3.1 softwares. Results: Complete response was obtained in 90% patients in the betahistine group as compared to 66% in the placebo group. Vomiting in the intraoperative and postoperative period was noted in 4% and 8% cases, respectively, in the betahistine group as compared to 18% and 26%, respectively, in the placebo group. Overall, vertigo was 10% versus 32% in betahistine group and placebo group, respectively. Conclusion: Betahistine as an add-on to ondansetron can significantly attenuate PONV and perioperative vertigo, following middle ear surgeries.

  13. Advances in Postoparative Nausea and Vomiting%手术后恶心呕吐的研究进展

    Institute of Scientific and Technical Information of China (English)

    刘学胜; 曾因明; 张健

    2005-01-01

    手术后恶心和呕吐(postoperative nausea and vomiting,PONV)最为常见,其发生机制可能和脑干催吐中枢接受体内一些催吐信号的刺激有关.影响PONV发生的因素众多,临床上单一用药在预防和治疗PONV可能难以达到预期效果,而联合用药可能阻断引起PONV的多个病因,从而达到治疗目的.

  14. 8-Way Randomized Controlled Trial of Doxylamine, Pyridoxine and Dicyclomine for Nausea and Vomiting during Pregnancy: Restoration of Unpublished Information

    Science.gov (United States)

    Zhang, Rujun; Persaud, Navindra

    2017-01-01

    Objectives We report information about an unpublished 1970s study (“8-way” Bendectin Study) that aimed to evaluate the relative therapeutic efficacy of doxylamine, pyridoxine, and dicyclomine in the management of nausea and vomiting during pregnancy. We are publishing the trial's findings according to the restoring invisible and abandoned trials (RIAT) initiative because the trial was never published. Design Double blinded, multi-centred, randomized placebo-controlled study. Setting 14 clinics in the United States. Participants 2308 patients in the first 12 weeks of pregnancy with complaints of nausea or vomiting were enrolled. Interventions Each patient was randomized to one of eight arms: placebo, doxylamine/pyridoxine/dicylcomine, doxylamine/pyridoxine, dicylomine/pyridoxine, doxylamine, dicyclomine/pyridoxine, pyridoxine and dicyclomine. Each patient was instructed to take 2 tablets at bedtime and 1 additional tablet in the afternoon or morning if needed, for 7 nights. Outcomes Reported outcomes included the number of hours of nausea reported by patients, the frequency of vomiting reported by patients and the overall efficacy of medication as judged by physicians. Results Data from 1599 (69% of those randomized) participants were analyzed. Based on the available summary data of physician evaluation of symptoms and ignoring missing data and data integrity issues, the proportion of participants who were “evaluated moderate or excellent” was greater in each of the seven active treatment groups when compared with placebo (57%): doxylamine/pyridoxine/dicylcomine (14% absolute difference versus placebo; 95% CI: 4 to 24), doxylamine/pyridoxine (21; 95% CI 11 to 30), dicylomine/pyridoxine (21; 95% CI 11 to 30), doxylamine (20; 95% CI 10 to 29), dicyclomine/pyridoxine (4; 95% CI -6 to 14), pyridoxine (9; 95% CI -1 to 19) and dicyclomine (4; 95% CI -6 to 14). Based on incomplete information, the most common adverse events were apparently drowsiness and fatigue

  15. Casopitant: a novel NK(1)-receptor antagonist in the prevention of chemotherapy-induced nausea and vomiting

    DEFF Research Database (Denmark)

    Ruhlmann, Christina; Herrstedt, Jørn

    2009-01-01

    , whereas the effect on nausea seems to be limited. The first NK(1) receptor antagonist, aprepitant, became clinically available in 2003, and casopitant, the second in this class of antiemetics, has now completed phase III trials. This review delineates the properties and clinical use of casopitant......-hydroxytryptamine (5-HT)(3)- and neurokinin (NK)(1) receptors in the emetic reflex arch. This has led to the development of two new classes of antiemetics acting as highly selective antagonists at one of these receptors. These drugs have had a huge impact in the protection from chemotherapy-induced vomiting...

  16. [Impacts of transcutaneous acupoint electric stimulation on the postoperative nausea and vomiting and plasma 5-HT concentration after cesarean section].

    Science.gov (United States)

    Liu, Yanli; Wang, Mingshan; Li, Qiujie; Wang, Ling; Li, Jingzhu

    2015-10-01

    To observe the effect of transcutaneous acupoint electric stimulation on the postoperative nausea and vomiting (PONV) and explore its mechanism. Ninety cases of elective cesarean section of I to II grade in American Society of Anesthesiologists (ASA) were collected and randomized into a transcutaneous acupoint electric stimulation group (group A), a sham-acupoint group (group B) and a blank control group (group C), 30 cases in each one. In the group A, 30 min before operation, the transcutaneous electric stimulation was applied to bilateral Neiguan (PC 6) and Zusanli (ST 36). The stimulation lasted during operation and 1 h after operation. In the group B, the same electric stimulation was given at the sites 3 cm lateral to the medial sides of Neiguan (PC 6) and Zusanli (ST 36). In the group C, the electric plaster was attached to bilateral Neiguan (PC 6) and Zusanli (ST 36), without any electric stimulation. The lumbar epidural combined anesthesia and the postoperative analgesia were same in each group. The mean arterial pressure (MAP), heart rate (HR) , oxygen saturation of blood (SpO2) and the VAS (visual analogue scale) score of nausea and vomiting were recorded before acupoint stimulation (T0), at skin incision (T1), fetal delivery (T2), abdominal exploration (T3) and 1 h after operation (T4) as well as bleeding and application of oxytocin, ephedrine and atropine during operation separately. The changes of plasma 5-hydroxytryptamine (5-HT) concentration were observed at T0 and 30 min after electric stimulation. The differences were not significant in MAP, HP and SpO2 at each time point of the three groups (all P> 0.05). The differences were not significant in bleeding and application of oxytocin, ephedrine and atropine during operation (all P > 0.05). The scores of nausea and vomiting in the group A during T1 to T4 were lower than those in the group B and group C (all P electric stimulation, plasma 5-HT concentration was lower than those in the group B and

  17. Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment.

    Science.gov (United States)

    O'Donnell, Amy; McParlin, Catherine; Robson, Stephen C; Beyer, Fiona; Moloney, Eoin; Bryant, Andrew; Bradley, Jennifer; Muirhead, Colin; Nelson-Piercy, Catherine; Newbury-Birch, Dorothy; Norman, Justine; Simpson, Emma; Swallow, Brian; Yates, Laura; Vale, Luke

    2016-01-01

    BACKGROUND Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG. DATA SOURCES MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsycINFO, Commonwealth Agricultural Bureaux (CAB) Abstracts, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, British Nursing Index, Science Citation Index, Social Sciences Citation Index, Scopus, Conference Proceedings Index, NHS Economic Evaluation Database, Health Economic Evaluations Database, China National Knowledge Infrastructure, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from inception to September 2014. References from studies and literature reviews identified were also examined. Obstetric Medicine was hand-searched, as were websites of relevant organisations. Costs came from NHS sources. REVIEW METHODS A systematic review of randomised and non-randomised controlled trials (RCTs) for effectiveness, and population-based case series for adverse events and fetal outcomes. Treatments: vitamins B6 and B12, ginger, acupressure/acupuncture, hypnotherapy, antiemetics, dopamine antagonists, 5-hydroxytryptamine receptor antagonists, intravenous (i.v.) fluids, corticosteroids, enteral and parenteral feeding or other novel treatment. Two reviewers extracted data and quality assessed studies. Results were narratively synthesised; planned meta-analysis was not possible due to heterogeneity and incomplete reporting. A simple economic evaluation considered

  18. How evidence-based is the information on the internet about nausea and vomiting of pregnancy?

    Science.gov (United States)

    Sacks, Samantha; Abenhaim, Haim A

    2013-08-01

    Contexte : Internet est devenu une importante source de renseignements au sujet de la grossesse et des préoccupations de santé en général. Cette étude a évalué la qualité des renseignements disponibles sur Internet pour ce qui est des problèmes courants de la nausée et du vomissement pendant la grossesse (NVG). Méthodes : Nous avons utilisé trois termes de recherche (« nausea and vomiting in pregnancy », « morning sickness » et « hyperemesis gravidarum ») pour identifier les sites les plus populaires, tels que classés par Google. Au moyen de modifications apportées à des outils déjà décrits, la qualité des sites Web a été évaluée en fonction de trois critères : la responsabilité (au moyen des critères Silberg), la présentation (au moyen d’un score Abbott modifié) et la lisibilité (au moyen du score de niveau de langue Flesch-Kincaid). Par la suite, les renseignements offerts par ces sites Web ont été comparés aux renseignements offerts par la directive clinique de la SOGC sur la prise en charge des NVG. Résultats : Nous avons identifié 24 sites Web particuliers comme étant les plus populaires. Les scores globaux en matière de responsabilité ont indiqué une piètre qualité, seulement 25 % des sites Web satisfaisant aux critères requis et moins de la moitié de ces sites indiquant le nom du ou des auteurs et leurs références. Les critères traitant de l’attrait esthétique ont été satisfaits pour ce qui est de plus de 75 % des sites Web. Le score de lisibilité de ces sites Web se situait considérablement au-dessus du score recommandé pour la population générale (score de niveau de langue Flesch-Kincaid moyen de 10,7 [max. = 12]). Quatre-vingt-sept pour cent de ces sites Web contenaient des recommandations précises et factuelles, conformes aux renseignements offerts dans la directive clinique de la SOGC sur la prise en charge des NVG. Conclusion : De façon globale, la majorité des

  19. The value of integrating pre-clinical data to predict nausea and vomiting risk in humans as illustrated by AZD3514, a novel androgen receptor modulator.

    Science.gov (United States)

    Grant, Claire; Ewart, Lorna; Muthas, Daniel; Deavall, Damian; Smith, Simon A; Clack, Glen; Newham, Pete

    2016-04-01

    Nausea and vomiting are components of a complex mechanism that signals food avoidance and protection of the body against the absorption of ingested toxins. This response can also be triggered by pharmaceuticals. Predicting clinical nausea and vomiting liability for pharmaceutical agents based on pre-clinical data can be problematic as no single animal model is a universal predictor. Moreover, efforts to improve models are hampered by the lack of translational animal and human data in the public domain. AZD3514 is a novel, orally-administered compound that inhibits androgen receptor signaling and down-regulates androgen receptor expression. Here we have explored the utility of integrating data from several pre-clinical models to predict nausea and vomiting in the clinic. Single and repeat doses of AZD3514 resulted in emesis, salivation and gastrointestinal disturbances in the dog, and inhibited gastric emptying in rats after a single dose. AZD3514, at clinically relevant exposures, induced dose-responsive "pica" behaviour in rats after single and multiple daily doses, and induced retching and vomiting behaviour in ferrets after a single dose. We compare these data with the clinical manifestation of nausea and vomiting encountered in patients with castration-resistant prostate cancer receiving AZD3514. Our data reveal a striking relationship between the pre-clinical observations described and the experience of nausea and vomiting in the clinic. In conclusion, the emetic nature of AZD3514 was predicted across a range of pre-clinical models, and the approach presented provides a valuable framework for predicition of clinical nausea and vomiting.

  20. Visual Loss, Retinal Hemorrhages, and Optic Disc Edema Resulting From Thiamine Deficiency Following Bariatric Surgery Complicated by Prolonged Vomiting

    Science.gov (United States)

    Lawton, Andrew W.; Frisard, Nicholas E.

    2017-01-01

    Background: Vision loss resulting from thiamine deficiency is a recognized complication of bariatric surgery. Most patients with such vision loss have Wernicke encephalopathy with characteristic changes seen on neuroimaging. Other patients may have retinal hemorrhages, optic disc edema, and peripheral neuropathy without Wernicke encephalopathy. The risk for thiamine deficiency is potentiated by the presence of prolonged vomiting. Case Report: A 37-year-old female presented with abrupt onset of vision loss and peripheral neuropathy following bariatric surgery. She had a history of prolonged vomiting postoperatively. Examination of the posterior segment of the eye revealed optic disc edema and large retinal hemorrhages bilaterally. Metabolic workup demonstrated thiamine deficiency. She responded quickly to parenteral thiamine therapy with recovery of normal vision and resolution of ophthalmologic findings. Conclusion: Patients who undergo bariatric surgery and have a thiamine deficiency can present with visual symptoms and ophthalmologic findings only visible by fundoscopy prior to developing more severe and potentially irreversible complications from the vitamin deficiency. Early detection of intraocular changes resulting from thiamine deficiency and initiation of therapy could prevent more devastating neurologic manifestations. Our case supports the consideration of a prospective study aimed at determining the true incidence of ocular and visual changes such as retinal hemorrhage, optic disc edema, and peripapillary telangiectasia in patients following bariatric surgery.

  1. Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double blind, and controlled trial

    Directory of Open Access Journals (Sweden)

    Sanguansak Rerksuppaphol

    2010-09-01

    Full Text Available Acute gastroenteritis is one of the most common infectious diseases of childhood. Its symptoms are vomiting, diarrhea, and dehydration. In the emergency ward, intravenous rather than oral rehydration is usually preferred because of the high likelihood of emesis. Treatments to reduce emesis are of value in improving the rehydration procedure. Our study is a double-blind randomized trial and proposes the use of ondansetron as an anti-emetic drug to treat children with acute gastroenteritis. Seventy-four in-patients, aged 3 months to 15 years, were enrolled and randomly assigned to an ondansetron or placebo group. Inclusion criteria were the diagnosis of acute gastroenteritis and the absence of other diseases or allergies to drugs. A single bolus (0.15 mg/kg of ondansetron was injected intravenously; normal 0.9% saline solution was used as a placebo. This treatment induced vomiting cessation in the ondansetron group significantly in comparison to the placebo group. The length of the hospital stay and the oral rehydration fluid volume were similar in the two groups and no adverse effects were noticed. Thus, safety, low cost, and overall bene­fit of ondansetron treatment suggests that this drug can be administered successfully to children with acute gastroenteritis.

  2. Reduction of nausea and vomiting from epidural opioids by adding droperidol to the infusate in home-bound patients.

    Science.gov (United States)

    Aldrete, J A

    1995-10-01

    In 184 adult patients with severe nonmalignant low back pain from postlaminectomy syndrome, temporary lumbar epidural catheters were infused with either 0.25% bupivacaine 92 mL, fentanyl 600 micrograms, and droperidol 5 mg (Group A), or 0.25% bupivacaine 92 mL, fentanyl 600 micrograms, and NaCl 0.9% 2 mL (Group B). Infusion rates ranged from 0.5 to 2 mL per hour, with an option for turning the infusion off when the patient had no pain and turning it on when the pain returned. Infusions were continued from 2 to 55 days, during which time the patient was at home. In Group A, only two patients had nausea without emesis, while in Group B, nausea occurred in 18 patients (P < 0.04) and four vomited (P < 0.05). The number of patients with headache, pruritus, somnolence, and/or numbness was minimal and without statistically significant group differences. During treatments, pain levels were 2 or less on a 10-cm visual analogue scale. Added to the epidural infusate, droperidol appears to significantly reduce nausea and vomiting in ambulatory patients receiving fentanyl and bupivacaine in extended epidural infusions. The possibility that droperidol potentiates analgesic effects could not be evaluated.

  3. Doxylamine succinate–pyridoxine hydrochloride (Diclegis for the management of nausea and vomiting in pregnancy: an overview

    Directory of Open Access Journals (Sweden)

    Nuangchamnong N

    2014-04-01

    Full Text Available Nina Nuangchamnong, Jennifer Niebyl Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa, IA, USA Abstract: Nausea and vomiting in pregnancy (NVP is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog 10 mg as a delayed-release combination pill called Diclegis for the treatment of NVP. Diclegis is currently the only medication that is FDA-approved for the indication of NVP. This review addresses the historical context, safety, efficacy, pharmacology, and practical role of doxylamine and pyridoxine for the management of NVP. The reintroduction of this doxylamine–pyridoxine combination pill into the American market fills a therapeutic gap in the management of NVP left by the removal of the same active drugs marketed over 30 years ago in the form of Bendectin. The substantial amount of safety data accumulated over the years makes it one of the few drugs that qualify for FDA Pregnancy Category A status. In the hierarchical approach to pharmacological treatment of NVP, the combination of doxylamine and pyridoxine should thus be first-tier. Keywords: doxylamine, pyridoxine, vitamin B6, nausea, vomiting, pregnancy

  4. The emetophobia questionnaire (EmetQ-13): psychometric validation of a measure of specific phobia of vomiting (emetophobia).

    Science.gov (United States)

    Boschen, Mark J; Veale, David; Ellison, Nell; Reddell, Tamara

    2013-10-01

    This study reports on the development and psychometric evaluation of a self-report assessment of the severity of symptoms of emetophobia. Using a sample of 95 individuals with emetophobia, and a matched sample of 90 control participants, a 13-items inventory was developed that showed a clear three-factor structure. The EmetQ-13 had good internal consistency (α=.82 in the clinical sample, and α=.85 in the control sample), and one-week test-retest reliability (rxx=.76). The EmetQ-13 showed significant correlations with another measure of emetophobia symptoms, the Specific Phobia of Vomiting Inventory, and related constructs such as disgust sensitivity. The measure showed excellent ability to classify emetophobic and non-emetophobic individuals, with correct assignment in 96.2% of cases. The EmetQ-13 also correlated significantly with a behavioural approach test using a vomit-like stimulus. The initial evaluation of the EmetQ-13 suggests that it is a reliable and valid measure for the assessment of emetophobia.

  5. The impact of audit in a district general hospital on post-operative nausea and vomiting after major gynaecological surgery.

    Science.gov (United States)

    Hadji, F; Eastwood, D; Fear, S; Corfield, H J

    1998-09-01

    An audit of post-operative nausea and vomiting (PONV) was undertaken in 935 female patients who used morphine patient-controlled analgesia (PCA) for pain relief after major gynaecological operations in a district general hospital. We investigated retrospectively five different antiemetic policies and a reference group without policy from January 1993 to July 1995. The department's computerized audit system was used to analyse the observations. At the beginning of the audit, the incidence of nausea and vomiting was as high as 71.5%. But as a consequence of this audit, a departmental policy was adopted 3 years later, which had an incidence of PONV of only 51.7%. During this time the compliance with antiemetic protocols increased from 41% to 76%. There was significantly less PONV if an antiemetic protocol was followed (P = 0.002). This emphasizes the importance of corporate involvement in the development, formulation and evaluation of departmental protocols if compliance is to be high. We conclude that audit as a corporate effort improves the acceptance of departmental protocols. This reduces PONV significantly irrespective of the type of antiemetic drug used.

  6. Clinical roundtable monograph. Treatment of chemotherapy-induced nausea and vomiting: a post-MASCC 2010 discussion.

    Science.gov (United States)

    Kris, Mark G; Urba, Susan G; Schwartzberg, Lee S

    2011-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and troubling side effects of treatment, and the side effect cancer patients tend to fear most. An improved understanding of the pathophysiology underlying CINV, together with a clear definition of the risk for nausea and vomiting associated with specific chemotherapeutic agents, has for allowed the development of specific and effective antiemetic regimens. Anti­emesis is most effective when used prophylactically, a principle shared among CINV management guidelines. Several antiemetic drug classes are available; among the most effective of these are serotonin (5HT₃) receptor antagonists, neurokinin 1 (NK₁) receptor antagonists, and steroids (primarily dexamethasone), although others are commonly used as well. When choosing an appropriate antiemetic regimen, clinicians should consider patient-specific factors such as sex and prior history of CINV, as well as treatment-specific factors such as the emetogenic potential of each chemotherapeutic agent. Using these factors, clinicians can follow the available algorithms included in guidelines from groups such as the National Comprehensive Cancer Network, the American Society of Clinical Oncology, and the Multinational Association for Supportive Care in Cancer. Ongoing and future clinical trials will be pivotal in helping to further delineate the optimal strategies to prevent and manage CINV in cancer patients.

  7. A Comparison of Preoperative Ondansetron and Dexamethasone in the Prevention of Post-Tympanoplasty Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Mahmoud Eidi

    2012-09-01

    Full Text Available Background: Nausea and vomiting are common complications of anesthesia and surgery. Patients undergoing tympanoplasty are exposed to a higher risk of postoperative nausea vomiting (PONV. These complications may alter the results of reconstruction and anatomical alignments. Numerous antiemetics have been studied to prevent and treat PONV in patients undergoing tympanoplasty. The aim of this study was to compare the effect of intravenous ondansetron and dexamethasone on post-tympanoplasty PONV.Methods: In a double-blind randomized controlled clinical trial, 219 patients were divided into three groups including one receiving ondansetron, one receiving dexamethazone, and one receiving distilled water. All patients were subjected to tympanoplasty type I. The patients in the first group received ondansetron (4 mg IV, second group received oexamethasone (8 mg IV, and third group received distilled water prior to induction of anesthesia. Using Bellivelle’s scoring system, the incidence of PONV and its severity during the 24-hour period after surgery were measured and compared.Results: There was no significant difference among PONV in the three groups in the first two hours after the surgery. However, in 2-8, 8-16 and 16-24 hours after the surgery the PONV in ondansetron and dexamethasone groups were significantly lower than that in the control group. Conclusion: Ondansetron and dexamethasone were more effective than placebo in controlling PONV after tympanoplasty surgeries. Moreover, dexamethasone was more effective than ondansetron in preventing PONV.Trial Registration Number: IRCT201106154005N4

  8. Effect of Transcutaneous Electrical Acupoint Stimulation on Nausea and Vomiting Induced by Patient Controlled Intravenous Analgesia with Tramadol

    Institute of Scientific and Technical Information of China (English)

    ZHENG Li-hong; SUN Hong; WANG Guo-nian; LIANG Jie; WU Hua-xing

    2008-01-01

    Objective" To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on nausea and vomiting (N&V) induced by patient controlled intravenous analgesia (PCIA) with Tramadol. Methods= Sixty patients who were ready to receive scheduled operation for tumor in the head-neck region and post-operation PCIA, aged 39-65 years, with the physique grades Ⅰ-Ⅱ of ASA, were randomized into two groups, A and B, 30 in each group. The pre-operation medication, induction of analgesia and continuous anesthesia used in the two groups were the same. TEAS on bilateral Hegu (LI4) and Neiguan (PC6) points was intermittently applied to the patients in group A starting from 30 min before analgesia induction to 24 h after operation, and the incidence and score of nausea and vomiting, antiemetic used, visual analogue scores (VAS), and PCIA pressing times in 4 time segments (0-4, 4-8, 8-12 and 12-24 h after the operation was finished) were determined. The same management was applied to patients in Group B, with sham TEAS for control. Results: The incidence and degree of N&V, as well as the number of patients who needed remedial antiemetic in Group A were less than those in Group B. The VAS score and PCIA pressing time were lower in Group A than those in Group B in the corresponding time segments respectively. Conclusion: TEAS could prevent N&V induced by PCIA with Tramadol.

  9. The Effectiveness of Midazolam for Preventing Postoperative Nausea and Vomiting: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ahn, Eun Jin; Kang, Hyun; Choi, Geun Joo; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Choel

    2016-03-01

    Previous randomized controlled trials regarding the effectiveness of perioperative midazolam in preventing postoperative nausea and vomiting (PONV) have produced conflicting results. Consequently, the present systematic review was performed to assess the effect of perioperative administration of midazolam on PONV. The MEDLINE®, Embase, and Cochrane Central Register of Controlled Trials databases were searched to identify all randomized controlled trials that investigated the effectiveness of midazolam under general anesthesia. The primary end points were defined as postoperative nausea (PON), postoperative vomiting (POV), and PONV. From 16 studies, 1433 patients were included in the final analysis. Compared with the control group, patients who received midazolam showed a lower overall incidence of PON (risk ratio [RR], 0.51; 95% confidence interval [CI], 0.40-0.65; I = 35%; number needed to treat [NNT] = 6; number of included studies [n] = 11), POV (RR, 0.46; 95% CI, 0.33-0.65; I = 0%; NNT = 8; n = 10), and PONV (RR, 0.45; 95% CI, 0.36-0.57; I = 31%; NNT = 3; n = 7). Perioperative administration of midazolam was effective in preventing PON, POV, and PONV.

  10. Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment

    Directory of Open Access Journals (Sweden)

    Blumentrath, Christian G.

    2017-03-01

    Full Text Available The cannabinoid hyperemesis syndrome (CHS and the cyclic vomiting syndrome in adults (CVS are both characterized by recurrent episodes of heavy nausea, vomiting and frequently abdominal pain. Both syndromes are barely known among physicians. Literature is inconsistent concerning clinical features which enable differentiation between CVS and CHS. We performed a literature review using the LIVIVO search portal for life sciences to develop a pragmatic approach towards these two syndromes. Our findings indicate that complete and persistent resolution of all symptoms of the disease following cannabis cessation is the only reliable criterion applicable to distinguish CHS from CVS. Psychiatric comorbidities (e.g. panic attacks, depression, history of migraine attacks and rapid gastric emptying may serve as supportive criteria for the diagnosis of CVS. Compulsive bathing behaviour, a clinical observation previously attributed only to CHS patients is equally present in CVS patients. Long-term follow-up is essential in order to clearly separate CHS from CVS. However, long-term follow-up of CVS and CHS cases is seldom. We provide a standard operating procedure applicable to a broad spectrum of health care facilities which addresses the major issues of CVS and CHS: awareness, diagnosis, treatment, and follow-up.

  11. 消化内科患者恶心呕吐的临床分析%Digestion medicine nausea and vomiting in patients clinical analysis

    Institute of Scientific and Technical Information of China (English)

    唐君; 李永春

    2012-01-01

      目的探讨恶心呕吐的病因,为临床诊断提供依据,方便及时治疗。方法通过消化内科住院患者100例出现恶心呕吐症状,对其病因统计分析。结果恶心呕吐常见病为反流性食管炎、巨幼贫、胆系结石、颅内占位和功能性消化不良。结论通过对恶心呕吐的对症治疗,所有患者恶心呕吐症状均逐渐减轻或消失。%  Objective: To investigate the cause of nausea and vomiting, to provide the basis for clinical diagnosis, to facilitate timely treatment. Methods: Gastroenterology hospitalized patients, 100 cases of nausea and vomiting, its etiology statistical analysis. Results: nausea and vomiting, common for reflux esophagitis, megaloblastic anemia, gal stones, intracranial mass and functional dyspepsia. Conclusion: al patients symptomatic treatment of nausea and vomiting, nausea and vomiting are gradualy reduce or disappear.

  12. Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery

    Directory of Open Access Journals (Sweden)

    Hiroaki Kawano

    2016-02-01

    Full Text Available BACKGROUND: We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. METHODS: Patients were randomly divided into three groups: those maintained with sevoflurane (Group S, n = 42, propofol (Group P, n = 42, or combined propofol and sevoflurane (Group PS, n = 42. We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use, incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24 h after surgery. RESULTS: The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2 h (74%, 76% and 43%, respectively, p = 0.001 and 0-24 h (71%, 76% and 38%, respectively, p < 0.0005. The incidence of nausea at 0-2 h (Group S = 57%, Group P = 26% and Group PS = 21%, p = 0.001 and 0-24 h (Group S = 62%, Group P = 29% and Group PS = 21%, p < 0.0005 was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24 h. CONCLUSION: Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. We term this novel method of anesthesia "combined intravenous-volatile anesthesia (CIVA".

  13. [Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery].

    Science.gov (United States)

    Kawano, Hiroaki; Ohshita, Naohiro; Katome, Kimiko; Kadota, Takako; Kinoshita, Michiko; Matsuoka, Yayoi; Tsutsumi, Yasuo M; Kawahito, Shinji; Tanaka, Katsuya; Oshita, Shuzo

    2016-01-01

    We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. Patients were randomly divided into three groups: those maintained with sevoflurane (Group S; n = 42), propofol (Group P; n = 42), or combined propofol and sevoflurane (Group PS; n = 42). We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use), incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24h after surgery. The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2h (74%; 76% and 43%; respectively, p = 0.001) and 0-24h (71%; 76%, and 38%; respectively, p < 0.0005). The incidence of nausea at 0-2h (Group S = 57%; Group P = 26% and Group PS = 21%; p = 0.001) and 0-24h (Group S = 62%; Group P = 29% and Group PS = 21%; p < 0.0005) was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24h. Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. Use of granisetron transdermal system in the prevention of chemotherapy-induced nausea and vomiting: a review

    Directory of Open Access Journals (Sweden)

    Albert Tuca

    2009-12-01

    Full Text Available Albert TucaPalliative Care Hospital Team, Palliative Care Department, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, SpainAbstract: Until now only intravenous and oral formulations of 5HT3 receptor antagonists have been available. Recently a new formulation of a 5HT3 receptor antagonist, transdermal granisetron, has been developed, and approved by the FDA. Three phase I studies to evaluate its pharmacokinetic profile have shown that granisetron administered by a transdermal delivery system is absorbed by passive diffusion and maximal concentration is reached 48 hours after patch application. The patch of 52 cm2, which contains 34.3 mg of granisetron, releases 3.3 mg of the drug every day and maintains a stable average plasma concentration of 2.2 ng/mL over 6 days, similar to levels obtained with 2 mg of oral granisetron, administered every day during the same period of time. Two randomized as yet unpublished clinical trials (phase II/III have been conducted to evaluate the antiemetic efficacy of transdermal granisetron in chemotherapy-induced nausea and vomiting, in patients receiving moderately and highly emetogenic chemotherapy, compared with 2 mg of oral granisetron. More than 800 cancer patients were included in the trials. The rate of complete control of acute emesis was 49% for the phase II trial and 60% for the phase III trial. Neither trial showed a statistically significant difference between transdermal and oral granisetron. The control of delayed emesis was observed in 46% of patients, and there were no statistically significant differences between transdermal and oral granisetron. The most common adverse effects in both trials were constipation (<7% and headache (<1%; there were no statistically significant differences between transdermal and oral granisetron. These data show that transdermal granisetron is effective and safe in controlling acute emesis induced by chemotherapy with both moderate and high

  15. [The mechanism of the occurrence of vomiting during the primary reaction after exposure of the body to ionizing radiations at large doses].

    Science.gov (United States)

    Martirosov, K S; Grigor'ev, Iu G; Zorin, V V; Norkin, I M

    1997-01-01

    In the experiments of dogs exposed to ionizing radiations at doses of 50 and 70 Gy, an essential role of the central mechanism in the origin of early postradiation vomiting has been confirmed. Insufficient efficiency of dimethpramide, a dophamynolytics, in this case may be connected either with initiation of other (non-dophamynosensitive) structures of the chemoreceptor trigger zone of with a growing role of the reflex way of vomiting arising due to a considerable intestinal injury that causes diarrhea. The inhibition of intestinal M-cholinoreceptors by methacine prevented diarrhea but didn't change the intensity of the vomiting reaction which, however, does not eliminate the possibility of afferentation from receptors that respond to others biologically active substances.

  16. Effects of Slow-stroke Back Massage on Chemotherapy-induced Nausea and Vomiting in the Pediatrics with Acute Leukemia: a Challenge of Controlling Symptoms

    Directory of Open Access Journals (Sweden)

    Mojtaba Miladinia

    2015-12-01

    Full Text Available Introduction Nausea and vomiting are the most common side effects of chemotherapy in the pediatrics with cancer which affect their quality of life. Use of some methods of complementary medicine in leukemia patients is problematic. Because, leukemia patients are at risk of infection and bleeding, therefore the use of acupressure, acupuncture, and deep massage can be risky in these patients. Slow- stroke back massage is applied on the surface of body, so does not have complications. No study has addressed the effect of massage therapy on chemotherapy-induced nausea and vomiting in pediatrics with acute leukemia in the world.  Material and methods This study was a two-group randomized controlled trial (RCT, double blind and repeated measures design. In this RCT, 45 school age children with acute leukemia were placed in the massage and control groups. Before start of the study, at the day of chemotherapy administration (day 1th, only nausea and vomiting were measured. Then during 6 days next (day 2 through 7, the intervention group received 5-minutes Super Smash Bros. Melee (SSBM, immediately before start of each session of chemotherapy. Nausea was measured during chemotherapy, 0.5 h and 3 h after each session of chemotherapy in the two groups. Also vomiting was recorded during 24 h after each session of chemotherapy. Repeated measures ANOVA, Chi-square, and t-test were used for analysis. Results Most of pediatrics were male (58.13%, and suffered from Acute myeloid leukemia (AML (81.7%. The repeated measure analysis showed that in the intervention group, the SSBM reduced progressive mean of nausea severity and frequency of vomit over time. While, this side effects have slightly increased over time in the control group. Conclusion The results of this study are suggesting that SSBM, as a non-pharmacologic, easy and safe method, is effective in controlling Chemotherapy-induced nausea and vomiting (CINV in the pediatrics with acute leukemia.

  17. Prophylactic gabapentin for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: A randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Pandey Chandra

    2006-01-01

    Full Text Available Background: Gabapentin is an antiepileptic drug. Its antiemetic effect is demonstrated in chemotherapy-induced acute and delayed onset of nausea and vomiting in breast cancer patients. Aim: To evaluate the antiemetic effect of gabapentin on incidence and severity of postoperative nausea and vomiting in laparoscopic cholecystectomy. Settings and Design: Double-blind, randomized, placebo-controlled study. Materials and Methods: Two hundred and fifty patients of ASA physical status I and II, scheduled for laparoscopic cholecystectomy were randomly assigned into two equal groups to receive 600 mg gabapentin or matching placebo two hours before surgery. Standard anaesthesia technique was used. Fentanyl was used as rescue postoperative analgesic. Ondansetron 4 mg was used intravenously as rescue medication for emesis. The total number of patients who had nausea or vomiting, and its severity and total fentanyl consumption in the first 24 hours were recorded. Statistical Analysis: "Z test" was used to test the significance of severity of post-operative nausea and vomiting between groups. Fentanyl consumed in each group (Mean±SD within 24 hrs was compared using student t test. P value< 0.05 was considered significant. Results: There were no demographic difference between the two groups. Incidence of post-operative nausea and vomiting within 24 hrs after laparoscopic cholecystectomy was significantly lower in gabapentin group (46/125 than in the placebo group (75/125 (37.8% vs 60%; P =0.04. There was a significantly decreased fentanyl consumption in gabapentin group (221.2±92.4 µg as compared to placebo group (505.9±82.0 µg; P =0.01. Conclusion: Gabapentin effectively suppresses nausea and vomiting in laparoscopic cholecystectomy and post-operative rescue analgesic requirement.

  18. Cryptosporidium avian genotype III as a possible causative agent of chronic vomiting in peach-faced lovebirds (Agapornis roseicollis).

    Science.gov (United States)

    Makino, Ikuko; Abe, Niichiro; Reavill, Drury R

    2010-09-01

    In the present study, Cryptosporidium oocysts were found, by light microscopy, in 37 fecal samples of peach-faced lovebirds (Agapornis roseicollis). Cryptosporidium avian genotype III was isolated in 13 of the 37 infected birds by sequence analysis of the small subunit ribosomal RNA and the actin genes. All of the birds showed chronic vomiting and weight loss with enlargement of isthmi, narrowed proventricular lumens, and thickened proventricular walls radiographically. Cryptosporidium parasites were found only in the ductal epithelium of the proventricular glands in three of the tissue samples provided for necropsy. To date, there have been no reports concerning the pathogenicity, nor the location, of avian genotype III in avian hosts. Our report confirms, for the first time, the presence of avian genotype III in peach-faced lovebirds in Japan and also reveals the location in the avian host.

  19. 导致幼儿呕吐的病原学检测%Etiological analysis on children's vomiting

    Institute of Scientific and Technical Information of China (English)

    张洪英; 祁贤; 华玲慧; 洪镭; 吴斌; 江晓; 何敏; 石利民

    2013-01-01

    目的 了解掌握某幼儿园突发以呕吐为主要症状的不明原因病例的病原学特点,为预防可能的流行提供科学依据.方法 收集某幼儿园2010年12月先后出现呕吐症状的3例患者的呕吐物进行病原学检测,包括细菌的常规分离培养及病毒的荧光定量PCR检测和测序分析.结果 细菌分离鉴定未发现致病菌.病毒学检测,3例均为诺如病毒核酸阳性,经测序分析为GⅡ.4亚型,确定为病毒感染所致,从而排除了细菌性食物中毒.根据实验室检测结果,进行相应的现场处置,包括餐具、玩具全面消毒,密切接触幼儿回家观察,相关班级隔离,防止该病毒的传播和扩散.结论 南京地区存在诺如病毒的威胁,导致该幼儿园幼儿呕吐的病原是诺如病毒.该病原很可能是由一个感染幼儿在幼儿园发病,其呕吐过程中呕吐物随空气传染靠近的两个幼儿所致.而首先发病幼儿的病原从何而来,还需要进一步采集样本进行检测确认.另外,与其他国家和地区一样,GⅡ.4亚型为主要流行亚型,应加强相应的抗病毒健康教育宣传,尤其是保育过程中的预防宣传工作.%xOBJECTIVE To understand the main reason for unknown cases mainly with the sudden symptoms of vomiting in a certain kindergarten, so as to provide scientific reference for prevention and control of enteric infectious diseases. METHODS The vomits of three children were collected during December 2010, treated and cultured for pathogenic bacteria detection as routine isolated culture or detected by real-time PCR and sequencing for the viral detection. RESULTS No pathogenic bacterium was detected While orovirus was detected in three vomits, with the same subtype of GⅡ .4. It was confirmed that the etiology was viral infection, rather than bacteria food poisoning. According to the laboratory test results, the corresponding on-site disposal , including comprehensive sterilization of table ware and toys

  20. Blood tests for investigating maternal wellbeing. 4. When nausea and vomiting in pregnancy becomes pathological: hyperemesis gravidarum.

    Science.gov (United States)

    Ballard, Sarah

    2011-01-01

    Nausea and vomiting in pregnancy (NVP) is commonplace, with many midwives frequently counselling women in their care. But how do midwives know when NVP becomes pathological? Although hyperemesis gravidarum (HEG) is less common, midwives must be able to recognise and differentiate between these two conditions, especially as HEG has the potential to have a detrimental effect on maternal and fetal wellbeing. The physiological impact of HEG is well documented but what often goes unacknowledged is the psychological, social, occupational and familial impact it also has on a woman's life. Knowledge about the aetiology of HEG and treatment options available is essential but a timely initial diagnosis is paramount. For this to occur the midwife must be skilled in history taking, clinical examination and utilisation of serum blood tests--specifically electrolytes and urea. An understanding of how electrolyte levels can cause pathology is vital if the midwife wishes to interpret blood tests for women with this condition.

  1. Psychometric assessment of the Chinese version of the MASCC Antiemesis Tool (MAT) for measuring chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Tan, Jing-Yu; Suen, Lorna K P; Molassiotis, Alex

    2016-09-01

    This paper aims to assess the psychometric properties of the Chinese version of the MASCC Antiemesis Tool (MAT) for measuring chemotherapy-induced nausea and vomiting (CINV). This was a psychometric study using a panel of experts and a prospective observational design. Six experts were invited to identify the content validity and face validity of the MAT, and 115 cancer patients were then recruited from three provincial medical centers in Fuzhou, China. The MAT was self-completed by the patients on the first and the fifth day after receiving the most recent chemotherapy, and patients also rated daily the Index of Nausea, Vomiting, and Retching (INVR) during the first 5 days after chemotherapy. Content validity was measured by the index of the content validity (CVI). Construct validity was estimated by the contrasted groups approach. Concurrent validity was measured by exploring the correlations between the INVR and MAT scores. The reliability of the MAT was examined by Cronbach's alpha and item-to-total correlations. One hundred and eleven subjects returned the completed measures. High content validity was determined. Contrasted groups analysis clearly discriminated the differences on the CINV symptom experiences between different age and gender groups. Excellent concurrent validity was identified, with the Spearman's correlation coefficient between the MAT total score and the INVR overall total score of 0.94 (P < 0.001). Cronbach's alpha for the MAT was 0.73, and the item-to-total correlations ranged from 0.50 to 0.71. The MAT Chinese version is a valid, reliable, and convenient instrument for measuring CINV in Chinese cancer patients.

  2. A Comparison of the Effects of Fentanyl and Remifentanil on Nausea, Vomiting, and Pain after Cesarean Section

    Directory of Open Access Journals (Sweden)

    Fatemeh Gourtanian

    2011-09-01

    Full Text Available Background: The effects of different opioids on postoperative nausea and vomiting (PONV and pain have not been conclusively determined. The aim of this study was to compare the effects of fentanyl, remifentanil or fentanyl plus morphine on the incidence of PONV and pain in women subjected to cesarean section under general anesthesia. Methods: The study was a randomized clinical trial recruiting 96 parturients with American Society of Anesthesiologists (ASA physical status I and II. They scheduled for cesarean section under general anesthesia using sodium thiopental, succynylcholine, and isoflurane O2/N2O 50/50 mixture. After clamping the umbilical cord, the patients were given fentanyl (2 µg/kg/h, remifentanil (0.05 µg/kg/h, or fentanyl (2 µg/kg pulse morphine (0.1 mg/kg intravenously. Visual analog scale for pain and nausea, frequency of PONV, meperidine and metoclopramide consumption were evaluated at recovery, and 4, 8, 12 and 24 hours after the surgery. Results: There was no significant difference between the three groups in terms of frequency of nausea, vomiting, and mean nausea and pain scores at any time points. None of the patients required the administration of metoclopramide. However, the mean VAS for pain in remifentanil-treated group was insignificantly more than that in fentanyl- or fentanyl plus morphine-treated group at recovery or 4 hours after the surgery. The mean mepridine consumption in remifentanil-treated group was significantly (P=0.001 more than that in fentanyl- or fentanyl plus morphine-treated group in 24 hours after the surgery respectively. There was no significant difference in hemodynamic parameters of the three groups in all measurements after the surgery. Conclusion: The findings of this study showed that early postoperative analgesia was better with fentanyl, and postoperative meperidine consumption was significantly less with fentanyl than with remifentanil or combined fentayl and morphine. Trial

  3. The efficacy of combination of ondansetron and aprepitant on preventing the radiotherapy-induced nausea and vomiting

    Science.gov (United States)

    Emami, Hamid; Hematti, Simin; Saeidian, Seyed Masoud; Feizi, Awat; Taheri, Shahin; Adeli, Pourya; Mahmoudi, Golshan

    2015-01-01

    Background: Depending on the site of irradiation, about 40-80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting. The current study aimed to investigate the efficacy of ondansetronas as a single agent and with a combination to aprepitant on preventing RT-induced nausea and vomiting (RINV). Materials and Methods: In a clinical randomized controlled trial (from September 2010 to September 2011), conducted in Radiation Oncology Department of Seyed-al-Shohada Hospital, Isfahan University of Medical Sciences, 40 abdominopelvic malignancies cancer patients were allocated into two aliquots using block randomization of size. Patients in the first group (group I) received ondansetron alone while those patients in the remaining group (group II) received ondansetron and aprepitant. Then, developing of RINV and its severity and benefit of adding aprepitant to ondansetron, in comparison with ondansetron as a single drug therapy were evaluated. Results: The average age of the patients in group I was 61.15 ± 12.27 years while in group II it was 50.1 ± 13.27 years. No statistically significant gender differences were found between the two groups. In patients treated with ondansetron single drug therapy (group I), frequency and grade of RINV were significantly more than the group treated simultaneously by aprepitant and ondansetron (group II) (odds ratio [OR] = 21.2; P < 0.01). Compared with RT alone, the patients whom underwent RT along with chemotherapy showed lower probability of experiencing RINV (OR = 0.13; P < 0.05). Conclusion: The present study indicated a significant superiority of combination of ondansetron and aprepitant in management of RINV, in patients undergoing RT, compared to ondansetron as a single agent therapy. More accurate follow-up studies are needed for the evaluation of the efficacy of ondansetron with combination to aprepitant on preventing the RINV. PMID:26109986

  4. The efficacy of combination of ondansetron and aprepitant on preventing the radiotherapy-induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Hamid Emami

    2015-01-01

    Full Text Available Background: Depending on the site of irradiation, about 40-80% of patients undergoing radiotherapy (RT will experience nausea and/or vomiting. The current study aimed to investigate the efficacy of ondansetronas as a single agent and with a combination to aprepitant on preventing RT-induced nausea and vomiting (RINV. Materials and Methods: In a clinical randomized controlled trial (from September 2010 to September 2011, conducted in Radiation Oncology Department of Seyed-al-Shohada Hospital, Isfahan University of Medical Sciences, 40 abdominopelvic malignancies cancer patients were allocated into two aliquots using block randomization of size. Patients in the first group (group I received ondansetron alone while those patients in the remaining group (group II received ondansetron and aprepitant. Then, developing of RINV and its severity and benefit of adding aprepitant to ondansetron, in comparison with ondansetron as a single drug therapy were evaluated. Results: The average age of the patients in group I was 61.15 ± 12.27 years while in group II it was 50.1 ± 13.27 years. No statistically significant gender differences were found between the two groups. In patients treated with ondansetron single drug therapy (group I, frequency and grade of RINV were significantly more than the group treated simultaneously by aprepitant and ondansetron (group II (odds ratio [OR] = 21.2; P < 0.01. Compared with RT alone, the patients whom underwent RT along with chemotherapy showed lower probability of experiencing RINV (OR = 0.13; P < 0.05. Conclusion: The present study indicated a significant superiority of combination of ondansetron and aprepitant in management of RINV, in patients undergoing RT, compared to ondansetron as a single agent therapy. More accurate follow-up studies are needed for the evaluation of the efficacy of ondansetron with combination to aprepitant on preventing the RINV.

  5. Associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy: The generation r study

    NARCIS (Netherlands)

    G. Bai (Guannan); I.J. Korfage (Ida); E.H.D. Hafkamp-De Groen (Esther); V.W.V. Jaddoe (Vincent); Mautner, E. (Eva); H. Raat (Hein)

    2016-01-01

    textabstractThe objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early

  6. Recurrent vomiting and ethylmalonic aciduria associated with rare mutations in the short-chain acyl-CoA dehydrogenase (SCAD) gene

    DEFF Research Database (Denmark)

    Seidel, J.; Streck, S.; Bellstedt, K.

    2003-01-01

    We report identification of short-chain acyl-CoA dehydrogenase (SCAD) deficiency in a 12-year-old boy who suffered from recurrent attacks of vomiting once or twice a year from infancy. Growth and development were normal and there were no muscular symptoms. Metabolic screening was performed during...

  7. Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with cisplatin therapy: randomized, double-blind study protocol--EASE

    DEFF Research Database (Denmark)

    Grunberg, Steven; Chua, Daniel; Maru, Anish;

    2011-01-01

    Addition of aprepitant, a neurokinin-1 receptor antagonist (NK1RA), to an ondansetron and dexamethasone regimen improves prevention of chemotherapy-induced nausea/vomiting (CINV), particularly during the delayed phase (DP; 25 to 120 hours). Therefore, recommended antiemetic regimens include multi...

  8. Prevention of Postoperative Nausea and Vomiting by Administration of Sub Hypnotic Doses of Propofol and Midazolam during Spinal Anesthesia for Cesarean Section

    Directory of Open Access Journals (Sweden)

    Saghar Samimi Sade

    2010-12-01

    Conclusion: Sub hypnotic dose of midazolam was as effective as the sub hypnotic dose of propofol for preventing of nausea and vomiting in parturients undergoing cesarean section under spinal anesthesia. We undertook this study in regard to examine a simple, safe and non-expensive antiemetic method.

  9. Daily and Momentary Mood and Stress Are Associated with Binge Eating and Vomiting in Bulimia Nervosa Patients in the Natural Environment

    Science.gov (United States)

    Smyth, Joshua M.; Wonderlich, Stephen A.; Heron, Kristin E.; Sliwinski, Martin J.; Crosby, Ross D.; Mitchell, James E.; Engel, Scott G.

    2007-01-01

    The relation of mood and stress to binge eating and vomiting in the natural environments of patients with bulimia nervosa (BN) was examined using real-time data collection. Women (n = 131; mean age = 25.3 years) with BN carried a palmtop computer for 2 weeks and completed ratings of positive affect (PA), negative affect (NA), anger/hostility (AH),…

  10. Daily and Momentary Mood and Stress Are Associated with Binge Eating and Vomiting in Bulimia Nervosa Patients in the Natural Environment

    Science.gov (United States)

    Smyth, Joshua M.; Wonderlich, Stephen A.; Heron, Kristin E.; Sliwinski, Martin J.; Crosby, Ross D.; Mitchell, James E.; Engel, Scott G.

    2007-01-01

    The relation of mood and stress to binge eating and vomiting in the natural environments of patients with bulimia nervosa (BN) was examined using real-time data collection. Women (n = 131; mean age = 25.3 years) with BN carried a palmtop computer for 2 weeks and completed ratings of positive affect (PA), negative affect (NA), anger/hostility (AH),…

  11. 美洲虎顽固性呕吐行为的矫正%Diagnosis and Treatment of a Case of Obstinate Vomiting in Panthera onca

    Institute of Scientific and Technical Information of China (English)

    尹军力; 王春香; 诸强; 赵玲玲

    2016-01-01

    A case of obstinate vomiting in Panthera onca in Nanjing Hongshan Forest Zoo was reported in this paper. The obsolete cage and limited activity space were considered to be associated with the occurrence of obstinate vomiting. The main clinical manifestation of the diseased Panthera onca was the recurring of"intaking-vomiting-intaking". In the early stage of the disease, the abnormal behavior of the Panthera onca was ignored by the breeders due to the fact that no obvious effects of the behavior on the health of the Panthera onca were observed. Subsequently, a leopard in the same zoo was also found to vomit occasionally. Effective treatment measures were taken to cure the obstinate vomiting of the Panthera onca, and the good curative effect was achieved.%南京市红山森林动物园中兽馆中1只成年美洲虎因笼舍陈旧(建于20世纪90年代),活动空间狭小,出现顽固性呕吐,临床表现为:饲养过程中出现呕吐行为,“进食—呕吐—进食”,反复数次后,完成进食。因未对其身体健康造成影响,前期未给予重视,后又发现中兽馆中金钱豹偶尔出现上述现象,遂采取一系列措施,对其顽固性呕吐行为进行人为干预矫正,取得一定成效。

  12. Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery.

    Science.gov (United States)

    Kawano, Hiroaki; Ohshita, Naohiro; Katome, Kimiko; Kadota, Takako; Kinoshita, Michiko; Matsuoka, Yayoi; Tsutsumi, Yasuo M; Kawahito, Shinji; Tanaka, Katsuya; Oshita, Shuzo

    2016-01-01

    We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. Patients were randomly divided into three groups: those maintained with sevoflurane (Group S, n=42), propofol (Group P, n=42), or combined propofol and sevoflurane (Group PS, n=42). We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use), incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24h after surgery. The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2h (74%, 76% and 43%, respectively, p=0.001) and 0-24h (71%, 76% and 38%, respectively, p<0.0005). The incidence of nausea at 0-2h (Group S=57%, Group P=26% and Group PS=21%, p=0.001) and 0-24h (Group S=62%, Group P=29% and Group PS=21%, p<0.0005) was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24h. Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. We term this novel method of anesthesia "combined intravenous-volatile anesthesia (CIVA)". Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  13. Nursing experience of nausea and vomiting after gynecologic laparoscopic surgery%妇科腹腔镜术后恶心呕吐的护理体会

    Institute of Scientific and Technical Information of China (English)

    孙祖燕; 沈居丽; 刘萍; 贾惠芳

    2014-01-01

    Objective To explore the causes and Countermeasures of nausea and vomiting after laparoscopic gynecologic operation under general anesthesia, in order to reduce the incidence of nausea and vomiting and nausea and vomiting degree. Methods 2014 January to 2014 May the laparoscopic operation in our department 300 patients, were randomly divided into experimental group and control group, 150 in experimental group, the preoperative and postoperative nursing intervention was adopted, there is a sense of nausea when the doctor give stop drugs, 150 in the control group, only in nausea symptoms when the doctor's advice to give stop the drugs were compared between the two groups, the incidence of nausea and vomiting and nausea and vomiting degree, compare the use of antiemetic effect. Results The experimental group vomiting rate lower than that of the control group, the severity of nausea and vomiting in the experimental group compared with the control group, the experimental group light, effect of nausea when using antiemetics is better than that of the control group, statistical y P < 0.05, there was statistical significance. Conclusion Before and after gynecological laparoscopic operation given nursing intervention ful y can reduce the incidence of postoperative vomiting and nausea and vomiting degree, and can enhance the antiemetic antiemetic effect.%目的:探讨全麻下妇科腹腔镜手术后恶心呕吐的发生原因及应对措施,以降低恶心呕吐的发生率及恶心呕吐的程度。方法将2014年1月至2014年5月在我科进行腹腔镜手术的病人300人,随机分为实验组和对照组,实验组150人,术前术后均采取护理干预,有恶心感时遵医嘱给予止吐剂,对照组150人,仅在出现恶心症状时遵医嘱给予止吐剂,比较两组恶心呕吐的发生率及恶心呕吐的程度,使用止吐剂的效果比较。结果实验组呕吐的发生率低于对照组,恶心呕吐的严重程度实验组较对照

  14. Antiemetic activity of volatile oil from Mentha spicata and Mentha × piperita in chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Tayarani-Najaran, Z; Talasaz-Firoozi, E; Nasiri, R; Jalali, N; Hassanzadeh, Mk

    2013-01-01

    This study is aimed at determining the efficacy of Mentha spicata (M. spicata) and Mentha × piperita (M. × piperita) in preventing chemotherapy-induced nausea and vomiting (CINV). This was a randomised, double-blind clinical trial study. Prior to the study, patients were randomly assigned into four groups to receive M. spicata or M. × piperita. Statistical analysis included the χ(2) test, relative risk, and Student's t-test. Fifty courses were analysed for each group that met our eligibility criteria. The treatment and placebo groups applied essential oils of M. spicata, M. × piperita, or a placebo, while the control group continued with their previous antiemetic regimen. Patients or guardians recorded the number of emetic events, the intensity of nausea over 20 h of chemotherapy, as well as any possible adverse effects that occurred during this time. There was a significant reduction in the intensity and number of emetic events in the first 24 h with M. spicata and M. × piperita in both treatment groups (p essential oils were used. M. spicata or M. × piperita essential oils are safe and effective for antiemetic treatment in patients, as well as being cost effective.

  15. Doxylamine succinate-pyridoxine hydrochloride (Diclegis) for the management of nausea and vomiting in pregnancy: an overview.

    Science.gov (United States)

    Nuangchamnong, Nina; Niebyl, Jennifer

    2014-01-01

    Nausea and vomiting in pregnancy (NVP) is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA) approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog) 10 mg as a delayed-release combination pill called Diclegis for the treatment of NVP. Diclegis is currently the only medication that is FDA-approved for the indication of NVP. This review addresses the historical context, safety, efficacy, pharmacology, and practical role of doxylamine and pyridoxine for the management of NVP. The reintroduction of this doxylamine-pyridoxine combination pill into the American market fills a therapeutic gap in the management of NVP left by the removal of the same active drugs marketed over 30 years ago in the form of Bendectin. The substantial amount of safety data accumulated over the years makes it one of the few drugs that qualify for FDA Pregnancy Category A status. In the hierarchical approach to pharmacological treatment of NVP, the combination of doxylamine and pyridoxine should thus be first-tier.

  16. Comparing pyridoxine and doxylamine succinate-pyridoxine HCl for nausea and vomiting of pregnancy: A matched, controlled cohort study.

    Science.gov (United States)

    Pope, Eliza; Maltepe, Caroline; Koren, Gideon

    2015-07-01

    Nausea and vomiting of pregnancy (NVP) is a common gestational condition. This is the first study to compare the use of vitamin B6 (pyridoxine) versus Diclectin (doxylamine succinate-pyridoxine HCl) for NVP symptoms. Participants were pregnant women with NVP who used either pyridoxine or doxylamine succinate-pyridoxine HCl for ≥4 days prior to calling the Motherisk NVP Helpline. Women receiving pyridoxine only (n = 80) were matched to a woman taking doxylamine succinate-pyridoxine HCl only (n = 80), accounting for potential confounders and baseline level of NVP, measured by the Pregnancy Unique Quantification of Emesis (PUQE) score. Change in NVP severity after a week of therapy with either pyridoxine or doxylamine succinate-pyridoxine HCl was quantified using the PUQE-24 scale, which describes NVP symptoms 24 hours prior to their call. Doxylamine succinate-pyridoxine HCl use found a significant reduction in PUQE score, compared with pyridoxine (+0.5 versus -0.2, P doxylamine succinate-pyridoxine HCl use saw a mean improvement of 2.6 versus 0.4 with pyridoxine (P doxylamine succinate-pyridoxine HCl use was associated with fewer women experiencing moderate to severe scores after a week of treatment, compared with the pyridoxine group (7 versus 17, P < .05), despite similar baseline PUQE scores.

  17. Opioid-free total intravenous anaesthesia reduces postoperative nausea and vomiting in bariatric surgery beyond triple prophylaxis.

    Science.gov (United States)

    Ziemann-Gimmel, P; Goldfarb, A A; Koppman, J; Marema, R T

    2014-05-01

    Patients undergoing bariatric surgery are at high risk of postoperative nausea and vomiting (PONV). Despite triple PONV prophylaxis, up to 42.7% of patients require antiemetic rescue medication (AERM). This prospective, randomized study was conducted from November 2011 to October 2012. In the Classic group (n=59), patients underwent general anaesthesia with volatile anaesthetics and opioids. In the Total i.v. anaesthesia (TIVA) group (n=60), patients underwent opioid-free TIVA with propofol, ketamine, and dexmedetomidine. The severity of PONV was assessed using a Likert scale (none, mild, moderate, and severe). Patients in both groups had similar clinical characteristics, surgical procedure, and PONV risk scores and required similar amounts of postoperative opioid. In the Classic group, 22 patients (37.3%) reported PONV compared with 12 patients (20.0%) in the TIVA group [P=0.04; risk 1.27 (1.01-1.61)]. The absolute risk reduction was 17.3% (number-needed-to-treat=6). The severity of nausea was statistically different in both groups (P=0.02). The severity of PONV was significantly worse in the Classic group. There was no difference either in the number of patients requiring AERM in the postoperative period or in the number of AERM doses required. This prospective randomized study demonstrates that opioid-free TIVA is associated with a large reduction in relative risk of PONV compared with balanced anaesthesia. Clinical trial registration NCT 01449708 (ClinicalTrials.gov).

  18. Palonosetron in the prevention of chemotherapy-induced nausea and vomiting in Italy: pharmacoeconomic and clinical aspects

    Directory of Open Access Journals (Sweden)

    Lorenzo Pradelli

    2007-06-01

    Full Text Available Despite considerable improvements in the last two decades, chemotherapy-induced nausea and vomiting (CINV remains a frequent and very bothersome medical problem. It is estimated that about one half to two thirds of all chemotherapy-treated patients experience CINV, the frequency depending on the chemotherapy regimen used and on patient-specific features. The impact of CINV, which may be acute, delayed or even anticipatory in experienced patients, on health-related quality of life (HRQoL is substantial in all domains. 
Until recently, effective treatment choices included corticosteroids and first-generation 5-HT3 antagonists, which have been supported by aprepitant, the first clinically available NK1 antagonist, and by palonosetron, considered the first second-generation 5-HT3 antagonist for its high receptor-subtype selectivity and affinity and long plasmatic half-life. In this paper, clinical pharmacology of the latter drug is briefly outlined and recent Italian papers on the epidemiology and HRQoL impact of CINV are reviewed, as well as national pharmacoeconomic evalutations conducted on palonosetron. The role in therapy of palonosteron and its potential for improved clinical, HRQoL and economic outcomes is discussed. 


  19. A comparison of intravenous ketoprofen versus pethidine on peri-operative analgesia and post-operative nausea and vomiting in paediatric vitreoretinal surgery.

    Directory of Open Access Journals (Sweden)

    Subramaniam R

    2003-01-01

    Full Text Available AIM: To compare the efficacy of ketoprofen and pethidine for peri-operative analgesia and post-operative nausea and vomiting in children undergoing vitreoretinal surgery and surgery for retinal detachment. MATERIAL AND METHODS: Children aged 7 to 16 years and ASA I status, undergoing vitreo-retinal surgery were randomly allocated to receive either ketoprofen 2mg/kg or pethidine 1mg/kg intravenously for peri-operative analgesia. In all patients, general anaesthesia was induced with thiopentone and intubation was facilitated with vecuronium bromide and maintained with 33% oxygen in nitrous oxide and isoflurane. Intra-operative and post-operative monitoring was done by an observer blinded to the technique. Intra-operative rescue analgesia was used if heart rate and/or blood pressure increased by 25% from pre-incision values. Post-operative pain and episodes of nausea and vomiting were evaluated at recovery (0 hour, 2, 6 and 24 hours intervals. Standard rescue analgesia and anti-emetic agents were administered if required. RESULTS: Eighty-six children were enrolled in the study. Forty-four received ketoprofen while 42 received pethidine. Intra-operative analgesia was comparable in both the groups and no significant difference was found in the requirement of intra-operative rescue analgesia, as well. Postoperatively 6/44 (13.6% children in ketoprofen group had pain at recovery compared to 17/42 (40.4% in pethidine group. Pain at 2, 6 and 24 hours, and postoperative analgesic requirement were not significantly different among the two groups. Post-operative nausea, vomiting, and antiemetic requirement were significantly less in the ketoprofen group at all time intervals. CONCLUSION: Ketoprofen is a satisfactory alternative analgesic to pethidine for vitreoretinal surgery and results in a lower incidence of postoperative nausea and vomiting.

  20. Nausea and vomiting in pregnancy and the impact upon dietary intakes and birth outcomes – a study performed in the Norwegian Mother and Child Cohort Study

    OpenAIRE

    Chortatos, Athanasios

    2011-01-01

    Background: Nausea and vomiting during pregnancy (NVP) is often experienced by women during gestation. Most studies report up to 80% of women experience one or both of these phenomena, and symptoms of NVP have been recorded from 2000 B.C. to the present time. Favorable birth outcomes are often reported for pregnancies experiencing NVP whilst simultaneously having negative effects upon quality of life of the expectant mother during pregnancy. At the present time the etiology of NVP is unkn...

  1. Treatment of postoperative nausea and vomiting after spinal anesthesia for cesarean delivery: A randomized, double-blinded comparison of midazolam, ondansetron, and a combination

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2012-01-01

    Full Text Available Background: The antiemetic efficacy of midazolam and ondansetron was shown before. The aim of the present study was to compare efficacy of using intravenous midazoalm, ondansetron, and midazolam in combination with ondansetron for treatment of nausea and vomiting after cesarean delivery in parturient underwent spinal anesthesia. Materials and Methods: One hundred thirty two parturients were randomly allocated to one of three groups: group M (n = 44 that received intravenous midazoalm 30 μg/kg; group O (n = 44 that received intravenous ondansetron 8 mg; group MO (n = 44 that received intravenous midazoalm 30 μg/kg combined with intravenous ondansetron 8 mg if patients had vomiting or VAS of nausea ≥ 3 during surgery (after umbilical cord clamping and 24 hours after that. The incidence and severity of vomiting episodes and nausea with visual analog scale (VAS > 3 were evaluated at 2 hours, 6 hours, and 24 hours after injection of study drugs. Results: The incidence of nausea was significantly less in group MO compared with group M and group O at 6 hours postoperatively (P = 0.01. This variable was not significantly different in three groups at 2 hours and 24 hours after operation. The severity of nausea and vomiting was significantly different in three groups at 6 hours after operation (P < 0.05. Conclusion: Our study showed that using intravenous midazolam 30 μg/kg in combination with intravenous ondansetron 8 mg was superior to administering single drug in treatment of emetic symptoms after cesarean delivery under spinal anesthesia.

  2. The Delayed-Release Combination of Doxylamine and Pyridoxine (Diclegis®/Diclectin®) for the Treatment of Nausea and Vomiting of Pregnancy

    OpenAIRE

    2014-01-01

    Nausea and vomiting of pregnancy (NVP) affects up to 85 % of all pregnancies. Effective treatment can greatly improve a woman’s quality of life, reduce the risk for maternal and fetal complications, and reduce healthcare costs. Unfortunately, many women receive either no pharmacological treatment or are recommended therapies for which fetal safety and efficacy have not been established. First-line treatment of NVP, as recommended by several leading healthcare and professional organizations, i...

  3. The effect of crystalloid versus Low molecular weight colloid solution on post-operative nausea and vomiting after ambulatory gynecological surgery - a prospective randomized trial

    LENUS (Irish Health Repository)

    Hayes, Ivan

    2012-07-31

    AbstractBackgroundIntravenous fluid is recommended in international guidelines to improve patient post-operative symptoms, particularly nausea and vomiting. The optimum fluid regimen has not been established. This prospective, randomized, blinded study was designed to determine if administration of equivolumes of a colloid (hydroxyethyl starch 130\\/0.4) reduced post operative nausea and vomiting in healthy volunteers undergoing ambulatory gynecologic laparoscopy surgery compared to a crystalloid solution (Hartmann’s Solution).Methods120 patients were randomized to receive intravenous colloid (N = 60) or crystalloid (N = 60) intra-operatively. The volume of fluid administered was calculated at 1.5 ml.kg-1 per hour of fasting. Patients were interviewed to assess nausea, vomiting, anti-emetic use, dizziness, sore throat, headache and subjective general well being at 30 minutes and 2, 24 and 48 hours post operatively. Pulmonary function testing was performed on a subgroup.ResultsAt 2 hours the proportion of patients experiencing nausea (38.2 % vs 17.9%, P = 0.03) and the mean nausea score were increased in the colloid compared to crystalloid group respectively (1.49 ± 0.3 vs 0.68 ± 0.2, P = 0.028). The incidence of vomiting and anti-emetic usage was low and did not differ between the groups. Sore throat, dizziness, headache and general well being were not different between the groups. A comparable reduction on post-operative FVC and FEV-1 and PEFR was observed in both groups.ConclusionsIntra-operative administration of colloid increased the incidence of early postoperative nausea and has no advantage over crystalloid for symptom control after gynaecological laparoscopic surgery.

  4. Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy.

    Science.gov (United States)

    Ogawa, Kohei; Jwa, Seung-Chik; Kobayashi, Minatsu; Morisaki, Naho; Sago, Haruhiko; Fujiwara, Takeo

    2017-05-01

    No previous study has shown the validity of a food frequency questionnaire (FFQ) in early pregnancy with consideration of nausea and vomiting during pregnancy (NVP). The aim of this study was to evaluate the validity of a FFQ in early pregnancy for Japanese pregnant women. We included 188 women before 15 weeks of gestation and compared estimated nutrient intake and food group intake based on a modified FFQ with that based on 3-day dietary records (DRs). Spearman's rank correlation coefficients, adjusting energy intake and attenuating within-person error, were calculated. Subgroup analysis for those with and without NVP was conducted. We also examined the degree of appropriate classification across categories between FFQ and DRs through division of consumption of nutrients and food groups into quintiles. Crude Spearman's correlation coefficients of nutrients ranged from 0.098 (sodium) to 0.401 (vitamin C), and all of the 36 nutrients were statistically significant. In 27 food groups, correlation coefficients ranged from -0.015 (alcohol) to 0.572 (yogurt), and 81% were statistically significant. In subgroup analysis, correlation coefficients in 89% of nutrients and 70% of food groups in women with NVP and 97% of nutrients and 74% of food groups in women without NVP were statistically significant. On average, 63.7% of nutrients and 60.4% of food groups were classified into same or adjacent quintiles according to the FFQ and DRs. The FFQ is a useful instrument, regardless of NVP, for assessing the diet of women in early pregnancy in Japan. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  5. Relationships Among Smoking, Drinking, Betel Quid Chewing and Pregnancy-Related Nausea and Vomiting in Taiwanese Aboriginal Women

    Directory of Open Access Journals (Sweden)

    Fan-Hao Chou

    2009-02-01

    Full Text Available A cross-sectional survey was conducted to investigate the associations among smoking, drinking, betel quid chewing and pregnancy-related nausea and vomiting (N/V in Taiwanese aboriginal women. A total of 901 aboriginal women from 11 hospitals were recruited into this study. A structured questionnaire on demographic and obstetric information, smoking history, alcohol consumption, betel quid chewing habits, and N/V by checklist was used to collect data. The findings of this study indicated that the prevalence of N/V, maternal smoking, drinking, and betel quid chewing were 75.6% (n = 682, 22.8% (n = 201, 31.9% (n = 287, and 34.7% (n = 313 respectively. Multiple logistic regression with adjustment for age, body mass index and antiemetics use revealed significant relationships between smoking habits and N/V before confirmation of pregnancy and during pregnancy. In comparison with those who did not smoke, women smoking in excess of 10 cigarettes a day before pregnancy were 1.65 times more likely to develop N/V; and women smoking in excess of 10 cigarettes a day during pregnancy were 2.79 times more likely to develop N/V. Based on the findings of this study, smoking was associated, with a dose-response effect, with pregnancy-related N/V. Reducing the intake of cigarettes could decrease the risk of pregnancy-related N/V. Health care providers should help these women decrease their uncomfortable symptoms and improve their experiences of pregnancy and birth outcome during critical times.

  6. Low doses of haloperidol combined with ondansetron are not effective for prophylaxis of postoperative nausea and vomiting in susceptible patients.

    Science.gov (United States)

    Veiga-Gil, Leonor; López-Olaondo, Luis; Pueyo, Javier; Callejas, Raquel; Duque, Paula; Carrascosa, Francisco

    2015-02-01

    In this observational study we reviewed the efficacy and side effects of different antiemetic combinations used in our hospital for postoperative nausea and vomiting (PONV) prophylaxis in high-risk women undergoing highly emetogenic surgery. After reviewing retrospectively the medical records of patients undergoing highly emetogenic elective surgeries under general anaesthesia, we selected 368 women whose Apfel risk score was ≥ 3 and receiving a combination of 2 antiemetics for PONV prophylaxis. We analysed the incidence of PONV at 2, 6, 12 and 24h after surgery, antiemetic rescue requirements, pattern of occurrence of PONV, side effects and level of sedation were also assessed. The main goal was complete response defined as no PONV within 24h after surgery. Ondansetron 4mg i.v. plus dexamethasone 8mg i.v. (O&Dex), haloperidol 1mg i.v. (O&Hal1), haloperidol 2mg i.v. (O&Hal2) or droperidol 1.25mg i.v. (O&Dro) were the combinations most frequently used. The complete response was better in groups O&Dex: 68.5% (CI: 58-78), O&Hal2: 64.1% (CI: 53-74) and O&Dro 63% (CI: 52-73) than in group O&Hal1: 41.3% (CI: 31-52) (p<0,01). Peak incidence of PONV occurred within the 2-6h period. The incidence of side effects was higher in group O&Hal2. In high risk patients for PONV who underwent highly emetogenic surgeries, the efficacy of low-dose haloperidol (1mg) in combination is limited. Higher doses (2mg) are more effective but its use is associated with a high incidence of side effects. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Effects of remifentanil versus nitrous oxide on postoperative nausea, vomiting, and pain in patients receiving thyroidectomy: Propensity score matching analysis.

    Science.gov (United States)

    Kim, Min Kyoung; Yi, Myung Sub; Kang, Hyun; Choi, Geun-Joo

    2016-10-01

    Remifentanil and nitrous oxide (N2O) are 2 commonly used anesthetic agents. Both these agents are known risk factors for postoperative nausea and vomiting (PONV). However, remifentanil and N2O have not been directly compared in a published study. Remifentanil can induce acute tolerance or hyperalgesia, thus affecting postoperative pain. The objective of this retrospective study is to compare the effects of remifentanil and N2O on PONV and pain in patients receiving intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy.We analyzed the electronic medical records of 992 patients receiving fentanyl-based IV-PCA after thyroidectomy at Chung-Ang University Hospital from January 1, 2010 to April 30, 2016. We categorized the patients according to anesthetic agents used: group N2O (n = 745) and group remifentanil (n = 247). The propensity score matching method was used to match patients in the 2 groups based on their covariates. Finally, 128 matched subjects were selected from each group.There were no differences between groups for all covariates after propensity score matching. The numeric rating scale for nausea (0.55 ± 0.88 vs 0.27 ± 0.76, P = 0.01) was higher and complete response (88 [68.8%] vs 106 [82.8%], P = 0.001) was lower in group N2O compared with group remifentanil on postoperative day 0. However, the visual analog scale score for pain (3.47 ± 2.02 vs 3.97 ± 1.48, P = 0.025) was higher in group remifentanil than group N2O on postoperative day 0.In patients receiving IV-PCA after thyroidectomy, postoperative nausea was lower but postoperative pain was higher in group remifentanil.

  8. The safety of higher than standard dose of doxylamine-pyridoxine (Diclectin) for nausea and vomiting of pregnancy.

    Science.gov (United States)

    Atanackovic, G; Navioz, Y; Moretti, M E; Koren, G

    2001-08-01

    A delayed-release combination of doxylamine-pyridoxine (D-P) (Diclectin) is the only approved antiemetic medication for use in pregnancy in Canada. The standard recommended dose is up to 4 tablets a day, regardless of body weight or severity of symptoms. The objective of this study was to determine the incidence of adverse maternal and fetal effects and pregnancy outcome in 225 women taking Diclectin at the recommended (n = 123) or higher than recommended (n = 102) doses. In this observational, prospective study, one-third (33.6%) of women reported having adverse effects (sleepiness, tiredness, and/or drowsiness) temporally related to the medication. There was no association between the dose per kg and rates of reported maternal adverse effects with doses ranging from 0.1 mg/kg to 2.0 mg/kg (1-12 tablets). Nausea and vomiting of pregnancy (NVP) was reported as severe by the majority (75.8%) of women. Mean birth weight (BW) was 3,400 g and gestational age (GA) 39 weeks. Multivariate analysis revealed that only prepregnancy weight and GA predicted lower BW, not the dose of D-P or the severity of NVP. There were two pregnancies with major malformation, a finding that is consistent with the rates of birth defects in the general population. It was concluded that the higher than standard dose of Diclectin, when calculated per kg of body weight, does not affect either the incidence of maternal adverse effects or pregnancy outcome. If needed, Diclectin can be given at doses higher than 4 tablets/day to normalize for body weight or optimize efficacy.

  9. Hollow silicon microneedle array based trans-epidermal antiemetic patch for efficient management of chemotherapy induced nausea and vomiting

    Science.gov (United States)

    Kharbikar, Bhushan N.; Kumar S., Harish; Kr., Sindhu; Srivastava, Rohit

    2015-12-01

    Chemotherapy Induced Nausea and Vomiting (CINV) is a serious health concern in the treatment of cancer patients. Conventional routes for administering anti-emetics (i.e. oral and parenteral) have several drawbacks such as painful injections, poor patient compliance, dependence on skilled personnel, non-affordability to majority of population (parenteral), lack of programmability and suboptimal bioavailability (oral). Hence, we have developed a trans-epidermal antiemetic drug delivery patch using out-of-plane hollow silicon microneedle array. Microneedles are pointed micron-scale structures that pierce the epidermal layer of skin to reach dermal blood vessels and can directly release the drug in their vicinity. They are painless by virtue of avoiding significant contact with dermal sensory nerve endings. This alternate approach gives same pharmacodynamic effects as par- enteral route at a sparse drug-dose requirement, hence negligible side-effects and improved patient compliance. Microneedle design attributes were derived by systematic study of human skin anatomy, natural micron-size structures like wasp-sting and cactus-spine and multi-physics simulations. We used deep reactive ion etching with Bosch process and optimized recipe of gases to fabricate high-aspect-ratio hollow silicon microneedle array. Finally, microneedle array and polydimethylsiloxane drug reservoir were assembled to make finished anti-emetic patch. We assessed microneedles mechanical stability, physico-chemical properties and performed in-vitro, ex- vivo and in-vivo studies. These studies established functional efficacy of the device in trans-epidermal delivery of anti-emetics, its programmability, ease of use and biosafety. Thus, out-of-plane hollow silicon microneedle array trans-epidermal antiemetic patch is a promising strategy for painless and effective management of CINV at low cost in mainstream healthcare.

  10. Anxiety and physiological responses to the Trier Social Stress Test for Children in adolescents with cyclic vomiting syndrome.

    Science.gov (United States)

    Tarbell, Sally E; Millar, Amanda; Laudenslager, Mark; Palmer, Claire; Fortunato, John E

    2017-01-01

    This study compared anxiety and physiological responses during the Trier Social Stress Test for Children (TSST-C) in adolescents. 38 subjects (26 females) were enrolled: 11 cyclic vomiting syndrome (CVS), 11 anxiety, and 16 controls. Salivary cortisol, α-amylase and heart rate variability (HRV) were assessed during the TSST-C. Anxiety was measured by the Screen for Childhood Anxiety Related Emotional Disorders (SCARED), Anxiety Disorders Interview Schedule, and State-Trait Anxiety Inventory for Children (STAI-C). 11 anxiety and 7 CVS subjects had ≥1 anxiety disorder. 82% in the anxiety and CVS groups met criteria for an anxiety disorder on the SCARED. Combining groups, cortisol increased from baseline to recovery during the TSST-C (p=0.0004) and the stressor to recovery (p=0.005). α-amylase did not differ during the TSST-C for the total sample, but increased for anxiety compared to controls from baseline to recovery (p=0.01). HRV decreased during the stressor (p=0.0001) and increased at recovery (p=0.004). No associations were found between biomarkers and trait anxiety. Associations were found between baseline HRV and pre-test state anxiety (r=-0.406, p=0.012) and between recovery HRV and post-test state anxiety (r=-0.501, p=0.002) for the total sample. Anxiety is prevalent in CVS warranting screening. HRV may serve as a biomarker for evaluating stress as a potential trigger for CVS episodes. State but not trait anxiety was associated with changes in HRV, suggesting acute anxiety may be more relevant in linking stress and CVS episodes. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy

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    Kohei Ogawa

    2017-05-01

    Full Text Available Background: No previous study has shown the validity of a food frequency questionnaire (FFQ in early pregnancy with consideration of nausea and vomiting during pregnancy (NVP. The aim of this study was to evaluate the validity of a FFQ in early pregnancy for Japanese pregnant women. Method: We included 188 women before 15 weeks of gestation and compared estimated nutrient intake and food group intake based on a modified FFQ with that based on 3-day dietary records (DRs. Spearman's rank correlation coefficients, adjusting energy intake and attenuating within-person error, were calculated. Subgroup analysis for those with and without NVP was conducted. We also examined the degree of appropriate classification across categories between FFQ and DRs through division of consumption of nutrients and food groups into quintiles. Results: Crude Spearman's correlation coefficients of nutrients ranged from 0.098 (sodium to 0.401 (vitamin C, and all of the 36 nutrients were statistically significant. In 27 food groups, correlation coefficients ranged from −0.015 (alcohol to 0.572 (yogurt, and 81% were statistically significant. In subgroup analysis, correlation coefficients in 89% of nutrients and 70% of food groups in women with NVP and 97% of nutrients and 74% of food groups in women without NVP were statistically significant. On average, 63.7% of nutrients and 60.4% of food groups were classified into same or adjacent quintiles according to the FFQ and DRs. Conclusions: The FFQ is a useful instrument, regardless of NVP, for assessing the diet of women in early pregnancy in Japan.

  12. Nausea and Vomiting

    Science.gov (United States)

    ... such as ginger ale, lemonade and water. Mint tea also may help. Oral rehydration solutions, such as ... Clinic does not endorse any of the third party products and services advertised. Advertising and sponsorship policy ...

  13. Cannabinoid 2 (CB2) receptor agonism reduces lithium chloride-induced vomiting in Suncus murinus and nausea-induced conditioned gaping in rats.

    Science.gov (United States)

    Rock, Erin M; Boulet, Nathalie; Limebeer, Cheryl L; Mechoulam, Raphael; Parker, Linda A

    2016-09-05

    We aimed to investigate the potential anti-emetic and anti-nausea properties of targeting the cannabinoid 2 (CB2) receptor. We investigated the effect of the selective CB2 agonist, HU-308, on lithium chloride- (LiCl) induced vomiting in Suncus murinus (S. murinus) and conditioned gaping (nausea-induced behaviour) in rats. Additionally, we determined whether these effects could be prevented by pretreatment with AM630 (a selective CB2 receptor antagonist/inverse agonist). In S. murinus, HU-308 (2.5, 5mg/kg, i.p.) reduced, but did not completely block, LiCl-induced vomiting; an effect that was prevented with AM630. In rats, HU-308 (5mg/kg, i.p.) suppressed, but did not completely block, LiCl-induced conditioned gaping to a flavour; an effect that was prevented by AM630. These findings are the first to demonstrate the ability of a selective CB2 receptor agonist to reduce nausea in animal models, indicating that targeting the CB2 receptor may be an effective strategy, devoid of psychoactive effects, for managing toxin-induced nausea and vomiting.

  14. The Influence of Oral Ginger before Operation on Nausea and Vomiting after Cataract Surgery under General Anesthesia: A double-blind placebo-controlled randomized clinical trial

    Science.gov (United States)

    Seidi, Jamal; Ebnerasooli, Shahrokh; Shahsawari, Sirous; Nzarian, Simin

    2017-01-01

    Background According to Iranian traditional medicine, using safe ginger may contribute to taking less chemical medicines and result in fewer side effects. Objective To determine the influence of using ginger before operation on nausea and vomiting, after cataract surgery under general anesthesia. Methods This study was a double-blind placebo-controlled randomized clinical trial conducted at Kurdistan University of Medical Sciences in 2015. 122 candidates of cataract surgery were randomly allocated in three groups. The first group received a ginger capsule in a single 1 g dose, the second received two separate doses of ginger capsule each containing 500 mg and the third group received placebo capsule before operation. The patients were examined and studied for the level of nausea and occurrence of vomiting for 6 hours after the operation. The intensity of nausea was scored from zero to ten, based upon Visual Analog Scale. SPSS version 20 was used to analyze the data. We used Chi square and Kruskal-Wallis test for the analyses of outcomes. Results The frequency and intensity of nausea and the frequency of vomiting after operation among those who had taken the ginger capsule in 2 separate 500 mg doses was less than the other 2 groups. This difference was significant (pKurdistan University of Medical Sciences, Sanandaj, Iran. PMID:28243400

  15. The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting--a systematic review and meta-analysis.

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    Kah Bik Cheong

    Full Text Available BACKGROUND: Acupuncture therapy for preventive and treatment of postoperative nausea and vomiting(PONV, a condition which commonly present after anaesthesia and surgery is a subject of growing interest. OBJECTIVE: This paper included a systematic review and meta-analysis on the effect of different type of acupuncture and acupoint selection in PONV prevention and treatment. METHODS: Randomised controlled trials(RCTs comparing acupuncture with non-acupuncture treatment were identified from databases PubMed, Cochrane, EBSCO, Ovid, CNKI and Wanfangdata. Meta-analysis on eligible studies was performed using fixed-effects model with RevMan 5.2. Results were expressed as RR for dichotomous data, with 95%CI. RESULTS: Thirty RCTs, 1276 patients (intervention and 1258 patients (control were identified. Meta-analysis showed that PC6 acupuncture significantly reduced the number of cases of early vomiting (postoperative 0-6h (RR=0.36, 95%CI 0.19,0.71; P=0.003 and nausea (postoperative 0-24h (RR=0.25, 95%CI 0.10,0.61; P=0.002, but not early nausea (postoperative 0-6h (RR=0.64, 95%CI 0.34,1.19; P=0.150 and vomiting (postoperative 0-24h (RR=0.82, 95%CI 0.48,1.38; P=0.450. PC6 acupressure significantly reduced the number of cases of nausea (RR=0.71, 95%CI 0.57,0.87; P=0.001 and vomiting (RR=0.62, 95%CI 0.49,0.80; P=0.000 at postoperative 0-24h. PC6 electro-acupoint stimulation significantly reduced the number of cases of nausea (RR=0.49, 95%CI 0.38,0.63; P<0.000 and vomiting (RR=0.50, 95%CI 0.36,0.70; P<0.000 at postoperative 0-24h. Stimulation of PC6 with other acupoint(s significantly reduced the number of cases of nausea and vomiting (RR=0.29, 95%CI 0.17,0.49; P<0.000 at postoperative 0-24h. Stimulation of other acupoint(s(non PC6 also significantly reduced the number of cases of nausea and vomiting (RR=0.63, 95%CI 0.49,0.81; P=0.000 at postoperative 0-24h. However, the quality of study was generally low in studies of PC6 combined with other acupoint(s and

  16. 预期性恶心呕吐患者性格特征的研究%Study on the characteristics of patients with expected nausea and vomiting

    Institute of Scientific and Technical Information of China (English)

    王云; 王学梅; 杜春玲

    2012-01-01

    Objective To screen out the people who are susceptible to the expected nausea and vomiting, and to take different intervention methods, reduce the incidence of the expected nausea and vomiting, and improve the life quality of chemotherapy patients. Methods Eysenck personality questionnaire (EPQ) was employed to survey personality traits of patients with expected nausea and vomiting. A comparison was made before and after intervention. Results There was no statistically significant difference between the study group and the control group in terms of P and L scores (P>0.05). The scores of E and N were significantly different (P<0.05). EPQ scores of the two groups were decreased after intervention. N factor had statistical significance (P<0.05). The expected level of nausea and vomiting was decreased significantly (P<0. 05). Conclusion Patients with expected nausea and vomiting have symptoms of anxiety, worry, depression, and nervousness, which can be classified into an emotionally unstable personality, According to EPQ, psychological and behavioral interventions should be given to patients with expected nausea and vomiting to reduce the incidence of nausea and vomiting.%目的 通过性格测定把预期性恶心呕吐的易感性格人群筛查出来,采取不同的干预措施,降低预期性恶心呕吐的发生率,提高化疗患者的生活质量.方法 采用艾森克个性问卷(EPQ)调查发生预期性恶心呕吐的患者性格特征,并进行干预前后的比较.结果 研究组和对照组精神质(P)维度、效度量表(L)分差异无显著性(P<0.05),神经质(N)、内-外倾(E)分有差异(P<0.05).两组干预后EPQ各因子分均下降,N因子差异有显著性意义(P<0 05),预期性恶心呕吐程度下降明显(P<0.05).结论 预期性恶心呕吐患者具有焦虑、担忧、忧郁不乐、情感反应强烈等神经质,属情绪不稳定个性,根据艾森克个性问卷中各量表值,对预期性恶心呕吐患者进行心理及行

  17. Anesthesiologists' practice patterns for treatment of postoperative nausea and vomiting in the ambulatory Post Anesthesia Care Unit

    Directory of Open Access Journals (Sweden)

    Claybon Louis

    2006-06-01

    Full Text Available Abstract Background When patients are asked what they find most anxiety provoking about having surgery, the top concerns almost always include postoperative nausea and vomiting (PONV. Only until recently have there been any published recommendations, mostly derived from expert opinion, as to which regimens to use once a patient develops PONV. The goal of this study was to assess the responses to a written survey to address the following questions: 1 If no prophylaxis is administered to an ambulatory patient, what agent do anesthesiologists use for treatment of PONV in the ambulatory Post-Anesthesia Care Unit (PACU?; 2 Do anesthesiologists use non-pharmacologic interventions for PONV treatment?; and 3 If a PONV prophylaxis agent is administered during the anesthetic, do anesthesiologists choose an antiemetic in a different class for treatment? Methods A questionnaire with five short hypothetical clinical vignettes was mailed to 300 randomly selected USA anesthesiologists. The types of pharmacological and nonpharmacological interventions for PONV treatment were analyzed. Results The questionnaire was completed by 106 anesthesiologists (38% response rate, who reported that on average 52% of their practice was ambulatory. If a patient develops PONV and received no prophylaxis, 67% (95% CI, 62% – 79% of anesthesiologists reported they would administer a 5-HT3-antagonist as first choice for treatment, with metoclopramide and dexamethasone being the next two most common choices. 65% (95% CI, 55% – 74% of anesthesiologists reported they would also use non-pharmacologic interventions to treat PONV in the PACU, with an IV fluid bolus or nasal cannula oxygen being the most common. When PONV prophylaxis was given during the anesthetic, the preferred PONV treatment choice changed. Whereas 3%–7% of anesthesiologists would repeat dose metoclopramide, dexamethasone, or droperidol, 26% (95% confidence intervals, 18% – 36% of practitioners would re

  18. Recent advances, trends and economic considerations in the risk assessment, prevention and treatment of postoperative nausea and vomiting.

    Science.gov (United States)

    Kranke, Peter; Schuster, Frank; Eberhart, Leopold H

    2007-12-01

    During the last two decades there have been considerable achievements regarding the management of postoperative nausea and vomiting (PONV). Due to the importance of these symptoms in the aim to streamline clinical processes and to improve patient satisfaction, the debate on the best strategies and also research that focuses on PONV continues. This review summarises the recent developments with respect to the management of PONV. Following a brief review on what is already known on the risk assessment, prevention and treatment of PONV, newer trends in the pharmacological prevention (dexamethasone, neurokinin-1 antagonists, multimodal prevention) will be discussed as well as new insights regarding the value of algorithms for the prevention of PONV. Further, pharmacogenetically based algorithms (according to the metaboliser status) as well as new treatment strategies (dexamethasone, multimodal treatment) will be covered. No drug so far can achieve a reduction of PONV of more than one third. Furthermore, all clinical studies consistently demonstrated that a combination treatment has a simple additive effect without any relevant interaction between different drugs or classes of drugs. The relative reduction of approximately 30% can also be expected from dexamethasone and it is likely that the substances presently in development and in an early clinical use (e.g., neurokinin-1 antagonists) will not represent the new panacea. However, they will probably replenish the existing antiemetic portfolio to better cope with high risk patients. Stratified prevention using pharmacogenetic knowledge is still in the early stages. Algorithms need to be customized to the local settings in order to prove efficient. Treatment remains a most important pillar and there is evidence that the principles of combining antiemetics to prolong effects and improve protection can be similarly applied to treatment. Recent developments in the area of PONV are more related to implementing the already

  19. Resource Utilization for Chemotherapy-Induced Nausea and Vomiting Events in Patients with Solid Tumors Treated with Antiemetic Regimens

    Science.gov (United States)

    Schwartzberg, Lee; Harrow, Brooke; Lal, Lincy S.; Radtchenko, Janna; Lyman, Gary H.

    2015-01-01

    Background Chemotherapy-induced nausea and vomiting (CINV) can lead to increased emergency department visits and hospitalizations, which may contribute to increased cost of care. Antiemetic agents, such as neurokinin-1 (NK1) receptor antagonists and 5-hydroxytryptamine (5-HT3) receptor antagonists, are prescribed for patients receiving highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). The current guidelines recommend a 3-drug combination of an NK1 receptor antagonist, a 5-HT3 receptor antagonist, and dexamethasone with HEC regimens and certain MEC regimens. Objective To compare the incidence of CINV and CINV-related resource utilization among patients who receive guideline-adherent HEC and MEC regimens and patients who receive non–guideline-adherent regimens. Methods In this retrospective, claims-based study, Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry) Research Edition database was used to identify 8089 patients with solid tumors receiving therapy with anthracycline plus cyclophosphamide (AC), cisplatin, or carboplatin from June 2013 to December 2013. The patients were stratified according to the use of an NK1 receptor antagonist regimen. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify CINV events associated with hospital, emergency department, and outpatient office visits among patients in the NK1 receptor antagonist group and the non-NK1 receptor antagonist group. Results A total of 1059 patients were included in the analysis, of whom 51% (N = 536) used an NK1 receptor antagonist–based regimen and 49% (N = 523) used non-NK1 receptor antagonist therapy. A higher percentage of patients receiving AC (73%) than cisplatin (56%) or carboplatin (23%) received an NK1 receptor antagonist. The incidence rates of total CINV events and CINV-related emergency department visits were lower in the group receiving an NK1 receptor

  20. The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Palli SR

    2015-06-01

    Full Text Available Swetha Rao Palli,1 Michael Grabner,1 Ralph A Quimbo,1 Hope S Rugo2 1HealthCore, Wilmington, DE, 2University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA Purpose: To determine the incidence of chemotherapy-induced nausea/vomiting (CINV and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT3 RA antiemetics. Materials and methods: This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC or moderately EC (MEC regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. Results: We identified 1,832 palonosetron and 2,387 other 5-HT3 RA (“other” patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026, and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, P<0.0001; MEC, 17.0% versus 26.8%, P<0.0001. Compared with the other cohort, patients receiving palonosetron were significantly more adherent to the index chemotherapy regimen with respect to the recommended time frame (HEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019 and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019. Conclusion: Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with

  1. Impact of 5-HT3 receptor antagonists on chemotherapy-induced nausea and vomiting: a retrospective cohort study

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    Lin Swu-Jane

    2012-07-01

    Full Text Available Abstract Background 1st generation 5-hydroxytryptamine receptor antagonists (5-HT3 RAs, and palonosetron, a 2nd generation 5-HT3 RA, are indicated for the prevention of chemotherapy (CT-induced nausea and vomiting (CINV associated with moderately (MEC and highly emetogenic CT agents (HEC. This study explores the impact of step therapy policies requiring use of an older 5-HT3 RA before palonosetron on risk of CINV associated with hospital or emergency department (ED admissions. Methods Patients who received cyclophosphamide post breast cancer (BC surgery or who were diagnosed with lung cancer on carboplatin (LC-carboplatin or cisplatin (LC-cisplatin were selected from PharMetrics’ (IMS LifeLink claims dataset (2005-2008. Patients were followed for 6 months from initial CT administration for CINV events identified through ICD-9-CM codes. Patients were grouped into those initiated with older, generic 5-HT3 RAs (ondansetron, granisetron, and dolasetron and those initiated and maintained on palonosetron throughout study follow-up. CINV events and CINV days were analyzed using multivariate regressions controlling for demographic and clinical variables. Results Eligible patients numbered 3,606 in BC, 4,497 in LC-carboplatin and 1,154 in LC-cisplatin cohorts, with 52%, 40%, and 34% in the palonosetron group, respectively. There was no significant difference between the two 5-HT3 RA groups in age or Charlson Comorbidity Index among the two MEC cohorts (BC and LC-carboplatin. Among the LC-cisplatin cohort, palonosetron users were older with more males than the older 5-HT3 RA group (age: 60.1 vs. 61.3; males, 66.9% vs. 56.9%. Compared to the older 5-HT3 RAs, the palonosetron groups incurred 22%-51% fewer 5-HT3 RA pharmacy claims, had fewer patients with CINV events (3.5% vs. 5.5% in BC, 9.5% vs. 12.8% in LC-carboplatin, 16.4% vs. 21.7% in LC-cisplatin, and had lower risk for CINV events (odds ratios 0.62, 0.71, or 0.71, respectively; p 3 RA group (p

  2. Effect of Persian Medicine Remedy on Chemotherapy Induced Nausea and Vomiting in Breast Cancer: A Double Blind, Randomized, Crossover Clinical Trial.

    Science.gov (United States)

    Nazari, Mohammad; Taghizadeh, Ali; Bazzaz, Mojtaba Mousavi; Rakhshandeh, Hassan; Shokri, Sadegh

    2017-01-01

    Chemotherapy induced nausea and vomiting (CINV) is a side effect, and has negative effect on quality of life and continuation of chemotherapy. Despite new regimen and drugs, the problems still remain and standard guidelines, effective treatment and supportive care for refractory CINV are still not yet established. Persian medicine, the old Iranian medical school, offer Persumac (prepared from Rhus Coriaria and Bunium Persicum Boiss). The specific objectives were to assess the effect of Persumac on the number and severity of nausea and vomiting in refractory CINV in acute and delayed phase. This randomized, double blind, crossover clinical trial study was carried out on 93 patients with breast cancer and refractory CINV, who received outpatient high emetogenic chemotherapy in Imam Reza hospital, Mashhad, Iran from October 2015 to May 2016. The study has three stages: in stage I patients received a questionaire and completed it after chemotherapy. In stage II they were randomly divided into intervention group with Persumac and control group with placebo (lactose were used). In stage III, wash out and crossover was conducted. Both groups in all stages received standard antiemetic therapy for CINV. The following were set as the inclusion criteria of the study: female, Age ≥18 years, clinical diagnosis of breast cancer, history of refractory CINV, normal blood tests and at least three courses of chemotherapy remaining. Exclusion criteria of this study were: Total or upper abdominal radiation therapy along with chemotherapy, drugs/therapy for nausea and vomiting not prescribed in this study, hypersensitivity to Sumac or Bunium Persicum, use of sumac and Bunium Persicum in seven days prior to the intervention, clinical diagnosis of digestion disorders, non-chemotherapy induced nausea and vomiting, milk allergy, loss of two consecutive or three intermittent doses of Persumac or placebo. Outcomes were gathered by Persian questionnaire. Number and severity of nausea and

  3. Effect of Persian Medicine Remedy on Chemotherapy Induced Nausea and Vomiting in Breast Cancer: A Double Blind, Randomized, Crossover Clinical Trial

    Science.gov (United States)

    Nazari, Mohammad; Taghizadeh, Ali; Bazzaz, Mojtaba Mousavi; Rakhshandeh, Hassan; Shokri, Sadegh

    2017-01-01

    Background Chemotherapy induced nausea and vomiting (CINV) is a side effect, and has negative effect on quality of life and continuation of chemotherapy. Despite new regimen and drugs, the problems still remain and standard guidelines, effective treatment and supportive care for refractory CINV are still not yet established. Persian medicine, the old Iranian medical school, offer Persumac (prepared from Rhus Coriaria and Bunium Persicum Boiss). Objective The specific objectives were to assess the effect of Persumac on the number and severity of nausea and vomiting in refractory CINV in acute and delayed phase. Methods This randomized, double blind, crossover clinical trial study was carried out on 93 patients with breast cancer and refractory CINV, who received outpatient high emetogenic chemotherapy in Imam Reza hospital, Mashhad, Iran from October 2015 to May 2016. The study has three stages: in stage I patients received a questionaire and completed it after chemotherapy. In stage II they were randomly divided into intervention group with Persumac and control group with placebo (lactose were used). In stage III, wash out and crossover was conducted. Both groups in all stages received standard antiemetic therapy for CINV. The following were set as the inclusion criteria of the study: female, Age ≥18 years, clinical diagnosis of breast cancer, history of refractory CINV, normal blood tests and at least three courses of chemotherapy remaining. Exclusion criteria of this study were: Total or upper abdominal radiation therapy along with chemotherapy, drugs/therapy for nausea and vomiting not prescribed in this study, hypersensitivity to Sumac or Bunium Persicum, use of sumac and Bunium Persicum in seven days prior to the intervention, clinical diagnosis of digestion disorders, non-chemotherapy induced nausea and vomiting, milk allergy, loss of two consecutive or three intermittent doses of Persumac or placebo. Outcomes were gathered by Persian questionnaire. Number

  4. Triple Therapy with Scopolamine, Ondansetron and Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Moderate to High Risk Patients Undergoing Craniotomy Under General Anesthesia: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Sergio Daniel Bergese

    2015-06-01

    Full Text Available Introduction: Postoperative nausea and vomiting is one of the most common complaints from patients and clinicians after a surgical procedure. According to the current Society of Ambulatory Anesthesia Consensus Guidelines, the general incidence of vomiting and nausea is around 30% and 50% respectively; and up to 80% in high risk patients. In previous studies, the reported incidence of PONV at 24 hours after craniotomy was 43%-70%. The transdermal scopolamine delivery system contains a 1.5 mg drug reservoir, which is designed to deliver a continuous slow release of scopolamine through intact skin during the first 72 hours of patch application. Therefore, we designed this single arm, non-randomized, pilot study to assess the efficacy and safety of triple therapy with scopolamine, ondansetron and dexamethasone to prevent PONV.Materials and methods: In the preoperative area, subjects received an active TDS 1.5 mg that was applied to a hairless patch of skin in the mastoid area approximately 2 hours prior to the operation. Immediately after anesthesia induction, all patients received a single 4 mg dose of ondansetron IV and a single 10 mg dose of dexamethasone IV. Patients that experienced nausea and/or vomiting received ondansetron 4 mg IV as the initial rescue medication. Results: A total of 36 subjects were analyzed. The overall incidence of PONV during the first 24 hours after neurological surgery was 33% (n=12. The incidence of nausea and emesis during the first 24 hours after surgery was recorded as 33% (n=12 and 16% (n=6 respectively. Conclusion: Our data also showed that this triple therapy regimen may be an efficient alternative regimen for PONV prophylaxis in patients undergoing neurological surgery with general anesthesia. Further studies using regimens affecting different receptor pathways should be performed to better prove the efficacy in preventing PONV or delayed PONV.

  5. Aprepitant in a Multimodal Approach for Prevention of Postoperative Nausea and Vomiting in High-Risk Patients: Is There Such a Thing as “Too Many Modalities”?

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    John J. Hache

    2009-01-01

    Full Text Available Postoperative and postdischarge nausea and vomiting (PONV and PDNV, respectively add morbidity to perioperative outcomes. Combining some antiemetic agents of different mechanisms is more effective than using single agents, although this concept has not yet been tested extensively with aprepitant. Consecutive high-risk patients for PONV (n = 100 were given preoperative aprepitant 40 mg before surgery and were followed perioperatively. Female patients receiving general anesthesia (n = 81 were selected for data analysis. The primary endpoints were PONV/PDNV in the 48 h after surgery. For patients included in the data analysis, using Apfel PONV risk factors, the median risk count was four out of four. PONV and PDNV incidences were 21% (95% CI: 14-31% and 37% (95% CI: 27-48%, respectively. Two patients experienced PACU (postanesthesia care unit vomiting and two patients experienced emesis postdischarge. When using regression modeling and comparing patients who received one or two vs. three or four mechanistically unique antiemetics (added to preoperative aprepitant, while adjusting for surgical case duration, the three or four additional antiemetic group showed more PONV/PDNV (Odds Ratio 3.73, 95% CI 1.3-10.9, p = 0.016 than did the one or two additional drug group. There were no other predictors of PONV/PDNV (transabdominal surgery, four vs. three Apfel risk factors in these patients. The low incidence of vomiting (2-5% suggests the potential importance of aprepitant in a multimodal antiemetic regimen. However, there may be the potential that too many unique antiemetic mechanisms combined with preoperative aprepitant may actually increase the incidence of perioperative nausea.

  6. Tolerability of nausea and vomiting and associations with weight loss in a randomized trial of liraglutide in obese, non-diabetic adults

    DEFF Research Database (Denmark)

    Lean, M E J; Carraro, R; Finer, N

    2014-01-01

    Background:Liraglutide 3.0 mg, with diet and exercise, produced substantial weight loss over 1 year that was sustained over 2 years in obese non-diabetic adults. Nausea was the most frequent side-effect.Objective:To evaluate routinely-collected data on nausea and vomiting with liraglutide......, and their influence on tolerability and body weight.Design:A randomized, placebo-controlled, double-blind 20-week study with 84-week extension (sponsor unblinded at 20 weeks, open-label after 1 year) in 8 European countries (Clinicaltrials.gov: NCT00422058).Subjects:After commencing a 500 kcal/day deficit diet plus...

  7. Effects of inhaled ginger aromatherapy on chemotherapy-induced nausea and vomiting and health-related quality of life in women with breast cancer.

    Science.gov (United States)

    Lua, Pei Lin; Salihah, Noor; Mazlan, Nik

    2015-06-01

    To assess the efficacy of inhaled ginger aromatherapy on nausea, vomiting and health-related quality of life (HRQoL) in chemotherapy breast cancer patients. Single-blind, controlled, randomized cross-over study. Patients received 5-day aromatherapy treatment using either ginger essential oil or fragrance-matched artificial placebo (ginger fragrance oil) which was instilled in a necklace in an order dictated by the treatment group sequence. Two oncology clinics in the East Coast of Peninsular Malaysia. VAS nausea score, frequency of vomiting and HRQoL profile (EORTC QLQ-C30 scores). Sixty female patients completed the study (age=47.3±9.26 years; Malay=98.3%; on highly emetogenic chemotherapy=86.7%). The VAS nausea score was significantly lower after ginger essential oil inhalation compared to placebo during acute phase (P=0.040) but not sustained for overall treatment effect (treatment effect: F=1.82, P=0.183; time effect: F=43.98, Pessential oil inhalation. A clinically relevant 10 points improvement on role functioning (P=0.002) and appetite loss (Pessential oil. At present time, the evidence derived from this study is not sufficiently convincing that inhaled ginger aromatherapy is an effective complementary therapy for CINV. The findings for HRQoL were however encouraging with significant improvement in several domains. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Comparing the Efficacy of Prophylactic P6 Acupressure, Ondansetron, Metoclopramide and Placebo in the Prevention of Vomiting and Nausea after Strabismus Surgery

    Directory of Open Access Journals (Sweden)

    Ali Reza Ebrahim Soltani

    2011-04-01

    Full Text Available To compare the efficacy of acupressure wrist bands, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Two hundred patients, ASA physical status I or II, aged between 10 and 60 years, undergoing strabismus surgery in Farabi Hospital in 2007-2008 years, were included in this randomized, prospective, double-blind and placebo-controlled study. Group I was the Control, group II received metoclopramide 0.2 mg/kg, group III received ondansetron 0.15 mg/kg iv just before induction, in Group IV acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I, II and III. The acupressure wrist bands were applied 30 min prior to the induction of anesthesia and removed six hours after surgery. Postoperative nausea and vomiting (PONV was evaluated within 0-2 hours and 2-24 hours after surgery by a blinded observer. Results were analyzed by X2 test. A P value of < 0.05 was taken as significant. The incidence of PONV was not significantly different in acupressure, metoclopramide and ondansetron during the 24 hours. Acupressure at P6 causes a significant reduction in the incidence of PONV 24 hours after strabismus surgery as well as metoclopramide 0.2 mg/kg and ondansetron 0.15 mg/kg iv for patients aged 10 or more.

  9. Does pharmacogenomics account for variability in control of acute chemotherapy-induced nausea and vomiting with 5-hydroxytryptamine type 3 receptor antagonists?

    Science.gov (United States)

    Trammel, Morgan; Roederer, Mary; Patel, Jai; McLeod, Howard

    2013-06-01

    Chemotherapy-induced nausea and vomiting is one of the most concerning adverse drug effects from cytotoxic chemotherapy. Despite appropriate use of antiemetic guidelines, 20-30 % of patients experience breakthrough nausea and vomiting secondary to chemotherapy. To assess the variability of 5-hydroxytryptamine type 3 receptor antagonist efficacy caused by genetic variation, a review of the available literature was conducted. From the literature, three sources of pharmacogenomic variability were identified: polymorphisms associated with 5-hydroxytryptamine type 3 receptor subunits, drug metabolism via cytochromes P450, and drug transport in the body. Testing for receptor subunit polymorphisms is not applicable to a clinical setting at this time; however, cytochrome P450 2D6 testing is FDA-approved and widely accessible. Cytochrome P450 2D6 ultrarapid metabolizers and poor metabolizers displayed altered antiemetic efficacy when compared with intermediate metabolizers and extensive metabolizers. We postulate that testing for cytochrome P450 2D6 phenotypes may be the most accessible way to provide individualized antiemetic therapy in the future.

  10. COMPARISON BETWEEN ACUPRESSURE AND PALONOSETRON IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING LAPAROSCOPIC TUBAL STERILISATION. A RANDOMISED CONTROL TRIAL

    Directory of Open Access Journals (Sweden)

    Raghavendra

    2016-03-01

    Full Text Available BACKGROUND AND OBJECTIVES To compare the effectiveness of acupressure at P6 point and palonosetron in prevention of postoperative nausea and vomiting in patients undergoing laparoscopic tubal sterilisation. METHODS AND MATERIALS After obtaining institutional ethical clearance and patient consent, this study was conducted during the period of July 2015 to November 2015. Patients undergoing laparoscopic tubal sterilisation belonging to ASA 1 and 2 were included, and patients with hypertension, diabetes neurological diseases, peripheral vascular diseases, local skin diseases, patients on antiemetics and unwilling patients were excluded from the study. Randomisation done by sealed envelope method into two groups of sample size 25 each; group A (acupressure, at P6 point and group B (palonosetron 0.075 mg IV. Acupressure band and Inj palonosetron were given just before the induction of anaesthesia. Episodes of PONV were recorded at 0-2 hours, 2-6 hours, 6- 12 hours and evaluated separately as none, mild, moderate and severe. Rescue antiemetic was given to those who had episode of vomiting. Data analysed using Student ‘t’ test and P value <0.05 considered to be significant. RESULTS Between two group comparisons no significant differences in terms of severity of PONV was observed and Group B showed no incidence of PONV. CONCLUSION Acupressure being non-invasive, non-pharmacological, inexpensive and better patient acceptability can be effectively used as an alternative for the prophylaxis of PONV. However, palonosetron was more effective than acupressure in preventing PONV.

  11. 肿瘤化疗所致恶心呕吐现状调查%Status Survey on Chemotherapy-Induced Nausea and Vomiting

    Institute of Scientific and Technical Information of China (English)

    董爽; 于世英

    2013-01-01

    目的 调查化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)的患者心理预期和发生情况,并评估CINV对患者生活质量的影响,为提高临床医生对CINV的认识和重视提供依据.方法 采用问卷调查的方式,调查华中科技大学同济医学院附属同济医院使用中度致吐风险化疗(MEC)或高度致吐风险化疗(HEC)的患者,并对其进行连续两周期相同化疗方案的随访.患者分别于化疗开始前、化疗第2天和化疗第6天,记录化疗期间急性、延迟性恶心呕吐发生情况、自主止吐用药和CINV对生活功能的影响,调查结果采用描述性分析和多元线性回归分析.结果 本研究共调查344例患者,最终303例患者完成问卷调查.结果显示:单日化疗MEC组急性、延迟性和总的完全缓解率分别为86.1%、76.6%和71.5%,HEC组为84.1%、71.0%和66.7%.多日化疗患者分别为93.8%、64.9%和64.9%;第2周期化疗前患者关于恶心呕吐预期值和焦虑值与患者前一周期化疗延迟性恶心发生的严重程度密切相关;约30%的患者因CINV对生活功能造成负面影响.结论 在行中度和高度致吐风险化疗的患者中,CINV治疗现状仍存在较大问题,尤其是在延迟期反应和恶心症状的控制方面.在临床实践中需进一步加强对CINV的关注,并提供更加有效的治疗措施.%Objective To investigate the patient's psychological anticipation and occurrence of chemotherapyinduced nausea and vomiting (CINV),and to assess the influence of CINV on quality of life,so as to provide evidence for clinical doctors to recognize and pay attention to CINV.Methods The patients in the Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology who took either moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC) were randomly sampled with a questionnaire for two circles.Patients were asked to

  12. Combining Traditional Chinese and Western Medicine Treatment Pregnancy Play Severe Vomiting Experience%中西医结合治疗妊娠剧吐临床体会

    Institute of Scientific and Technical Information of China (English)

    李颖

    2011-01-01

    目的:探讨中西医结合方法治疗妊娠剧吐的临床疗效.方法:选取辽宁中医药大学附属一院2009年6月-2010年4月妊娠剧吐患者30例.采用中西医结合治疗,观察其临床疗效.结果:中西医结合治疗妊娠剧吐患者30例,治愈28例,好转1例,无效1例.结论:西医治疗以控制病情,及时输液以迅速控制代谢紊乱,纠正酸碱平衡;中医从根本上纠正脾胃虚弱,肝胃不和症状,达到标本兼治之目的.同时嘱患者注意治愈后的饮食调养和情绪控制,以防止复发.此法疗效确切,值得临床推广应用.%Objective: To study the method of combining traditional Chinese and western medicine treatment of pregnancy severe vomiting clinical curative effect. Methods: Select 30 cases of pregnancy severe vomiting patients from liaoning university of traditional Chinese medicine attached the first hospital that from June 2009 until 2010 April. By combining traditional Chinese medicine with western medicine treatment,observe its clinical curative effect. Results: Combining traditional Chinese medicine with western medicine treatment of 30 cases of pregnancy sereve vomiting patients, cure 28 cases, improvement in 1,1 case ineffective. Conclusion: Treatment of western to control disease, timely infusion by rapid control metabolic disorder, correcting the balance of acid-base, TCM fundamentally correct the symptoms which spleen and stomach, liver and stomach weak. At the end attaining the specimen purposes.After curing ask patients to pay more attention about diet aftercare and controling emotional, so as to prevent recurrence.This method definite effect, and worth being popularized in clinical application.

  13. Prophylaxis of Radiation-Induced Nausea and Vomiting Using 5-Hydroxytryptamine-3 Serotonin Receptor Antagonists: A Systematic Review of Randomized Trials

    Energy Technology Data Exchange (ETDEWEB)

    Salvo, Nadia; Doble, Brett [Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Canada); Khan, Luluel [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Amirthevasar, Gayathri [Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Canada); Dennis, Kristopher [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Pasetka, Mark; DeAngelis, Carlo [Department of Oncology Pharmacy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Tsao, May [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-01-01

    Purpose: To systematically review the effectiveness and safety of 5-hydroxytryptamine-3 receptor antagonists (5-HT3 RAs) compared with other antiemetic medication or placebo for prophylaxis of radiation-induced nausea and vomiting. Methods and Materials: We searched the following electronic databases: MEDLINE, Embase, the Cochrane Central Register of Controlled Clinical Trials, and Web of Science. We also hand-searched reference lists of included studies. Randomized, controlled trials that compared a 5-HT3 RA with another antiemetic medication or placebo for preventing radiation-induced nausea and vomiting were included. We excluded studies recruiting patients receiving concomitant chemotherapy. When appropriate, meta-analysis was conducted using Review Manager (v5) software. Relative risks were calculated using inverse variance as the statistical method under a random-effects model. We assessed the quality of evidence by outcome using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: Eligibility screening of 47 articles resulted in 9 included in the review. The overall methodologic quality was moderate. Meta-analysis of 5-HT3 RAs vs. placebo showed significant benefit for 5-HT3 RAs (relative risk [RR] 0.70; 95% confidence interval [CI] 0.57-0.86 for emesis; RR 0.84, 95% CI 0.73-0.96 for nausea). Meta-analysis comparing 5-HT3 RAs vs. metoclopramide showed a significant benefit of the 5-HT3 RAs for emetic control (RR 0.27, 95% CI 0.15-0.47). Conclusion: 5-Hydroxytryptamine-3 RAs are superior to placebo and other antiemetics for prevention of emesis, but little benefit was identified for nausea prevention. 5-Hydroxytryptamine-3 RAs are suggested for prevention of emesis. Limited evidence was found regarding delayed emesis, adverse events, quality of life, or need for rescue medication. Future randomized, controlled trials should evaluate different 5-HT3 antiemetics and new agents with novel mechanisms of action such at the NK

  14. Prophylaxis of Postoperative Nausea and Vomiting in Adolescent Patients: A Review with Emphasis on Combination of Fixed-Dose Ondansetron and Transdermal Scopolamine

    Directory of Open Access Journals (Sweden)

    Joseph V. Pergolizzi

    2011-01-01

    Full Text Available Postoperative nausea and vomiting (PONV is a relatively common occurrence (20–30% that delays discharge and, if persistent, can lead to serious complications. The incidence of PONV is a function of patient characteristics, the type and duration of surgery, the type of anesthesia, and the choice of pre-, intra-, and postoperative pharmacotherapy. There are no completely effective antiemetic agents for this condition, but recommendations for treatment strategies are separately available for pediatric and adult patients. Left unclear is whether adolescents should be guided by the pediatric or the adult recommendations. We review the developmental physiology of the relevant physiological factors (absorption, distribution, metabolism, and elimination. We also review the clinical evidence regarding the safety and efficacy of a fixed-dose combination of ondansetron (4 mg, i.v. and transdermal scopolamine (1.5 mg.

  15. Magnetic resonance imaging brain findings in a case of aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder, presenting with intractable vomiting and hiccups

    Directory of Open Access Journals (Sweden)

    Prerna Garg

    2017-01-01

    Full Text Available Neuromyelitisoptica (NMO and multiple sclerosis (MS were once considered to be differing manifestation of same auto immune disease, NMO predominantly involving the optic nerve and cord. Now with discovery of NMO antibody the concept has changed and a spectrum of disorders with lesions in brain has been identified. Occasionally, brain may be the first or the only site of involvement in these disorders hence it is essential to be aware of this spectrum. The brain lesions in NMO/NMOSD may be located in characteristic regions and present with symptoms mimicking non neurological disease. We herein present a case of an adult female who was admitted with intractable vomiting and hiccups; subsequently on MRI brain found to have very tiny demyelinating foci in Area Postrema.

  16. Magnetic resonance imaging brain findings in a case of aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder, presenting with intractable vomiting and hiccups

    Science.gov (United States)

    Garg, Prerna; Rajasekaran, Muthusubramanian; Pandey, Salil; Gurusamy, Gnanashanmugam; Balalakshmoji, Devanand; Rathinasamy, Rajakumar

    2017-01-01

    Neuromyelitisoptica (NMO) and multiple sclerosis (MS) were once considered to be differing manifestation of same auto immune disease, NMO predominantly involving the optic nerve and cord. Now with discovery of NMO antibody the concept has changed and a spectrum of disorders with lesions in brain has been identified. Occasionally, brain may be the first or the only site of involvement in these disorders hence it is essential to be aware of this spectrum. The brain lesions in NMO/NMOSD may be located in characteristic regions and present with symptoms mimicking non neurological disease. We herein present a case of an adult female who was admitted with intractable vomiting and hiccups; subsequently on MRI brain found to have very tiny demyelinating foci in Area Postrema. PMID:28149102

  17. Magnetic resonance imaging brain findings in a case of aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder, presenting with intractable vomiting and hiccups.

    Science.gov (United States)

    Garg, Prerna; Rajasekaran, Muthusubramanian; Pandey, Salil; Gurusamy, Gnanashanmugam; Balalakshmoji, Devanand; Rathinasamy, Rajakumar

    2017-01-01

    Neuromyelitisoptica (NMO) and multiple sclerosis (MS) were once considered to be differing manifestation of same auto immune disease, NMO predominantly involving the optic nerve and cord. Now with discovery of NMO antibody the concept has changed and a spectrum of disorders with lesions in brain has been identified. Occasionally, brain may be the first or the only site of involvement in these disorders hence it is essential to be aware of this spectrum. The brain lesions in NMO/NMOSD may be located in characteristic regions and present with symptoms mimicking non neurological disease. We herein present a case of an adult female who was admitted with intractable vomiting and hiccups; subsequently on MRI brain found to have very tiny demyelinating foci in Area Postrema.

  18. Granisetron, Aprepitant, and Dexamethasone in Preventing Nausea and Vomiting in Patients Receiving Chemotherapy for Stage II, III, or IV Ovarian Cancer

    Science.gov (United States)

    2016-03-16

    Malignant Ovarian Mixed Epithelial Tumor; Nausea and Vomiting; Ovarian Brenner Tumor; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

  19. Characteristics of women with nausea and vomiting of pregnancy who chose to continue compassionate use of placebo after a randomised trial.

    Science.gov (United States)

    Matok, I; Umans, J; Feghali, M N; Clark, S; Caritis, S; Miodovnik, M; Hankins, G; Mattison, D R; Nordeng, H; Koren, G

    2013-08-01

    The placebo effect has not been characterised in pregnant women suffering from nausea and vomiting of pregnancy (NVP). Our aim was to characterise determinants of the placebo effect in women treated with placebo for NVP. We analysed data from a multicentre, double blind randomised controlled trial of Diclectin (delayed release doxylamine and pyridoxine) vs placebo for the treatment of NVP. A total of 127 women in the placebo arm and 130 in the active arm provided evaluable data for this analysis. Women who chose to continue placebo on a compassionate basis (n = 41) had significantly better improvement in symptoms of NVP and higher Wellbeing scores than those who did not ask to continue compassionate use. Results were similar in the active drug arm. The request to continue compassionate use of either placebo or active drug could be predicted by greater improvement in symptoms of NVP during the trial period.

  20. Diaphragmatic rupture causing repeated vomiting in a combined abdominal and head injury patient: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Symeonidis Dimitrios

    2012-07-01

    Full Text Available Abstract Background Diaphragmatic rupture after blunt abdominal injury is a rare trauma condition. Delayed diagnosis is not uncommon especially in the emergency room setting. Associated injuries often shift diagnosis and treatment priorities towards other more life-threatening conditions. Case presentation We present a challenging case of a young male with combined abdominal and head trauma. Repeated episodes of vomiting dominated on clinical presentation that in the presence of a deep scalp laceration and facial bruising shifted differential diagnosis towards a traumatic brain injury. However, a computed tomography scan of the brain ruled out any intracranial pathology. Finally, a more meticulous investigation with additional imaging studies confirmed the presence of diaphragmatic rupture that justified the clinical symptoms. Conclusions The combination of diaphragmatic rupture with head injury creates a challenging trauma scenario. Increased level of suspicion is essential in order to diagnose timely diaphragmatic rupture in multiple trauma patients.

  1. Explore the effect of palonosetron prevent nausea and vomiting in lung cancer chemotherapy%帕洛诺司琼预防肺癌化疗中恶心、呕吐的效果观察

    Institute of Scientific and Technical Information of China (English)

    朱明珍; 蒋华

    2014-01-01

    目的:探析帕洛诺司琼预防肺癌化疗中恶心、呕吐的效果。方法:随机选择晚期肺癌化疗患者40例,分为观察组与对照组。观察患者化疗中急性呕吐反应、延迟呕吐的情况、恶心分级情况及改善不良反应。结果:观察组患者急性呕吐与对照组差异无统计学意义(P>0.05);延迟呕吐情况、患者恶心控制情况,观察组均显著高于对照组。观察组不良反应发生率较对照组低,差异无统计学意义(P>0.05)。结论:晚期肺癌的化疗中,帕洛诺司琼在延迟呕吐的止吐方面及患者恶心控制方面较阿扎司琼疗效好,在急性呕吐止吐方面作用与阿扎司琼相似,临床不良反应轻微,值得推广应用。%Objective To explore the effect of palonosetron prevent nausea and vomiting in lung cancer chemotherapy.Methods Randomly selected 40 advanced lung cancer chemotherapy patients.divided them into observation group and control group.observed patients with acute vomiting response,vomiting of delay. the nausea classification in two groups、suspend the vomiting prevention of adverse reactions.Results The observation group of patients with acute vomiting and control group had no significant difference(P>0.05);delayed vomiting, nausea and control patients,the observation group were significantly higher than those of control group.The adverse reaction in observation group was lower than that in the control group,no significant difference(P>0.05).Conclusion In late lung cancer chemotherapy,the curative effect of palonosetron patients with delayed anti-nausea aspects of vomiting,nausea control is better than Aza SiQiong,has the similar effect of the aspect of acute vomiting anti-nausea to Aza SiQiong,little clinical adverse reaction,it is worthy of popularization application.

  2. Nausea and Vomiting following Balanced Xenon Anesthesia Compared to Sevoflurane: A Post-Hoc Explorative Analysis of a Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Astrid V Fahlenkamp

    Full Text Available Like other inhalational anesthetics xenon seems to be associated with post-operative nausea and vomiting (PONV. We assessed nausea incidence following balanced xenon anesthesia compared to sevoflurane, and dexamethasone for its prophylaxis in a randomized controlled trial with post-hoc explorative analysis.220 subjects with elevated PONV risk (Apfel score ≥2 undergoing elective abdominal surgery were randomized to receive xenon or sevoflurane anesthesia and dexamethasone or placebo after written informed consent. 93 subjects in the xenon group and 94 subjects in the sevoflurane group completed the trial. General anesthesia was maintained with 60% xenon or 2.0% sevoflurane. Dexamethasone 4mg or placebo was administered in the first hour. Subjects were analyzed for nausea and vomiting in predefined intervals during a 24h post-anesthesia follow-up.Logistic regression, controlled for dexamethasone and anesthesia/dexamethasone interaction, showed a significant risk to develop nausea following xenon anesthesia (OR 2.30, 95% CI 1.02-5.19, p = 0.044. Early-onset nausea incidence was 46% after xenon and 35% after sevoflurane anesthesia (p = 0.138. After xenon, nausea occurred significantly earlier (p = 0.014, was more frequent and rated worse in the beginning. Dexamethasone did not markedly reduce nausea occurrence in both groups. Late-onset nausea showed no considerable difference between the groups.In our study setting, xenon anesthesia was associated with an elevated risk to develop nausea in sensitive subjects. Dexamethasone 4mg was not effective preventing nausea in our study. Group size or dosage might have been too small, and change of statistical analysis parameters in the post-hoc evaluation might have further contributed to a limitation of our results. Further trials will be needed to address prophylaxis of xenon-induced nausea.EU Clinical Trials EudraCT-2008-004132-20 ClinicalTrials.gov NCT00793663.

  3. Chemotherapy-induced nausea and vomiting: incidence and characteristics of persistent symptoms and future directions NCCTG N08C3 (Alliance).

    Science.gov (United States)

    Kottschade, Lisa; Novotny, Paul; Lyss, Alan; Mazurczak, Miroslaw; Loprinzi, Charles; Barton, Debra

    2016-06-01

    Despite newer agents, chemotherapy-induced nausea and vomiting (CINV) continues to remain a distressing side effect to a proportion of patients undergoing systemic anti-cancer therapy. We recently performed an unplanned secondary analysis on a previously reported negative phase III trial (N08C3) looking at the efficacy of gabapentin/placebo in combination with dexamethasone and a 5HT3 receptor antagonist in the prevention of CINV for 413 patients undergoing regimens with highly emetogenic chemotherapy (HEC). In the current study, we attempted to better understand the higher than expected rate of overall patient satisfaction, despite a low complete response rate in both arms. Additionally, we looked at patient variables and their relationship to rates of CINV. Approximately one third of patients experienced more than mild nausea and reported scores on the Functional Living Index-Emesis that indicated interference with activities. Thirty-five percent reported nausea greater than 2.5 on a scale of 0 to 10 (0 being none), 19 % reported at least one emetic episode, and 49 % reported taking rescue medication. Nausea and vomiting on day 1, cisplatin therapy, and history of motion sickness significantly predicted delayed CINV. Age, combination chemotherapy (HEC with moderately emetogenic), and getting treatment for breast cancer predicted CINV on day 1. These data confirm previous reports that subgroups of patients may be more prone to acute and delayed CINV. Future CINV study design may benefit from a more individualized approach to CINV management, targeting those patients who are truly at risk for CINV despite continued drug development efforts.

  4. COMPARATIVE EVALUATION OF ORALLY DISINTEGRATING FILM OF ONDANSETRON VERSUS INTRAVENOUS GRANISETRON IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE, RANDOMIZED DOUBLE - BLIND PLACEBO - CONTROLLED STUDY

    OpenAIRE

    2015-01-01

    BACKGROUND : Ondansetron and granisetron are first generation 5 - hydroxytry - ptamine - 3 (5 - HT3) receptor antagonists widely used in the prophylaxis of postoperative nausea and vomiting (PONV). Orally Disintegrating Film (ODF) formulations are novel and advanced oral drug delivery systems used in management of (PONV). We aimed to study the efficacy of ODF of Ondansetron in the prophylaxis of PONV and to co...

  5. A randomized, double-blind, multicentre study comparing daily 2 and 5 mg of tropisetron for the control of nausea and vomiting induced by low-dose cisplatin- or non-cisplatin-containing chemotherapy

    NARCIS (Netherlands)

    Wymenga, ANM; vanderGraaf, WTA; Wils, JA; vanHeukelom, LS; vanderLinden, GHM; DullemondWestland, AC; Nooy, M; vanderHeul, C; deBruijn, KM; deVries, EGE

    1996-01-01

    Background: This study compares efficacy safety and tolerability of 2 and 5 mg tropisetron in prevention of nausea and vomiting induced by low-dose cisplatin- or non-cisplatin-containing chemotherapy. Patients and methods: 152 chemotherapy-naive cancer patients were randomized in a double-blind mann

  6. 舒尔通合剂止吐和抑制食管上皮增生实验的研究%Study of Prevent Vomiting and Esophageal Epithelial Hyperplasia Inhibition Effect of Shu Er Tong He Ji

    Institute of Scientific and Technical Information of China (English)

    张玉花; 叶延程; 李少海; 王学满; 付婷

    2013-01-01

    目的 观察舒尔通合剂止吐、对食管上皮增生的作用.方法 家鸽静脉注射硫酸铜制作呕吐动物模型,舒尔通灌胃后观察药物防止呕吐的作用;手术方法制作大鼠食管反流模型,应用滴灌到胃的给药方法观察对大鼠食管上皮组织增生的影响.结果 舒尔通合剂能对抗硫酸铜引起的家鸽的呕吐,与对照组比较呕吐次数及呕吐潜伏时间差异有统计学意义(P<0.01);HE染色显示舒尔通合剂能减少由于食管反流引起的上皮损伤.结论 舒尔通合剂具有防止呕吐的作用,并能明显改善食管上皮由于反流造成的组织损伤.%OBJECTIVE To observe the role of the Shu Er Tong He Ji in preventing vomiting and inhibiting of esophageal epithelial hyperplasia. METHODS Vomiting animal model was established by CuSO4 intraveneus injection in pigeon. The vomiting precent role was observed by drip delivery of Shu Er Tong He Ji. Rats esophaged reflux model was produced by operation. The influence of drug on epithelial tissue hyperplasia was observed by drip irrigation. RESULTS The Shu Er Tong He Ji could relieve the vomit caused by CuSO4, it has significant difference compared with control group on the frequency of vomiting and vomiting latent time (P<0.01); Hematoxylin eosin(HE) staining showed that The Shu Er Tong He Ji can reduce the epithelial damage cause by esophageal reflux. CONCLUSION The Shu Er Tong He Ji might prevent vomiting and improve the esophageal epithelium due to tissue damage caused by the reflux.

  7. Palonosetron versus other 5-HT(3) receptor antagonists for prevention of chemotherapy-induced nausea and vomiting in patients with cancer on chemotherapy in a hospital outpatient setting.

    Science.gov (United States)

    Balu, Sanjeev; Buchner, Deborah; Craver, Chris; Gayle, Julie

    2011-04-01

    Despite favorable evidence from clinical trials for single-dose palonosetron versus other commercially available 5-HT(3)-receptor antagonists for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV), clinical comparative data are scarce from hospital outpatient settings, where these antiemetic agents are used in patients diagnosed with cancer who are receiving chemotherapy (CTH). The purpose of our retrospective study was to assess the hospital claims to evaluate the rate of uncontrolled CINV with antiemetic prophylaxis using palonosetron versus other 5-HT(3)-receptor antagonists in patients diagnosed with cancer who are receiving CTH (highly emetogenic CTH, moderately emetogenic CTH, low-emetogenic CTH, or minimally emetogenic CTH) treatment in a hospital outpatient setting. Patients aged ≥18 years who had cancer and were being treated with CTH and antiemetic prophylaxis with palonosetron (Group 1) and other 5-HT(3) receptor antagonists (Group 2) for the first time between April 1, 2007, and March 31, 2009, were identified using a hospital-service database. Within each CTH cycle, CINV events were identified through International Classification of Diseases (ICD)-9 codes for nausea, vomiting, and/or volume depletion (from Day 1 of each CTH administration until the end of the CTH cycle) or for use of rescue medications (Day 2 until the end of the CTH cycle). A multivariate regression model was developed to predict uncontrolled CINV event rates per CTH cycle between Groups 1 and 2 matched on CTH emetogenicity distribution in the study follow-up period (first of 8 cycles or 6 months). A subgroup analysis of patients on CTH with the highest risk of nausea and vomiting (highly emetogenic CTH or moderately emetogenic CTH) was also conducted. Of 9144 identified patients, 1775 were prescribed palonosetron (Group 1). Group 1 patients were statistically younger (61.2 vs 62.8 years; P < 0.001), composed of more females (57.1% vs 51.9%; P < 0.001) and more

  8. 薄氏腹针治疗乳腺癌化疗后恶心呕吐的疗效观察%An Observation on Effect of Bo's Abdominal Acupuncture on Nausea and Vomiting after Chemotherapy for Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    赖米林; 刘丹

    2015-01-01

    Objective:To observe the clinical effect of Bo's abdominal acupuncture on nausea and vomiting after chemotherapy for breast cancer.Methods:Randomly divide 140 patients into treatment group and control group in the ratio of 1:1 .The control group were treated with Granisetron Hydrochloride to prevent vomiting and the treated with abdominal acupuncture on the base of conventional treatment.Compare the improvement in the 2 groups in the aspect of nausea and vomiting.Results:After 1 day of treatment ,the improvement in the aspect of nausea and vomiting in treatment group was more obvious than that in control group(P0. 05).Conclusion:Abdominal acupuncture is effective to alleviate nausea and vomiting,improve patients'appe-tite ,it shall be applied to treat as earlier as possible.%目的::观察薄氏腹针治疗乳腺癌化疗后恶心、呕吐的临床效果。方法:140例患者按照1∶1的比例随机分为治疗组和对照组。对照组给予盐酸格拉司琼注射液预防呕吐,治疗组在常规处理的基础上加用腹针治疗,比较两组恶心、呕吐改善效果。结果:治疗1d后治疗组患者恶心、呕吐改善有效率显著优于对照组(P0.05)。结论:腹针治疗可减轻恶心和呕吐症状,改善患者食欲情况,应及早进行治疗。

  9. The effect of dexketoprofen pre-emptively administered on the consumption of tramadol and the incidence of nausea and vomiting after laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Costea D.

    2014-05-01

    Full Text Available The aim of our study has been to assess the comparative use of the two NSAIDs, dexketoprofen and ketoprofen, for postoperative analgesia after laparoscopic cholecystectomy mainly following: the quality of the analgesia, the incidence of potential adverse effects (for example, postoperative nausea and vomiting and the rescue analgesics consumption (tramadol. This prospective, randomized, double-blind study included 90 patients undergoing laparoscopic cholecystectomy under general anaesthesia. Patients were randomly assigned into 2 groups: group D (n = 45 - patients that have received dexketoprofen 50 mg in dilution with10 ml saline solution iv., 30 minutes before the induction and group K (n = 45 - patients that have received ketoprofen 100 mg in dilution with 10 ml saline solution iv., 30 minutes before the induction (preemptive analgesia. Surgical interventions were conducted under general anaesthesia, with identical protocol for the two groups of study. Post-surgery analgesic regime consisting in 4 g of paracetamol administered for example in the first 24 hours, was started immediately after surgery. Boluses of tramadol of 100 mg (until 400 mg /daily have been used as rescue analgesia. The main objectives of our study have been: post-surgery analgesia (VAS at mobilization, 0-100 mm at 0, 2, 6, 12 and 24 hours after the surgery,the consumption of tramadol, incidence of PONV and the length of hospitalization period (LOS. Secondary objectives of the study have been: the incidence of gastrointestinal symptoms and the incidence of postsurgery blood losses. In the two study groups there have not been any differences concerning demographic data, post-surgery gastro-intestinal symptoms, postsurgery loss of blood and the hospitalization period. VAS was significantly lower in group D vs. K, at 0 and 6 hours after the surgery (p <0,05. The incidence of PONV was lower in the group of patients who received preemptive analgesia with dexketoprofen (p <0

  10. A comparison of the effects of droperidol and the combination of droperidol and ondansetron on postoperative nausea and vomiting for patients undergoing laparoscopic cholecystectomy.

    LENUS (Irish Health Repository)

    Awad, Imad T

    2012-02-03

    STUDY OBJECTIVES: To compare the prophylactic antiemetic efficacy of the combination of ondansetron and droperidol with that of droperidol alone in patients undergoing elective laparoscopic cholecystectomy. DESIGN: Randomized, double-blind controlled trial. University affiliated teaching hospital after induction of standardized general anesthesia. PATIENTS: 64 ASA physical status I or II patients aged 18 to 80 years, undergoing elective laparoscopic cholecystectomy. INTERVENTION: Following induction of general anesthesia, patients received either droperidol 1.25 mg intravenously (IV; n = 30; Group D) or the combination of droperidol 1.25 mg IV and ondansetron 4 mg IV (n = 34; Group D+O). MEASUREMENTS: Number and severity of nausea episodes, number of emetic episodes, total analgesic consumption, and rescue antiemetic administration were assessed at 1, 3, and 24 hours after admission to the recovery room. Data were analyzed using Fisher\\'s Exact test and unpaired Student\\'s t-test; a p-value <0.05 was considered significant. RESULTS: The proportions of patients who experienced nausea (70% and 53% for D and D+O groups, respectively) and vomiting (30% and 19% for D and D+O groups, respectively) were similar in the two groups. The frequency of moderate and severe nausea (requiring administration of antiemetic) was less in group D + O (7%) compared with group D (19%; p < 0.05). CONCLUSIONS: Patients who received the combination of droperidol and ondansetron experienced less severe nausea compared with patients who received droperidol alone.

  11. Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

    Directory of Open Access Journals (Sweden)

    Renu Sinha

    2016-01-01

    Full Text Available Aim. Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV in children undergoing elective strabismus surgery. Methods. A total of 136 children (1–15 years were included. Children received either granisetron (40 mcg/kg [group G] or combination of granisetron (40 mcg/kg and dexamethasone (150 mcg/kg [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen. Results. The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68 of children in group G and 76.9% (50/65 of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46. Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex. Conclusion. Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial was CTRI/2009/091/001000.

  12. A Review of NEPA, a Novel Fixed Antiemetic Combination with the Potential for Enhancing Guideline Adherence and Improving Control of Chemotherapy-Induced Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Paul J. Hesketh

    2015-01-01

    Full Text Available Combination antiemetic regimens targeting multiple molecular pathways associated with emesis have become the standard of care for prevention of chemotherapy-induced nausea and vomiting (CINV related to highly and moderately emetogenic chemotherapies. Antiemetic consensus guidelines from several professional societies are widely available and updated regularly as new data emerges. Unfortunately, despite substantial research supporting the notion that guideline conformity improves CINV control, adherence to antiemetic guidelines is unsatisfactory. While studies are needed to identify specific barriers to guideline use and explore measures to enhance adherence, a novel approach has been taken to improve clinician adherence and patient compliance, with the development of a new combination antiemetic. NEPA is an oral fixed combination of a new highly selective NK1 receptor antagonist (RA, netupitant, and the pharmacologically and clinically distinct 5-HT3 RA, palonosetron. This convenient antiemetic combination offers guideline-consistent prophylaxis by targeting two critical pathways associated with CINV in a single oral dose administered only once per cycle. This paper will review and discuss the NEPA data in the context of how this first combination antiemetic may overcome some of the barriers interfering with adherence to antiemetic guidelines, enhance patient compliance, and offer a possible advance in the prevention of CINV for patients.

  13. [Combination effects of capsicum plaster at the Korean hand acupuncture points k-d2 with prophylactic antiemetic on postoperative nausea and vomiting after gynecologic laparoscopy].

    Science.gov (United States)

    Jung, Hyun Jung; Park, Sang Youn

    2013-04-01

    This study was done to evaluate the combination effects of capsicum plaster at the Korean hand acupuncture points K-D2 with prophylactic antiemetic on Postoperative Nausea and Vomiting (PONV). An experimental research design (a randomized, a double-blinded, and a placebo-control procedure) was used. The participants were female patients undergoing gynecologic laparoscopy; the control group (n=34) received intravenous prophylactic ramosetron 0.3mg, while the experimental group (n=34) had Korean Hand Therapy additionally. In the experimental group, capsicum plaster was applied at K-D2 of both 2nd and 4th fingers by means of Korean Hand Therapy for a period of 30 minutes before the induction of anesthesia and removed 8 hours after the laparoscopy. The occurrence of nausea, nausea intensity and need for rescue with antiemetic in the experimental group was significantly less than in the control group 2 hours after surgery. Results of the study show capsicum plaster at K-D2 is an effective method for reducing PONV in spite of the low occurrence of PONV because of the prophylactic antiemetic medication.

  14. Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial.

    Science.gov (United States)

    Sinha, Renu; Shende, Dilip; Maitra, Souvik; Kumar, Neeraj; Ray, Bikash Ranjan; Mohan, Virender Kumar

    2016-01-01

    Aim. Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery. Methods. A total of 136 children (1-15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen. Results. The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p = 0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex. Conclusion. Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial was CTRI/2009/091/001000.

  15. The delayed-release combination of doxylamine and pyridoxine (Diclegis®/Diclectin ®) for the treatment of nausea and vomiting of pregnancy.

    Science.gov (United States)

    Madjunkova, Svetlana; Maltepe, Caroline; Koren, Gideon

    2014-06-01

    Nausea and vomiting of pregnancy (NVP) affects up to 85 % of all pregnancies. Effective treatment can greatly improve a woman's quality of life, reduce the risk for maternal and fetal complications, and reduce healthcare costs. Unfortunately, many women receive either no pharmacological treatment or are recommended therapies for which fetal safety and efficacy have not been established. First-line treatment of NVP, as recommended by several leading healthcare and professional organizations, is the combination of doxylamine and pyridoxine. This combination, formulated as a 10 mg/10 mg delayed-release tablet, was approved by the US Food and Drug Administration (FDA) for the treatment of NVP in April 2013 under the brand name Diclegis(®), and has been on the Canadian market since 1979, currently under the brand name Diclectin(®). The efficacy of Diclegis(®)/Diclectin(®) has been demonstrated in several clinical trials, and, more importantly, studies on more than 200,000 women exposed to doxylamine and pyridoxine in the first trimester of pregnancy have demonstrated no increased fetal risk for congenital malformations and other adverse pregnancy outcomes. The present review aims to present the scientific evidence on the effectiveness and fetal safety of Diclegis(®)/Diclectin(®) for the treatment of NVP to justify its use as first-line treatment for NVP.

  16. Use of transdermal and intravenous granisetron and the ability of the Hesketh score to assess nausea and vomiting induced by multiday chemotherapy

    Science.gov (United States)

    Boccia, Ralph V; Clark, Gemma; Howell, Julian D

    2012-01-01

    Purpose Hesketh scores define emetogenicity of single-agent and multiagent single-day chemotherapy. This analysis determined the emetogenicity of multiagent, multiday chemotherapy and the Granisetron Transdermal System (GTDS; Sancuso®). Methods This was a retrospective analysis of a multicenter, randomized, double-blind, phase III noninferiority trial of GTDS versus oral granisetron in patients receiving 3 days of multiagent moderately or highly emetogenic chemotherapy, regardless of granisetron formulation. Emesis was defined as vomiting/retching or the use of rescue medication. Logistic regression and classification trees were used to determine the optimal combination of Hesketh scores over the multiagent, multiday regimens for the prediction of emesis. Results Of 393 patients, 272 (69.2%) were chemotherapy naïve. The most common types of cancer were lung (30.5%) and gynecologic (21.9%). The most common chemotherapeutic regimen (in 14.2% of patients) was cisplatin plus etoposide on days 1–3. The best binary emesis predictor was day 1 Hesketh score. Patients with a day 1 Hesketh score of 5 had the highest rate of emesis (62.5%) versus patients with a score < 5 (31.7%). For patients with day 1 Hesketh score < 5, only 14.3% of those receiving only one drug on day 1 experienced emesis. Conclusion Hesketh emetogenicity scores of individual agents are applicable to multiday, multiagent chemotherapeutic regimens in patients receiving antiemetics. PMID:22904638

  17. The cannabinoids: an overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection.

    Science.gov (United States)

    Mechoulam, R; Hanu, L

    2001-01-01

    The present paper describes the historical use of cannabis, starting with its use in Assyria and China. Recent advances in the understanding of the molecular basis of cannabis action are explained, including the identification of the cannabinoid receptors CB(1) and CB(2), as well as the isolation of endogenous cannabinoids from the brain and periphery. The use of delta(9)-tetrahydrocannabinol as an anti-vomiting and anti-nausea drug for cancer chemotherapy, and as an appetite-enhancing agent is described. Clinical work in multiple sclerosis, which may lead to the approval of tetrahydrocannabinol as a drug for this condition, is presented. Preclinical and clinical investigations with cannabidiol, a non-psychotropic cannabis constituent, are also described. Recent work with cannabidiol in animal models of rheumatoid arthritis may lead to clinical investigations. A synthetic cannabinoid, HU-211 (Dexanabinol), is in advanced clinical stages of investigation as a neuroprotectant in head trauma. The above clinical approaches may ultimately lead to the realization that cannabinoids are valuable clinical drugs in numerous fields.

  18. Phase III trial of casopitant, a novel neurokinin-1 receptor antagonist, for the prevention of nausea and vomiting in patients receiving moderately emetogenic chemotherapy

    DEFF Research Database (Denmark)

    Herrstedt, Jørn; Apornwirat, Wichit; Shaharyar, Ahmed

    2009-01-01

    -group, placebo-controlled clinical trial. All patients received dexamethasone 8 mg intravenously (IV) on day 1 and oral ondansetron 8 mg twice daily on days 1 to 3. Patients were randomly assigned to a control arm (placebo), a single oral dose casopitant arm (150 mg orally [PO] on day 1), a 3-day oral casopitant...... arm (150 mg PO on day 1 plus 50 mg PO on days 2 to 3), or a 3-day IV/oral casopitant arm (90 mg IV on day 1 plus 50 mg PO on days 2 to 3). The primary end point was the proportion of patients achieving complete response (no vomiting/retching or rescue medications) in the first 120 hours after...... the initiation of MEC. RESULTS: A significantly greater proportion of patients in the single-dose oral casopitant arm, 3-day oral casopitant arm, and 3-day IV/oral casopitant arm achieved complete response (73%, 73%, and 74%, respectively) versus control (59%; P

  19. Combination of Palonosetron, Aprepitant, and Dexamethasone Effectively Controls Chemotherapy-induced Nausea and Vomiting in Patients Treated with Concomitant Temozolomide and Radiotherapy: Results of a Prospective Study

    Science.gov (United States)

    MATSUDA, Masahide; YAMAMOTO, Tetsuya; ISHIKAWA, Eiichi; AKUTSU, Hiroyoshi; TAKANO, Shingo; MATSUMURA, Akira

    2016-01-01

    Concomitant use of temozolomide (TMZ) and radiotherapy, which is the standard therapy for patients with high-grade glioma, involves a unique regimen with multiple-day, long-term administration. In a previous study, we showed not only higher incidence rates of chemotherapy-induced nausea and vomiting (CINV) during the overall study period, but also substantially higher incidence rates of moderate/severe nausea and particularly severe appetite suppression during the late phase of the treatment. Here, we prospectively evaluated the efficacy of a combination of palonosetron, aprepitant, and dexamethasone for CINV in patients treated with concomitant TMZ and radiotherapy. Twenty-one consecutive patients with newly diagnosed high-grade glioma were enrolled. CINV was recorded using a daily diary and included nausea assessment, emetic episodes, degree of appetite suppression, and use of antiemetic medication. The percentage of patients with a complete response in the overall period was 76.2%. The percentages of patients with no moderate/severe nausea were 90.5, 100, and 90.5% in the early phase, late phase, and overall period, respectively. Severe appetite suppression throughout the overall period completely disappeared. The combination of palonosetron, aprepitant, and dexamethasone was highly effective and well tolerated in patients treated with concomitant TMZ and radiotherapy. This combination of antiemetic therapy focused on delayed as well as acute CINV and may have the potential to overcome CINV associated with a multiple-day, long-term chemotherapy regimen. PMID:27666343

  20. Dolasetron versus ondansetron as single-agent prophylaxis for patients at increased risk for postoperative nausea and vomiting: a prospective, double-blind, randomized trial.

    Science.gov (United States)

    Birmingham, Sean D; Mecklenburg, Brian W; Lujan, Eugenio; Dacanay, Rhodel G; Boyle, Patrick K; Green, Richard

    2006-09-01

    This study identified 100 ambulatory surgery patients receiving general anesthesia who were at increased risk for postoperative nausea and vomiting (PONV) and randomly assigned them to receive single-agent prophylaxis (12.5 mg of dolasetron or 4 mg of ondansetron) 15 to 30 minutes before the end of surgery. Data were collected in the postanesthesia care unit, and patients completed a questionnaire 24 hours after surgery. No statistically significant difference existed between study groups in demographic features, history of PONV, history of motion sickness, or type and duration of surgery and anesthesia. No statistically significant difference existed in satisfaction with the medication used for PONV prophylaxis (dolasetron, 70.9 of 100 mm; ondansetron, 67.9 of 100 mm; p = 0.69). No statistically significant difference existed in satisfaction with the overall surgical experience (dolasetron, 87.9 of 100 mm; ondansetron, 85.3 of 100 mm; p = 0.36). Costminimization strategies should be considered without fear of substandard care or increased patient dissatisfaction.

  1. Nursing intervention for tumor patients with nausea and vomiting caused by chemotherapy%肿瘤患者化疗所致恶心呕吐的护理干预

    Institute of Scientific and Technical Information of China (English)

    陈国萍; 周瑞芳; 李淑琴

    2013-01-01

    目的 探讨护理干预对血液科肿瘤患者化疗所致恶心、呕吐(CINV)的影响.方法 将107例接受化疗方案的血液科肿瘤患者随机分为干预组54例与对照组53例,2组均接受常规护理,干预组另加心理干预、行为干预、饮食干预.结果 干预组患者的预期性、急性、延迟性CINV的发生率均较对照组明显降低,程度较对照组明显减轻(P<0.05).结论 护理干预在减少血液科肿瘤患者的CINV中起积极作用,通过心理干预、行为干预、饮食干预,可使患者恶心、呕吐的发生率明显降低,程度减轻.%Objective To explore the effect of nursing intervention on the tumor patients with nausea and vomiting caused by chemotherapy in department of hematology. Methods 107 tumor patients with chemotherapy in department of hematology were randomly divided into the intervention group (n =54) and the control group (n =53). Both of two groups were conducted with conventional nursing, on this basis, the intervention group was conducted with additional measures such as psychological intervention, behavioral intervention and dietary intervention. Results About the nausea and vomiting caused by chemotherapy, there were three types: predicted type, acute type and delayed type. Incidence rates of the three types of nausea and vomiting caused by chemotherapy in the intervention group were significantly lower than the control group, furthermore the levels of nausea and vomiting were obviously lower than the control group (P < 0.05). Conclusion Nursing intervention plays a positive role in reducing the degree of nausea and vomiting caused by chemotherapy in the tumor patients in department of hematology. Through the psychological intervention, behavioral intervention and dietary intervention, incidence rates of nausea and vomiting can be obviously reduced.

  2. Discuss of Clinical Observation on Patients With Nausea and Vomiting in Gastroenterology%探讨消化内科患者恶心呕吐的临床观察

    Institute of Scientific and Technical Information of China (English)

    刘雁

    2015-01-01

    目的 探讨消化内科患者恶心呕吐的原因,为诊断提供依据,避免漏诊和误诊的现象发生.方法 选取我院2013年10月~2014年10月收治的119例恶心呕吐的消化内科患者,观察其恶心呕吐病因,并详细记录,进行统计学分析.结果 消化内科患者恶心呕吐的原因有:白细胞减少症、急性胃炎、消化性溃疡、腹部术后、胃内异物、急性阑尾炎等都会导致患者出现呕吐恶心的现象.结论 消化内科疾病种类繁多,医学知识面广,操作复杂而精细,诊断及治疗都需要有一定的经验,因此,把消化内科患者恶心呕吐的临床原因观察清楚,可以使医生积累临床经验,更有效的为患者服务.%Objective To investigate the cause of nausea and vomiting in patients of Gastroenterology, provide the basis for diagnosis, to avoid phenomenon of misdiagnosis and missed diagnosis. Methods119 cases of patients with nausea and vomiting in Gastroenterology of our hospital from October 2013 to October 2014 were selected, and observate the cause of nausea and vomiting, and detailed records, then do some statistical analysis.Results The cause of nausea and vomiting in patients of Gastroenterology: leukopenia, acute gastritis, peptic ulcer, gastric foreign body after abdominal surgery, acute appendicitis, etc. which would lead to patients with nausea and vomiting phenomenon.Conclusion Different kinds of digestive diseases, medical knowledge is wide, complex and fine operation, diagnosis and treatment need certain experience. Therefore, clear observation on the cause of nausea and vomiting in patients of Gastroenterology, can make the doctor accumulate more clinical experience, and more effective service for patients.

  3. Related factors analysis and nursing countermeasures on nausea and vomiting for patients after hysterectomy%子宫切除术后患者恶心呕吐相关因素分析及护理对策

    Institute of Scientific and Technical Information of China (English)

    李峥嵘; 陈爱双; 杨琳; 郑伟

    2013-01-01

    Objective To analyze the related factors on nausea and vomiting for patients after hysterectomy and find out countermeasures. Method Information of 495 cases of hysterectomy under general anaesthesia are analyzed retrospectively. Record related factors and values of nausea and vomiting. Evaluate the related factors by single factor analysis and multiple stepwise regression analysis. Result Nausea and vomiting appears in 55 (11. 1%) cases of patients after hysterectomy. Multiple stepwise regression analysis shows that nausea and vomiting is related to pre-operation fasting time, pre-operation duration of anesthesia and post-operation usage of analgesia pump. Conclusion Rate of nausea and vomiting for patients after hysterectomy is high. The main factors are pre-operation fasting time, pre-operation duration of anesthesia and post-operation usage of analgesia pump. Rate of nausea and vomiting can be reduced by intervene on these related factors.%目的 分析子宫切除术后患者发生恶心呕吐的相关因素,提出对策.方法 回顾性分析495例全身麻醉下行子宫切除术的资料,记录发生恶心呕吐的拟定相关因素及赋值.应用单因素分析和多元逐步回归分析评价发生恶心呕吐的相关因素.结果 495例子宫切除术后患者发生恶心呕吐55例,发生率11.1%,多元逐步回归分析显示发生恶心呕吐与术前禁食时间、麻醉时间、术后使用镇痛泵有关.结论 子宫切除术后患者发生恶心呕吐率较高,主要影响因素是术前禁食时间、麻醉时间、术后使用镇痛泵,干预这些相关因素可降低恶心呕吐的发生率.

  4. 儿保门诊婴幼儿吐乳症915例发病调查及疗效研究%Incidence investigation and efficacy study on infant functional vomiting in 915 infants of child health care outpatient

    Institute of Scientific and Technical Information of China (English)

    韩海琼; 陈伟斌

    2013-01-01

    目的:了解上海市虹口区婴幼儿吐乳症发病情况及治疗疗效观察。方法通过门诊915例婴幼儿常规查体检出吐乳症患儿,并通过“董氏指压法”治疗,间隔1周重复1次,3次1个疗程。结果发病578例,发病率为63.17%,男女发病率相近,无显著差异,主要表现为溢乳和呕吐,占93.08%。治疗后痊愈347例,占60.03%;显效130例,占22.49%;有效85例,占14.71%;无效16例,占2.77%。治疗总有效率达97.23%。结论吐乳症在婴幼儿十分普遍,运用董氏指压法治疗,预后良好。%Objective To understand and observe the incidence and efficacy on infant functional vomiting in hongkou district of Shanghai city. Methods The infants with functional vomiting were examined in outpatient routine examination for 915 infants,and the infants with functional vomiting were treated with "Dong acupressure"every other week,three times was a period of treatment. Results There were 578 infants with functional vomiting and the incidence rate was 63.17%.The incidence rate of men was similar to women,the difference was not significant.The main symptoms of patients were galactorrhea and vomiting,which accounted for 93.08%.There were cure in 347 cases(60.03%), markedly effective in 130 cases(22.49%),effective in 85 cases(14.71%),invalid in 16 cases(2.77%). The total effective rate was 97.23%. Conclusion Infant functional vomiting is widespread,which treated with "Dong acupressure"has good prognosis.

  5. 术后恶心呕吐的中西医认识和临床对策%Knowledge and Clinical Strategies of Postoperative Nausea and Vomiting in Western Medicine and TCM

    Institute of Scientific and Technical Information of China (English)

    李宝贵; 陶富盛

    2011-01-01

    术后恶心呕吐(PONV)很难避免,发病机制也不明确,目前没有标准的临床处理对策.现就近几年来中西医对于术后恶心呕吐的认识、临床对策等的研究做如下综述.%Postoperative nausea and vomiting ( PONV ) is hard to avoid, the pathogenesis is not clear,there is no standard clinical treatment countermeasures at present. Now it is to summarize that the knowledge and clinical strategies of postoperative nausea and vomiting in the Western Medicine and Traditional Chinese Medicine in recent years as follows.

  6. Clinical and economic burden of chemotherapy-induced nausea and vomiting among patients with cancer in a hospital outpatient setting in the United States.

    Science.gov (United States)

    Craver, Chris; Gayle, Julie; Balu, Sanjeev; Buchner, Deborah

    2011-01-01

    This study evaluated the overall burden of illness of chemotherapy-induced nausea and vomiting (CINV) and associated all-cause costs from a hospital's perspective (costs to the hospital) in patients with cancer treated with chemotherapy (CT) in the US hospital outpatient setting. Patients with a cancer diagnosis aged ≥18 years initiating CT in a hospital outpatient setting for the first time between April 1 2007 and March 31 2009 were extracted from the Premier Perspective Database. Patients were followed through eight CT cycles or 6 months post-index date, whichever occurred first. Within each CT cycle, the follow-up time for CINV event estimation was from day 1 (except rescue medication use that was identified from day 2) to cycle end. A multivariate regression model was developed to predict the CINV event rate per CT cycle in the study follow-up period. Associated total all-cause costs of managing CINV from a hospital's perspective were analyzed descriptively. Event rate and associated costs were estimated in the entire hospital setting (outpatient, inpatient, and emergency room). All-cause costs included inpatient, hospital outpatient, and ER visit costs (identified through a primary or secondary diagnosis code for nausea, vomiting, and/or volume depletion) and pharmacy cost (rescue medications for CINV treatment). All physician costs and non CINV-related treatment (pharmacy) costs were excluded from the analyses. Among 11,495 study patients, 8,806 patients (76.6%) received prophylaxis for all cycles in the follow-up period. The overall base population had an average age of 63.3 years, was 51.0% female, and 72.7% White. The distribution of emetogenicity for cycle 1 CT cycle was 26.0% HEC, 46.1% MEC, and 26.4% LEC/MinEC combined. In the follow-up period, a total of 47,988 CINV events with an associated total all-cause treatment cost of $89 million were observed. Average daily treatment cost for all care settings was $1854.7. The regression model predicted a 20

  7. Efficacy of orally disintegrating film of ondansetron versus intravenous ondansetron in prophylaxis of postoperative nausea and vomiting in patients undergoing elective gynaecological laparoscopic procedures: A prospective randomised, double-blind placebo-controlled study

    OpenAIRE

    2014-01-01

    Background and Aims: Ondansetron is one of the most widely used drugs for postoperative nausea and vomiting (PONV) prophylaxis. Orally disintegrating film (ODF) formulations are relatively recent innovations. We evaluated the efficacy of ODF of ondansetron for the prophylaxis of PONV. Methods: One hundred and eighty American Society of Anaesthesiologists-I or II women, in the age group 18-65 years, scheduled for elective gynaecological laparoscopic procedures were studied in a prospective ran...

  8. Effect observation of dexmedetomidine to prevent nausea and vomiting after laparoscopic cholecystectomy%右美托咪定预防腹腔镜胆囊切除术后恶心呕吐效果观察

    Institute of Scientific and Technical Information of China (English)

    朱玉梅; 汤海俊; 张红; 夏晶

    2016-01-01

    目的:观察右美托咪定预防腹腔镜胆囊切除术后恶心呕吐的临床效果。方法选择择期全麻下拟行腹腔镜胆囊切除术患者40例,将患者随机分为治疗组和对照组,每组20例,观察术后24h 出现恶心呕吐的情况。结果治疗组恶心呕吐发生率为15.0%明显低于对照组的55.0%,差异有统计学意义(P <0.05)。结论右美托咪定复合麻醉可显著降低腹腔镜胆囊切除术后恶心呕吐的发生率,值得临床推广使用。%Objective To observe the effects of dexmedetomidine to prevent nausea and vomiting after laparoscopic cholecystectomy. Methods 40 cases of patients undergoing laparoscopic cholecystectomy under general anesthesia were select-ed and randomly divided into treatment group and control group,with 20 cases in each group. The occurrence of nausea and vomiting was observed during 24 hours after operation. Results The incidence of nausea and vomiting in the treatment group (15. 0%)was significantly lower than that of the control group(55. 0%),the difference was statistically significant(P <0. 05). Conclusion Dexmedetomidine can reduce incidence of nausea and vomiting after laparoscopic cholecystectomy,and worthy of clinical use.

  9. Causative Analysis and Prevention and Treatment of Nausea and Vomiting in Post-surgical Children%小儿术后恶心、呕吐的原因分析与防治

    Institute of Scientific and Technical Information of China (English)

    马建中; 李晓雯; 郭爱武; 张宗旺

    2002-01-01

    @@ 小儿术后恶心与呕吐(postoperative nausea and vomiting,PONV)是一种比较严重的并发症,轻者造成患儿不适,重者导致刀口裂开、胃内容物误吸、出血、脱水和电解质紊乱[1].因此,防治PONV具有重要的意义.

  10. Clinical Study of Auricular Plaster Therapy for Post-laparoscopic Cholecystectomy Nausea and Vomiting%耳穴压豆缓解腹腔镜胆囊切除术后恶心、呕吐的临床研究

    Institute of Scientific and Technical Information of China (English)

    费华华; 贾丽萍

    2015-01-01

    目的:观察耳穴压豆缓解腹腔镜胆囊切除术后恶心、呕吐的效果。方法将240例腹腔镜胆囊切除术患者随机分为治疗组和对照组,每组120例。两组均采用常规护理,治疗组在此基础上给予耳穴压豆治疗。观察两组恶心、呕吐发生情况。结果治疗组恶心、呕吐发生率为46.7%,对照组为60.8%,两组比较差异具有统计学意义(P<0.05)。结论耳穴压豆法能缓解腹腔镜胆囊切除术后患者恶心、呕吐症状。%Objective To investigate the efficacy of auricular plaster therapy for post-laparoscopic cholecystectomy nausea and vomiting. Methods Two hundred and forty laparoscopic cholecystectomy patients were randomly allocated to treatment and control groups, 120 cases each. Both groups received routine nursing care. In addition, the treatment group received auricular plaster therapy. The incidence of nausea and vomiting was observed in the two groups.Results The incidence of nausea and vomiting was 46.7% in the treatment group and 60.8% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Auricular plaster therapy can relieve postoperative nausea and vomiting in laparoscopic cholecystectomy patients.

  11. 婴幼儿呕吐及先天性肥厚性幽门狭窄诊断分析%Analysis of diagnosis of infantile vomiting and congenital hypertrophic pyloric stenosis

    Institute of Scientific and Technical Information of China (English)

    王丽静; 赵海; 赵宏然; 宫术娟

    2015-01-01

    Objective:To analyze the causes of infant vomiting, congenital hypertrophic pyloric stenosis diagnosis. Methods:analyzed the clinical data of 2009. 1-2014. 2 in our hospital 185 cases of vomiting in infants, the retrospective analysis of diagnosis of congenital hypertrophic pyloric stenosis in children, and summarize the diagnosis anddifferential diagnosis. Results:among the 149 cases of vomiting caused bygastrointestinal and respiratory diseases;18 cases of intussusception;congenital hypertrophic pyloric stenosis in 12 cases;in oth-er 6 cases. Conclusion:The causes of infant vomiting is complicated, through the analysis of disease by imaging examination, could reduce or avoid misdiagnosis, missed diagnosis.%目的::分析婴幼儿呕吐原因,探讨先天性肥厚性幽门狭窄诊断要点。方法:分析2009年1月~2014年2月在我院就诊185例呕吐婴幼儿的临床资料,对确诊先天性肥厚性幽门狭窄的患儿回顾性分析,总结其诊断及鉴别诊断要点。结果:其中胃肠炎及呼吸道疾病所致呕吐149例;肠套叠18例;先天性肥厚性幽门狭窄12例;其它6例。结论:婴幼儿呕吐原因繁杂,通过分析病情借助影像学检查,可以降低或避免误诊、漏诊。

  12. Additive effect of rikkunshito, an herbal medicine, on chemotherapy-induced nausea, vomiting, and anorexia in uterine cervical or corpus cancer patients treated with cisplatin and paclitaxel: results of a randomized phase II study (JORTC KMP-02)

    OpenAIRE

    Ohnishi, Shunsuke; Watari, Hidemichi; Kanno, Maki; Ohba, Yoko; Takeuchi, Satoshi; Miyaji, Tempei; Oyamada, Shunsuke; NOMURA, EIJI; Kato, Hidenori; Sugiyama, Toru; Asaka, Masahiro; Sakuragi, Noriaki; Yamaguchi, Takuhiro; Uezono, Yasuhito; Iwase, Satoru

    2017-01-01

    Objective Rikkunshito, an herbal medicine, is widely prescribed in Japan for the treatment of anorexia and functional dyspepsia, and has been reported to recover reductions in food intake caused by cisplatin. We investigated whether rikkunshito could improve chemotherapy-induced nausea and vomiting (CINV) and anorexia in patients treated with cisplatin. Methods Patients with uterine cervical or corpus cancer who were to receive cisplatin (50 mg/m2 day 1) and paclitaxel (135 mg/m2 day 0) as fi...

  13. The assessment and management of chemotherapy-induced nausea and vomiting among cancer patients in a chemotherapy ward: a best practice implementation project.

    Science.gov (United States)

    Gu, Lingli; Li, Jing

    2016-03-01

    Chemotherapy-induced nausea and vomiting (CINV) are considered to be two of the most distressing side-effects of chemotherapy. They have a negative impact on a patient's quality of life and can influence the continuance of treatment. Owing to the lack of effective management of CINV, regular assessment and management of CINV is recommended for patients undergoing chemotherapy. The aim of this project was to integrate the available evidence on the assessment and management of CINV into practice, and implement strategies to improve compliance with evidence-based practice. The project carried out a pre- and post-implementation audit procedure using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. Five audit criteria were established according to the best available evidence on the assessment and management of CINV. The program was divided into three phases and conducted over four months in the chemotherapy ward, Fudan University Shanghai Cancer Center, Shanghai, China. Sixty patients and 14 oncology nurses were involved in this project. The results of the follow-up cycle showed that the compliance rates regarding patient education, risk factors evaluation and non-pharmacologic managements were 100%, 100% and 80%, respectively. The rate of validated tools being used by patients and nurses improved by 93% and 97%, respectively. This project demonstrated that the use of pre- and post-best practice audits is an effective method for incorporating evidence into practice in a chemotherapy ward. The practice of assessing and managing CINV was significantly improved. The next step is to develop strategies for sustaining the new procedures of CINV assessment and management.

  14. A COMPARATIVE STUDY TO EVALUATE THE EFFECTIVENESS OF P6 ACUPOINT STIMULATION VERSUS ONDANSETRON FOR PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING

    Directory of Open Access Journals (Sweden)

    Binu Sajid

    2016-08-01

    Full Text Available BACKGROUND AND AIMS Postoperative Nausea and Vomiting (PONV is one of the most common and distressing problems after anaesthesia and surgery. 5-HT3 receptor antagonist ondansetron is widely used for PONV prophylaxis. P6 acupoint stimulation, a non-pharmacological technique is a simple, inexpensive, and effective method for prevention of PONV. We compared the efficacy of P6 acupoint stimulation against monotherapy with intravenous ondansetron for prophylaxis of PONV. METHODS One hundred American Society of Anaesthesiologists - I or II patients, aged between 18 and 65 years, scheduled for thyroidectomy under general anaesthesia were included in this prospective, randomised, double-blind study. The patients were randomised into two groups: Group A (acupuncture and Group O (ondansetron. PONV was assessed in two epochs of 0-6 and 6-24 hrs. Primary outcome measure was incidence of PONV and secondary outcome measures were severity of PONV, need for rescue antiemetic, overall patient satisfaction, and side effects to either intervention. Outcome was compared using MannWhitney U-test or chi-square test as applicable. RESULTS Data of 100 patients were analysed. The incidence of PONV was similar during the 24 hrs. period in both groups. Complete response was seen in 82% of patients in both groups in the first 6 hrs. and in 98% in the late postoperative period. There was no difference in the requirement of rescue antiemetic or severity of PONV between the groups. Over all patient satisfaction was comparable in both groups. CONCLUSION P6 acupoint stimulation is safe, inexpensive, and equally effective as monotherapy with intravenous ondansetron in preventing PONV.

  15. Eliminating Postoperative Nausea and Vomiting in Outpatient Surgery with Multimodal Strategies including Low Doses of Nonsedating, Off-Patent Antiemetics: Is “Zero Tolerance“ Achievable?

    Directory of Open Access Journals (Sweden)

    Susan J. Skledar

    2007-01-01

    Full Text Available For ondansetron, dexamethasone, and droperidol (when used for prophylaxis, each is estimated to reduce risk of postoperative nausea and/or vomiting (PONV by approximately 25%. Current consensus guidelines denote that patients with 0–1 risk factors still have a 10–20% risk of encountering PONV, but do not yet advocate routine prophylaxis for all patients with 10–20% risk. In ambulatory surgery, however, multimodal prophylaxis has gained favor, and our previously published experience with routine prophylaxis has yielded PONV rates below 10%. We now propose a “zero-tolerance” antiemetic algorithm for outpatients that involves routine prophylaxis by first avoiding volatile agents and opioids to the extent possible, using locoregional anesthesia, multimodal analgesia, and low doses of three nonsedating off-patent antiemetics. Routine oral administration (immediately on arrival to the ambulatory surgery suite of perphenazine 8 mg (antidopaminergic or cyclizine 50 mg (antihistamine, is followed by dexamethasone 4 mg i.v. after anesthesia induction (dexamethasone is avoided in diabetic patients. At the end of surgery, ondansetron (4 mg i.v., now off-patent is added. Rescue therapy consists of avoiding unnecessary repeat doses of drugs acting by the same mechanism: haloperidol 2 mg i.v. (antidopaminergic is prescribed for patients pretreated with cyclizine or promethazine 6.25 mg i.v. (antihistamine for patients having been pretreated with perphenazine. If available, a consultation for therapeutic acupuncture procedure is ordered. Our approach toward “zero tolerance” of PONV emphasizes liberal identification of and prophylaxis against common risks.

  16. Feasibility of using the Multinational Association of Supportive Care in Cancer Antiemesis Tool for assessment of chemotherapy-induced nausea and vomiting at the Tom Baker Cancer Centre.

    Science.gov (United States)

    Warr, Julia K; Chambers, Carole R; Cusano, Frances L; Cuthbert, Colleen A; Mah, Michelle S

    2015-10-01

    Chemotherapy-induced nausea and vomiting (CINV) has been shown to adversely impact patient anxiety, quality of life, treatment adherence, and use of health care resources. CINV control still remains a challenge, and lack of effective communication between the patient and clinician has been highlighted in the literature as the main barrier to optimal control. The Multinational Association of Supportive Care in Cancer (MASCC) has developed a tool (MASCC Antiemesis Tool (MAT)) to improve assessment and subsequent management of CINV by enhancing communication between patients and their clinicians. This study assessed the feasibility of using the MAT in patients at the Tom Baker Cancer Centre. The secondary objective was to describe the incidence of CINV as identified by the tool. This study involved a prospective survey using the MAT in patients receiving intravenous chemotherapy. Subjects completed the MAT twice post-chemotherapy regarding CINV symptoms and returned it at their next clinic appointment. Participants were also surveyed to evaluate feasibility with regard to using the MAT. Of the 50 patients recruited, 56% returned surveys. The majority of patients reported that the MAT facilitated communication with their clinician, particularly those who had experienced CINV. Fifty-four percent of patients who returned the MAT reported CINV; however, less than half of them had received American Society of Clinical Oncology-recommended antiemetic regimens. Only four patients with CINV had antiemetic changes made for subsequent cycles. The MAT is a feasible tool which can improve communication of CINV symptoms between patients and clinicians, a foundational step toward improving CINV management. © The Author(s) 2014.

  17. Clinical characteristics of 41 children with cyclic vomiting syndrome%小儿周期性呕吐综合征41例报告

    Institute of Scientific and Technical Information of China (English)

    董梅; 李正红; 李刚

    2008-01-01

    目的 分析小儿周期性呕叶综合征(CVS)的临床特点及诊治经验.方法 对1994至2007年确诊为CVS的41例患儿的临床资料、诊断治疗及随访结果进行分析.结果 本组41例,男21例,女20例,平均年龄8岁,平均发病年龄4岁,平均病程4年.呕吐可持续数天,问有完全健康的间歇期.重症发作高峰时呕吐次数>6次/h.全组发作期有精神萎靡、不能交流、顽同恶心、不能进食、发作呈突发突止的刻板形式,此为小儿CVS特征表现.1994至2000年随访8例,3例用多虑平和阿普唑仑治疗后2.2年(1.0~4.0年)痊愈;5例未按医嘱预防性治疗者,就诊后7.7年(4~10年)痊愈.2001至2007年随访>1年的14例,9例用丙戊酸钠、多塞平、塞庚啶联合治疗后2.3年(1~4年)痊愈;5例未按医嘱预防性治疗者,就诊后1.9年(1~3年)痊愈.结论 小儿CVS的诊断应根据发作期特征性表现,有完全健康间歇期,并排除器质性呕叶病因.大多数CVS患儿症状随年龄增长而减轻.对发作频率≥1次/月,并影响生长发育的重症患儿,应给予精神安定剂、抗抑郁剂、抗偏头痛剂等长期预防性治疗;对轻症患儿,则采用发作期抗呕吐、输液等对症综合治疗.%Objective To analyze the clinical characteristics of children with cyclic vomiting syndrome(CVS),summarize the experience for twelve years,and improve awareness,diagnosis and treatment level of CVS.Methods The clinical data and results of long-term follow-up of the children with CVS seen from 1994 to 2007 in our department were analyzed.Results Forty-one children were enrolled in the study,21 were male,and 20 female,mean age was 8 years,mean age of onset was 4 years,mean interval from onset to proper diagnosis was 4 years;13/41 and 20/41 patients had family history of migraine and motion sickness,20/41 patients had triggers,such as upper respiratory tract infection,diet,and mental/emotional factor.Vomiting lasted for days,during the periods

  18. 帕洛诺司琼防治术后恶心呕吐效果的观察%Clinical observation on effect of Palonosetron for prevention of postoperative nausea and vomiting

    Institute of Scientific and Technical Information of China (English)

    常钧

    2013-01-01

    Objective To observe the effect of Palonosetron preventing postoperative nausea and Vomiting. Methods Sixty patients undergoing laparoscopic hysteromyomectomy were randomly divided into Group Ⅰ and GroupⅡ. Before general anesthetic induction, GroupⅠintravenously received Palonosetron 0.25 mg, and Group Ⅱreceived Tropisetron 5 mg. The severity of nausea and vomiting, side effects were recorded at 24 h、48 h and 72h after surgery. Results 24 h after laparoscopic hysteromyomectomy, tthe effective control rate of nausea and vomiting have no significant difference between two groups (allP0.05);术后48 h、72 h内Ⅰ组患者PONV的发生明显少于Ⅱ组,差异有统计学意义(P<0.05)。结论术后24 h发生的PONV,帕洛诺司琼与托烷司琼的防治效果相似,但对于延迟发生的PONV,帕洛诺司琼有更好的防治效果。

  19. Effect of nursing intervention for patients to relieve nausea and vomiting from gynecologic total hysterectomy.%护理干预减轻子宫全切术后恶心呕吐的效果

    Institute of Scientific and Technical Information of China (English)

    路启芳; 黄光葵

    2011-01-01

    目的:探讨护理干预预防和减轻妇科子宫全切术后患者恶心呕吐的效果.方法:选择硬膜外阻滞麻醉下择期子宫全切患者100例,ASAI~II级,将患者随机分成干预组50例和对照组50例,比较两组患者的恶心呕吐情况及焦虑评分.结果:干预组手术后发生恶心呕吐的患者明显减少,程度明显减轻,两组比较差异显著(P<0.05);干预组患者手术前后焦虑评分明显低于对照组(P<0.05).结论:护理干预可明显降低子宫全切手术患者的焦虑情绪,减轻恶心呕吐症状,提高患者的生活质量.%Objective:To investigate the effect of nursing intervention for gynecologic patients to relieve nausea and vomiting from total hysterectomy. Methods : Choosing 100 patients with epidural block anesthesia total hysterectomy, the level is from ASA I - TJ , they were randomly divided into intervention group ( n - 50 ) and control group ( n -50 ). The degree of nausea and vomiting and anxiety level were compared between the two groups. Results:The incidence of nausea and vomiting in the intervention group was less than that in the control group, the degree of nausea and vomiting was apparently alleviative. The difference was significant ( P <0. 05 ). The anxiety scores before and after chemotherapy in the intervention group were lower than that of the control group ( P < 0. 05 ). Conclusion: Nursing intervention can help to alleviate anxiety, nausea and vomiting of patients from gynecologic total hysterectomy, so as to improve the quality of their life.

  20. Effect of health-related quality of life in women with nausea and vomiting of pregnancy%恶心呕吐对妊娠妇女生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    文玉华; 万兰

    2012-01-01

    Objective To investigate the quality of life in women with nausea and vomiting of pregnancy and analyze the main social and somatic factors impacting the quality of life. Methods One hundred and ninety five women with nausea and vomiting of pregnancy who attended the antenatal clinic between 6 and 14 weeks of gestation were invited to complete the pregnancy-unique quantification of emesis and nausea ( PUQE) for quantitative analysis of symptoms. The quality of life was measured by SF-36 and nausea and vomiting of pregnancy quality of life questionnaire (NVPQOL). The demographic characteristics were recorded. Logistic regression analysis was performed to sift the social and somatic factors impacting the quality of life. Results Nausea (96.4% ) , retch (91. 3% ) and vomiting (63. 1% ) were the most common symptoms of women with nausea and vomiting of pregnancy, older and high-income patients' symptoms are relatively light. Both tests demonstrated that the quality of life was significantly correlated with PUQE scores, but the NVPQOL is more sensitive to physical symptoms than the SF-36 (OR 2.463 versus 1.588). Conclusion Nausea and vomiting of pregnancy are the main factors which have a profound impact on women' s quality of life. The NVPQOL in measuring the quality of life of women with nausea and vomiting of pregnancy is superior to SF-36.%目的 对有恶心呕吐症状的妊娠妇女生活质量进行横断面调查,分析影响生活质量的社会及躯体因素.方法 195例有恶心呕吐症状的妊娠妇女,孕6~14周,采用妊娠专用恶心呕吐量化表(PUQE)对患者症状进行量化,运用医疗结局研究量表简表SF-36及妊娠恶心呕吐生活质量量表(NVPQOL)对患者的生活质量进行评测.记录患者的入口学特征,运用多元回归分析筛选影响生活质量的社会及躯体因素.结果 妊娠呕吐患者最常见的症状依次为恶心(96.4%),干呕(91.3%),呕吐(63.1%);年长及较高收入患者的症状相对

  1. Efficacy of oral palonosetron compared to intravenous palonosetron for the prevention of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy: a phase 3 trial.

    Science.gov (United States)

    Boccia, Ralph; Grunberg, Steven; Franco-Gonzales, Edwin; Rubenstein, Edward; Voisin, Daniel

    2013-05-01

    Palonosetron (Aloxi(®), Onicit(®)) is a pharmacologically unique 5-HT3 receptor antagonist (RA) approved as a single IV injection for the prevention of nausea and vomiting induced by chemotherapy (CINV) of either moderate or highly emetogenic potential (MEC and HEC, respectively). An oral palonosetron formulation has been developed and compared to the IV formulation. In this multinational, multicenter, double-blind, double-dummy, dose-ranging trial, 651 patients were randomly assigned to receive one of the following as a single dose prior to moderately emetogenic chemotherapy: oral palonosetron 0.25, 0.50, and 0.75 mg or IV palonosetron 0.25 mg. Patients were also randomized (1:1) to receive dexamethasone 8 mg IV or matched placebo on day 1. The primary endpoint was complete response (CR; no emesis, no rescue therapy) during the acute phase (0-24 h). Acute CR rates were 73.5, 76.3, 74.1, and 70.4 % for all patients receiving the palonosetron 0.25, 0.50, and 0.75 mg oral doses, and for IV palonosetron 0.25 mg, respectively; delayed CR (24-120 h) rates were 59.4, 62.5, 60.1, and 65.4 %, and overall CR (0-120 h) rates were 53.5, 58.8, 53.2, and 59.3 %, respectively. The addition of dexamethasone improved emetic control (acute CR rate) by at least 15 % for all groups except oral palonosetron 0.25 mg, where the acute CR improvement was approximately 7 %. Adverse events were similar in nature, incidence, and intensity for all oral and IV palonosetron groups, and were the expected adverse events for 5-HT3 RAs (primarily headache and constipation). Oral palonosetron has a similar efficacy and safety profile as IV palonosetron 0.25 mg and may be the preferred formulation in certain clinical situations. Among the tested oral treatments, a palonosetron 0.50-mg oral dose has been favored for the prevention of CINV in patients receiving moderately emetogenic chemotherapy due to a numerical gain in efficacy without a side effect disadvantage.

  2. Palonosetron in the prevention of chemotherapy-induced nausea and vomiting: an evidence-based review of safety, efficacy, and place in therapy

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    Celio L

    2015-08-01

    Full Text Available Luigi Celio, Monica Niger, Francesca Ricchini, Francesco Agustoni Medical Oncology Unit 1, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy Introduction: The second-generation 5-hydroxytryptamine-3 (5-HT3 receptor antagonist palonosetron is effective in the prevention of chemotherapy-induced nausea and vomiting (CINV associated with highly and moderately emetogenic chemotherapy (HEC and MEC, respectively. In addition, palonosetron has been the first and, at present, the only 5-HT3 receptor antagonist to have a specific indication for the prevention of delayed CINV associated with MEC. The unique pharmacology of this antagonist is thought to partly explain its improved efficacy against delayed symptoms. Aims: To review the evidence underlying the use of palonosetron in preventing CINV. Evidence review: A recent meta-analysis consistently showed that palonosetron significantly increases the control of both emesis and nausea during the acute and delayed phases after single-day HEC or MEC. Consistent with these findings from trials that did not include an neurokinin-1 (NK-1 receptor antagonist, randomized controlled trials recently showed that a triple combination with palonosetron achieves significantly better control of delayed CINV, particularly delayed nausea, in patients undergoing HEC or the high-risk combination of an anthracycline and cyclophosphamide (AC. Evidence from randomized studies also supports palonosetron as a valuable option to reduce the total corticosteroid dose administered in patients undergoing multiple cycles of MEC or AC chemotherapy. Additional benefits of palonosetron include the lack of a warning on cardiac safety and no known clinically significant drug–drug interactions. Place in therapy and conclusion: Evidence currently available indicates that palonosetron significantly adds to the clinician’s ability to effectively control CINV in patients undergoing HEC or MEC. It is

  3. Efficacy of orally disintegrating film of ondansetron versus intravenous ondansetron in prophylaxis of postoperative nausea and vomiting in patients undergoing elective gynaecological laparoscopic procedures: A prospective randomised, double-blind placebo-controlled study

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    Harihar V Hegde

    2014-01-01

    Full Text Available Background and Aims: Ondansetron is one of the most widely used drugs for postoperative nausea and vomiting (PONV prophylaxis. Orally disintegrating film (ODF formulations are relatively recent innovations. We evaluated the efficacy of ODF of ondansetron for the prophylaxis of PONV. Methods: One hundred and eighty American Society of Anaesthesiologists-I or II women, in the age group 18-65 years, scheduled for elective gynaecological laparoscopic procedures were studied in a prospective randomised, double-blind, placebo-controlled trial. The patients were randomised into four groups: Placebo, intravenous (IV ondansetron 4 mg, ODF of ondansetron 4 mg (ODF4 and 8 mg (ODF8 groups. PONV was assessed in two epochs of 0-6 and 7-24 h. Primary outcome measure was the incidence of PONV and secondary outcome measures were severity of nausea, need for rescue anti-emetic, analgesic consumption, time to oral intake, overall patient satisfaction and side effects such as headache and dizziness. PONV was compared using analysis of variance or Mann-Whitney U-test as applicable. Results: Data of 173 patients were analysed. The incidence of postoperative nausea was significantly lower (P = 0.04 only during the 0-6 h in the ODF8 group when compared with the placebo group. During the 0-6 h interval postoperatively, the ODF8 group had a significantly lower incidence of vomiting when compared with the placebo (P = 0.002 and the IV group (P = 0.044. During the 0-24 h interval postoperatively, ODF4 (P = 0.01 and ODF8 (P = 0.002 groups had a significantly lower incidence of vomiting compared to the placebo group. Conclusions: Orally disintegrating film of ondansetron is an efficacious, novel, convenient and may be a cost-effective option for the prophylaxis of PONV.

  4. COMPARATIVE EVALUATION OF ORALLY DISINTEGRATING FILM OF ONDANSETRON VERSUS INTRAVENOUS GRANISETRON IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE, RANDOMIZED DOUBLE - BLIND PLACEBO - CONTROLLED STUDY

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    Snehalatha

    2015-05-01

    Full Text Available BACKGROUND : Ondansetron and granisetron are first generation 5 - hydroxytry - ptamine - 3 (5 - HT3 receptor antagonists widely used in the prophylaxis of postoperative nausea and vomiting (PONV. Orally Disintegrating Film (ODF formulations are novel and advanced oral drug delivery systems used in management of (PONV. We aimed to study the efficacy of ODF of Ondansetron in the prophylaxis of PONV and to compare it with intravenous Granisetron and placebo in patients undergoing Laparoscopic cholecystectomy . MATERIALS AND METHODS : In this prospective, randomized double - blind placebo - controlled study, 120 consented adult patients of ASA grade I and grade II, aged between 25 - 55 years of both genders, undergoing elective Laparoscopic cholecystectomy , w ere randomized into 3 groups of 40 patients each as Placebo, intravenous Granisetron 2mg and ODF of Ondansetron 8mg (ODF8 g roups. Study drugs were administered just before induction of Anaesthesia. Standardized anesthetic technique was used, and data was collected. Incidence of PONV was assessed and the number of patients suffering from nausea and vomiting at 0 - 6, 7 - 14, and overall 0 - 24 hours post - operatively was evaluated in all the groups and need for rescue anti - emetic noted. RESULTS : Data was analysed using one - way ANOVA test, Chi ‑ square test and Mann – Whitney test. The incidence and severity of nausea and vomiting at different time intervals in Group G and ODF Group was significantly lower when compared with Placebo Group ( p=0.000 . But there was no significant difference in between the ODF and in travenous groups. There was no significant difference in the incidence of side effects in between the three groups. CONCLUSION : orally disintegrating film of Ondansetron is a safe, simple and cost - effective, novel formulation , equally effective to intraven ous Granisetron in preventing PONV in patients undergoing laparoscopic cholecystectomy.

  5. Clinical Analysis of Moxibustion in Preventing Nausea and Vomiting Caused by Chemotherapy%艾灸防治化疗所致恶心呕吐的临床观察

    Institute of Scientific and Technical Information of China (English)

    张燕

    2015-01-01

    目的观察艾灸防治化疗所致恶心呕吐的临床疗效。方法将70例拟行化疗的肿瘤患者随机分为两组,对照组(35例)单纯采用静脉药物止吐;治疗组(35例)采用艾灸配合静脉药物。观察患者恶心、呕吐程度。结果治疗组总有效率达88.57%,对照组为71.43%,差异有显著统计学意义(<0.01)。结论艾灸防治化疗患者恶心呕吐的疗效显著,值得推广。%Objective To observe the clinical therapeutic ef ect of Moxibustion in preventing and treating chemotherapy induced nausea vomiting. Methods 70 cases of tumor undergoing chemotherapy patients were randomly divided into 2 groups, the control group (35 cases) simply by intravenous antiemetic drugs;treatment group (35 cases) treated with moxibustion combined with intravenous therapy. Observation of patients with nausea, vomiting degree. Results The ef ective rate of treatment group was 88.57%, 71.43%in the control group, the dif erence was statistical y significant ( <0.01). Conclusion the curative ef ect of moxibustion of prevention and treatment of nausea and vomiting in patients with significant, worthy of promotion.

  6. Phase III Double-Blind, Placebo-Controlled Study of Gabapentin for the Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy, NCCTG N08C3 (Alliance)

    Science.gov (United States)

    Barton, Debra L.; Thanarajasingam, Gita; Sloan, Jeff A.; Diekmann, Brent; Fuloria, Jyotsna; Kottschade, Lisa A.; Lyss, Alan P.; Jaslowski, Anthony J.; Mazurczak, Miroslaw A.; Blair, Scott C.; Terstriep, Shelby; Loprinzi, Charles L.

    2014-01-01

    BACKGROUND Despite targeted antiemetics, data support an unmet need related to the management of delayed nausea and vomiting (NV). Promising pilot data informed this phase III trial evaluating gabapentin for delayed NV from highly emetogenic chemotherapy (HEC). METHODS Participants were randomized to receive prophylactic treatment with 20 mg of dexamethasone and a 5HT3 receptor antagonist (RA) on the day of chemotherapy, followed by gabapentin 300 mg twice a day and dexamethasone (dex) or placebo and dex after HEC. Gabapentin/placebo was started the day of chemotherapy and continued through day 5 for the first chemotherapy cycle, whereas dex was titrated down on days 2–4. The primary end point was complete response (CR), defined as no emesis and no use of rescue medications on days 2–6, using an NV diary. The percentages of those in each group with a CR were compared by Fisher’s exact test. RESULTS Four hundred thirty patients were enrolled in this study. Forty-seven percent of patients in the gabapentin arm and 41% in the placebo arm had a CR (P = .23). Mean number of emesis episodes was <0.5 daily, and mean nausea severity was <2 (mild). In both arms, patient satisfaction with NV control was greater than 8 (with 10 being perfectly satisfied). There were no significant differences in unwanted side effects. CONCLUSIONS In this study, gabapentin did not significantly improve delayed NV. Patients were satisfied with the control of their nausea and vomiting irrespective of arm. The use of a 5HT3 RA and dexamethasone provided good control of nausea and vomiting for most patients. PMID:25043153

  7. Acupressure wristbands prevent postoperative nausea and vomiting: a Meta-analysis%穴位按压腕带缓解术后恶心呕吐随机对照试验的Meta分析

    Institute of Scientific and Technical Information of China (English)

    周璇; 王琦

    2011-01-01

    Objective To examine the impact of acupressure wristbands encircling the wrist and compressing Neiguan acupuncture point on prevention of postoperative nausea and vomiting in adults.Methods MEDLINE, CNKI and other databases were searched,and the randomized controlled trials were enrolled and analysed with Revman 5.0.Results Nine studies were recruited.Compared with the placebo controls, acupressure wristbands encircling the wrist and compressing Neiguan acupuncture point reduced vomiting (RR=0.50, 95% CI: 0.37-0.66, P<0.01).No statistical difference was found in occurrence of nausea between the acupressure wristbands group and the placebo group (RR=0.85, 95%CI:0.72-1.00, P>0.05).Conclusion Usage of acupressure wristbands encircling the wrist and compressing Neiguan acupuncture point can ease postoperative vomiting, but it can not reduce postoperative nausea.High quality RCTs are still needed to assess the effects of acupressure wristbands on prevention of postoperative nausea and vomiting.And Chinese nurses can bring in these wristbands to prove their effectiveness and applicability.%目的 评价穴位按压腕带作用于内关穴缓解成人术后恶心呕吐的效果.方法 检索MEDLINE、CNKI等数据库,纳入所有相关的随机对照试验(RCT),采用RevMan5.0分析数据.结果 共纳入9个RCT.相对于安慰剂对照组,试验组即穴位按压腕带作用于内关穴可以有效减少术后呕吐的发生率(RR=0.50,95%CI:0.37~0.66,P0.05).结论 术后护理中应用穴位按压腕带作用于内关穴可以有效缓解术后呕吐,而缓解术后恶心作用不显著,需要今后的研究者进行更加可靠的RCT试验进一步研究和探讨.护理人员可以引进穴位按压腕带进行有效性和适用性的研究.

  8. Research progress of midazolam in the prevention of postoperative nausea and vomiting%咪达唑仑用于预防术后恶心呕吐的研究进展

    Institute of Scientific and Technical Information of China (English)

    崔琦芬; 钱金桥

    2014-01-01

    Background As one of the short acting benzodiazepines,Midazolam is widely used as a premedicant before surgery,for antianxiety,and for conscious sedation.Objective This paper is made to give a overall statement on it.Content During these years,there are so many reports,at home and abroad,on midazolam's use as an anti-emetic to prevent and treat postoperative nausea and vomiting (PONV).Trend Hope in the near future,midazolam,as an antiemetic,will be widely used in clinical work.%背景 咪达唑仑作为一个短效的苯二氮(革)类药物,临床上广泛应用于抗焦虑、镇静和麻醉手术前用药. 目的 就咪达唑仑用于预防术后恶心呕吐(postoperative nausea and vomiting,PONV)进行综述. 内容 最近几年,国内外有许多关于咪达唑仑作为一个止吐药,预防和治疗PONV的研究报道. 趋向 期望在不久的将来,咪达唑仑作为一个止吐药广泛应用于临床工作中.

  9. 腹腔注射催吐剂后非呕吐动物大鼠脑内呕吐反应区Fos阳性神经元的表达%Expression of Fos positive neurons in vomiting reflex regions of brain in non-vomiting rats after intraperitoneal injection of emetic

    Institute of Scientific and Technical Information of China (English)

    孔哲; 季淑梅; 高萱; 陈应城; 管振龙

    2005-01-01

    10.3),(17.3±3.4),(78.8±10.5)].结论:催吐剂能使大鼠产生内脏不适,其中枢神经系统内可能存在着与呕吐动物相似的催吐区,但可能缺乏与呕吐相关的调节机制.催吐剂的刺激使大鼠脑内相关区域Fos阳性神经元数量增加,提示非呕吐动物大鼠脑内也存在类似与恶心相关的神经化学通路.%BACKGROUND: It is discovered by administrating different emetics to vomiting animals, like cats, that there are a large amount of Fos positive neuronal expressions in the arc region from nucleus of solitary tract, lateral tegmentum to ventrolateral area. And it has been viewed that the arc region from area postrema, nucleus of solitary tract to ventrolateral reticular structure is the main emetic region. Whether do the non-vomiting animals reflect in response or not after emetic injection?OBJECTIVE: To observe the distribution of Fos positive neurons in relevant emetic regions of brain and spinal cord in rats after abdominal injection of emetic, cisplatin.DESIGN: Randomized controlled experiment based on animals.SETTING: Neural Physiological Research Room of Life Science College in Hebei Normal University and Physiological Room of Basic Medicine Institute in Hebei Medical University.MATERIALS: The experiment was performed in Neural Physiological Research Room of Life Science College in Hebei Normal University and Physiological Room of Basic Medicine Institute in Hebei Medical University from March to August 2003. Twelve SD male rats were employed, body weighted varied from 220 to 250 g, of clean-grade. They were randomized into experimental group of 6 rats and the control of 6 rats.INTERVENTIONS: In experimental group, the emetic, cisplatin, was injected abdominally 10 mg/kg. In the control, the physiological saline of same dose was injected. Afterwards, the activity changes in rats were observed at room temperature, quiet and light-avoided environment. Six hours later, the brain tissue was collected for frozen

  10. Risk factors of nausea and vomiting syndrome after thyroidectomy%甲状腺术后患者发生恶心呕吐综合征的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    林义清; 黄英凯; 王雅燕

    2014-01-01

    目的:探讨甲状腺术后患者发生恶心呕吐综合征(symdrome of postoperative nausea and vomiting,SPNV)影响因素。方法对214例行甲状腺手术患者资料进行回顾性分析,了解患者SPNV发生及影响因素情况。结果术后发生SPNV 72例,发生率为33.64%;其中恶心发生率为100.00%,1度、2度、3度分别占47.22%、27.78%、25.00%;呕吐发生率为38.89%,轻度、中度、重度分别占32.14%、57.14%、10.71%;患者不同性别、吸烟史、麻醉方式与手术时间与患者术后发生SPNV具有相关性(均P<0.05);多因素分析结果显示,患者为女性、全麻麻醉方式、手术时间≥2 h是引起患者术后发生SPNV的独立危险因素(均P<0.05)。结论甲状腺手术患者术后SPNV发生率较高,女性、全麻麻醉方式及手术时间长是引起患者发生SPNV的独立危险因素。%Objective To investigate the risk factors of nausea and vomiting syndrome after thyroidectomy.Method The clinical data of 214 patients undergoing thyroidectomy were analyzed retrospectively to look into the risk factors.Results Seventy-two patients contracted nausea and vomiting syndrome after thyroidectomy,with an incidence of 33.64%.All of them had nausea of degrees 1,2 and 3,taking up 47.22%,27.78%and 25.00%,respectively.38.89%of them had vomiting of mild,intermediate and severe degrees, accounting for 32.14%,57.14% and 10.71%,respectively.Gender,smoking history,anesthesia and surgical duration were correlated with the syndrome(All P<0.05).Non-conditional Logistic regression analysis showed that female,general anesthesia, operative duration ≥2h were independent risk factors(all P<0.05).Conclusions Syndrome of nausea and vomiting after hyroidectomy has a higher incidence.Female,general anesthesia and surgical duration are independent risk factors.Interventional measures pertinent to these factors may reduce the incidence of nausea and vomiting syndrome after thyroidectomy.

  11. The effect of dexamethasone on post-tonsillectomy nausea, vomiting and bleeding Efeito da dexametasona sobre sangramento, vômito e náusea pós-amigdalectomia

    Directory of Open Access Journals (Sweden)

    Jochen P. Windfuhr

    2011-06-01

    Full Text Available It has been stated, that the administration of Dexamethasone has an impact on the morbidity following tonsillectomy. OBJECTIVE: To re-calculate the blood values for Dexamethasone when given as fixed doses and to evaluate the effect of Dexamethasone on post-operative nausea, vomiting and bleeding rates following tonsillectomy. MATERIALS AND METHODS: The charts of 272 children (2-15 years who had undergone tonsillectomy were analyzed. The rates of post-operative nausea, vomiting and bleeding in relation to Dexamethasone were calculated-in general and different doses (0 mg/kg, 0.15 mg/kg. STUDY DESIGN: Retrospective cohort study. RESULTS: Dexamethasone was administered in 121 children (43.7% according to the preference of the anesthesist (mean dose: 0.2 +/- 0.12 mg/kg; range: 0.04 - 0.62 mg/kg. There was no significant difference in nausea and vomiting (p=0.953 or bleeding (p=0.827 across groups receiving or not receiving Dexamethasone. Stratification into three different groups of Dexamethasone concentration also did not identify a dose-related risk of postoperative nausea or vomiting (p=0.98 or bleeding (p=0.71. CONCLUSION: At least under common non-controlled conditions in the clinic, Dexamethasone does not appear to have an effect on nausea or vomiting or bleeding following tonsillectomy.É conhecido o impacto da administração de dexametasona sobre a morbidade no pós-operatório de amigdalectomia. OBJETIVO: Recalcular os valores séricos para dexametasona quando administrada em doses fixas e avaliar seus efeitos sobre as taxas de náusea, vômito e sangramento no pós-operatório de amigdalectomia. MATERIAIS E MÉTODOS: Analisamos os prontuários de 272 crianças (idades entre 2-15 anos submetidas a amigdalectomias. As taxas de náusea, vômitos e sangramentos foram calculadas para a dexametasona em geral e em diferentes doses (0 mg/kg; 0,15 mg/ kg. TIPO DE ESTUDO: Coorte retrospectivo. RESULTADOS: A dexametasona foi administrada em 121

  12. 针刺内关穴预防腹腔镜胆囊切除术后恶心呕吐的疗效观察%Effect of Acupuncture at“Neiguang”in Preventing Nausea and Vomiting after Laparoscopic Cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To observe the effect of acupuncture at“Neiguan”in preventing nausea and vomiting after laparoscopic cho-lecystectomy. Methods 178 cases for selective laparoscopic cholecystectomy were randomly divided into 3 groups: control group (n=60), metoclopramide group (n=58) and acupuncture at“Neiguan”group (n=60); the curative effects at the time point of 4h, 8h, 12h and 24h after surgery were observed and compared. Results The occurrence of nausea and vomiting within 8 hours after surgery in metoclo-pramide group and acupuncture at“Neiguan”group was lower than that in control group and the scores of Nausea Visual Analog Scale (NVAS) in acupuncture at“Neiguan”group was lower than that in control group. Conclusions Acupuncture at“Neiguan”is effective in preventing the occurrence of nausea and vomiting after laparoscopic cholecystectomy, it shares the same effect with metoclopramide, and can decrease the severity of nausea.%  目的观察针刺内关穴预防术后恶心呕吐(PONV)的疗效。方法行腹腔镜胆囊切除手术患者178例,随机分为对照组(60例)、甲氧氯普胺组(58例)及针刺内关穴组(60例),于术后4h、8h、12h、24h随访,进行疗效对比。结果在术后8h内甲氧氯普胺组和针刺内关穴组恶心呕吐发生率均较对照组低,针刺内关穴组恶心程度的视觉模拟评分(NVAS)较对照组低。结论针刺内关穴可预防腹腔镜胆囊切除术后恶心呕吐,与甲氧氯普胺等效,还可降低恶心程度。

  13. Prevenção e tratamento de náuseas e vômitos no período pós-operatório Prevention and treatment of postoperative nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Naegeli Gondim

    2009-03-01

    Full Text Available Náuseas e vômitos pós-operatórios são comuns e podem ser evitados. Complicações provenientes deste problema acarretam aumento de morbi-mortalidade. Foi realizada revisão de literatura no MEDLINE, com foco em estudos clínicos controlados. A fisiopatologia é complexa, com várias vias centrais aferentes e eferentes, e seu entendimento ajuda na escolha das medicações. Fatores de risco são apresentados, com escala de estratificação de chance para desenvolvimento de náuseas e vômitos pósoperatórios. Algoritmo para abordagem de pacientes com maior risco foi elaborado e estratifica nível de prevenção/tratamento a ser recebido, de modo a evitar uso excessivo de drogas e seus paraefeitos. Náuseas e vômitos pós-operatórios devem ser prevenidos, pois acarretam complicações e desconforto nos pacientes. Abordagem sistemática com análise de fatores de risco per-operatórios e prescrição de medicações podem ser eficazes para sua prevenção.Postoperative nausea and vomiting are common and can be prevented. Complications of this condition cause higher rates of morbidity and mortality. A review of literature was carried out on MEDLINE, with focus on controlled clinical trials. Pathophysiology is complex, with many afferent and efferent pathways, and its comprehension facilitate the choice of medication. Risk factors are presented, with a stratified score of chance to develop postoperative nausea and vomiting. An algorithm for identification of higher risk patients was elaborated and classified the level of prevention/treatment recommended to avoid excessive use of drugs and their side effects. Postoperative nausea and vomiting must be prevented, because of the involved complications and discomfort for patients. A systematic approach with analysis of preoperative risk factors and prescription of medication can be effective for prevention.

  14. Influence of abdomenal hot compress combined to diet intervention on nausea and vomiting of liver cancer patients after undergoing interventional treatment%腹部热敷联合饮食干预对肝癌介入术后病人恶心、呕吐的影响

    Institute of Scientific and Technical Information of China (English)

    尹秀芬; 尹旭明; 谭李军; 唐桂香; 罗革

    2013-01-01

    介绍了恶心、呕吐的定义及分级,对介入术后恶心、呕吐及胃痛的原因进行分析,从药物、腹部热敷、饮食干预方面对肝癌介入术后病人恶心、呕吐的影响进行综述.%It introduced the definition and classification of nausea and vomiting, and analyzed the causes of nausea and vomiting and stomach ache after the intervention,and reviewed the influence on nausea and vomiting of liver cancer patients after undergoing interventional treatment from aspects of drug,abdomenal hot compress and diet interventions.

  15. 双联抗呕吐方案在腹腔镜术后呕吐预防中的应用研究%Research of applied double anti-vomiting scheme in preventing and treatment postoperative nausea and vomiting ;after laparoscopic operation

    Institute of Scientific and Technical Information of China (English)

    鲁斌; 杨一唯; 王海明

    2015-01-01

    目的:探讨5-羟色胺(5-HT3)受体拮抗剂昂丹司琼与多巴胺受体拮抗剂甲氧氯普安联合应用在防止腹腔镜手术后呕吐中的效果。方法选取腹腔镜胆囊切除手术263例患者为研究对象,按知情自愿的原则分为昂丹司琼+甲氧氯普安组(双联组,95例),单用昂丹司琼(5-HT组,87例)和单用甲氧氯普安(胃复安组,81例),分析并比较三组患者术后48 h内呕吐和并发症的发生率。结果双联组患者完全控制率84.21%,缓解率13.68%,无效率2.11%;5-HT组患者完全控制率、缓解率、无效率分别为:71.26%、19.54%和9.20%;胃复安组分别为:55.56%、33.33%和11.11%。双联组完全控制率明显高于5-HT组和胃复安组,差异有统计学意义(χ2=4.43、17.44,P均<0.05),且双联组总有效率显著高于其余两者(χ2=4.30、6.05,P均<0.05)。虽然5-HT组的完全控制率较胃复安组明显升高(χ2=4.47,P<0.05),但是两组总有效率比较差异无统计学意义(χ2=0.16,P>0.05)。所有患者治疗后均未观察到明显并发症发生。结论在腹腔镜术后呕吐的预防和治疗中,联合使用昂丹司琼和甲氧氯普安不仅未增加不良反应发生率,且治疗效果明显高于两药单独使用。%Objective To study the effect of 5-HT3 receptor antagonist ondansetron combined with dopamine receptor antagonists metoclopramide on preventing postoperative nausea and vomiting(PONV) after laparoscopic operation. Methods A total of 263 patients accepted laparoscopic operation under general anesthesia were enrolled. According to the principle of voluntarines and legitimacy,they were divided into three groups,ondansetron joined metoclopramide(combination group, 95 cases),ondansetron(5-HT group, 87 cases) and metoclopramide group(81 cases). The vomiting and complication rates in 48 hours after operation were analyzed. Results In combination group,the complete

  16. Study of music intervention on expected nausea and vomiting during chemotherapy of ovarian cancer%音乐干预对卵巢癌化疗患者预期性恶心和呕吐的影响研究

    Institute of Scientific and Technical Information of China (English)

    刘惠茹; 陈桂华; 陈素兰; 吴志云; 张桂荣

    2012-01-01

    Objective To investigate the music intervention in patients with ovarian cancer who had expected nausea and vomiting.Methods Sixty-six cases of patients with expected nausea and vomiting of grade Ⅱ and Ⅲ music class were randomly divided into intervention and control group,with 33 cases in each group.Patients in intervention group accepted conventional treatment plus music intervention with their favorite music,while patients in control group accepted only conventional treatment.Results The incidence and the level of expected nausea and vomiting in intervention group were significantly lower than those in control group [(3.18 ±0.31) scores vs(2.33 ± 0.24)scores,P < 0.01].Condusions Music intervention can reduce expected nausea and vomiting during chemotherapy of ovarian cancer.It can be used to improve patients quality of life during chemotherapy.%目的 探讨音乐干预对卵巢癌化疗患者预期性恶心和呕吐的影响.方法 将我院收治的66例卵巢癌预期性恶心和呕吐Ⅱ级和Ⅲ级患者完全随机分为音乐干预组和对照组,每组33例.对照组采用常规治疗,音乐干预组在常规治疗的基础上加用音乐干预.结果 对照组呕吐分级多集中Ⅰ、Ⅱ级[分别为15例(45.5%)、12例(36.4%)],呕吐级别评分为(2.33±0.24)分;而音乐干预组经过音乐干预后呕吐分级多集中在0、Ⅰ级[分别为11例(33.3%)、18例(54.5%)],呕吐级别评分为(3.18±0.31)分.音乐干预组预期性恶心和呕吐发生率和级别明显低于对照组,2组比较差异有统计学意义(P<0.01).结论 音乐干预能减少和降低卵巢癌化疗患者预期性恶心和呕吐的程度,提高患者在化疗期间的生活质量.

  17. Comparison of the Prophylactic Antiemetic Efficacy of Aprepitant Plus Palonosetron Versus Aprepitant Plus Ramosetron in Patients at High Risk for Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy: A Prospective Randomized-controlled Trial.

    Science.gov (United States)

    Choi, Eun Kyung; Kim, Dong Gyeong; Jeon, Younghoon

    2016-10-01

    We compared the antiemetic efficacy of aprepitant plus palonosetron versus aprepitant plus ramosetron in patients after laparoscopic cholecystectomy. A total of 88, nonsmoking, female patients undergoing laparoscopic cholecystectomy were randomly allocated to 2 groups of 44 each who received palonosetron 0.075 mg (aprepitant plus palonosetron group) and ramosetron 0.3 mg (aprepitant plus ramosetron group) after induction of anesthesia. All patients received aprepitant 80 mg 2 hours before surgery. The incidence of postoperative nausea and vomiting (PONV), use of rescue antiemetic, pain severity, and any side effects were assessed for 24 hours after surgery. The incidence of PONV and use of rescue antiemetic were less in aprepitant plus palonosetron group than in aprepitant plus ramosetron group for 24 hours after surgery (Pplus palonosetron significantly prevents PONV, compared with aprepitant plus ramosetron in patients at high risk for PONV after laparoscopic cholecystectomy.

  18. Efficacy and safety of casopitant mesylate, a neurokinin 1 (NK1)-receptor antagonist, in prevention of chemotherapy-induced nausea and vomiting in patients receiving cisplatin-based highly emetogenic chemotherapy: a randomised, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Grunberg, Steven M; Rolski, Janusz; Strausz, Janos

    2009-01-01

    was the proportion of patients achieving complete response (no vomiting, retching, or use of rescue medications) in the first 120 h after receiving HEC. Efficacy analysis was done on the modified intention-to-treat population (n=800), which included all patients who received placebo or study drug and HEC (n=265...... casopitant group achieved complete response in cycle 1 of HEC treatment than did those in the control group (175 [66%] patients in the control group, 228 [86%] in the single-dose oral casopitant mesylate group [p... (p=0.0004 vs control]). This improvement was sustained over multiple cycles of HEC. Adverse events occurred in 205 (77%) patients in the single-dose oral casopitant mesylate group and 203 (75%) patients in the 3-day intravenous and oral casopitant mesylate group compared with 194 (73%) of patients...

  19. Clinical Observation on Dingchen Touge Powder for Delayed Chemotherapy-induced Vomiting%丁沉透膈散治疗化疗延迟呕吐临床观察

    Institute of Scientific and Technical Information of China (English)

    陈鹏飞; 陈红侠

    2013-01-01

    Objective:To investigate the therapeutic effect of Dingchen Touge powder for chemotherapy induced gastrointestinal reaction . Methods:A total of 136 patients with delayed chemotherapy-induced vomiting were randomly divided into two groups , in chemotherapy cycle, treatment group was given Dingchen Touge powder orally;while control group was given methoxychlor tome amine and dexametha -sone.Clinical effect and adverse reaction in two groups were observed and compared .Results:The effect for symptoms of anorexia , nau-sea and vomiting in treatment group was obviously superior to control group , and the difference was statistically significant (P<0.05). Conclusion:Dingchen Touge powder has good comprehensive effect on chemotherapy -induced gastrointestinal reaction , and is worthy to be clinically popularized and applied .%目的:观察中药丁沉透膈散治疗肿瘤化疗所致消化道反应的疗效。方法:将136例化疗所致延迟呕吐的患者随机分为2组,在化疗周期中实验组以中药丁沉透膈散汤剂口服;对照组予甲氧氯普胺+地塞米松,比较2组的临床效果与药物不良反应。结果:实验组在治疗食欲不振、抑制恶心、呕吐等方面明显优于对照组,差异有统计学意义(P值均小于0.05)。结论:中药丁沉透膈散防治化疗药物所致消化道反应综合疗效较好,值得临床推广应用。

  20. Acupuncture and PC6 stimulation for the prevention of postoperative nausea and vomiting in patients undergoing elective laparoscopic resection of colorectal cancer: a study protocol for a three-arm randomised pilot trial

    Science.gov (United States)

    Kim, Kun Hyung; Kim, Dae Hun; Bae, Ji Min; Son, Gyung Mo; Kim, Kyung Hee; Hong, Seung Pyo; Yang, Gi Young; Kim, Hee Young

    2017-01-01

    Introduction This study aims to assess the feasibility of acupuncture and a Pericardium 6 (PC6) wristband as an add-on intervention of antiemetic medication for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing elective laparoscopic colorectal cancer resection. Methods and analysis A total of 60 participants who are scheduled to undergo elective laparoscopic resection of colorectal cancer will be recruited. An enhanced recovery after surgery protocol using standardised antiemetic medication will be provided for all participants. Participants will be equally randomised into acupuncture plus PC6 wristband (Acupuncture), PC6 wristband alone (Wristband), or no acupuncture or wristband (Control) groups using computer-generated random numbers concealed in opaque, sealed, sequentially numbered envelopes. For the acupuncture combined with PC6 wristband group, the embedded auricular acupuncture technique for preoperative anxiolysis and up to three sessions of acupuncture treatments with manual and electrical stimulation within 48 hours after surgery will be provided by qualified Korean medicine doctors. The PC6 wristband will be applied in the Acupuncture and Wristband groups, beginning 1 hour before surgery and lasting 48 hours postoperatively. The primary outcome will be the number of participants who experience moderate or severe nausea, defined as nausea at least 4 out of 10 on a severity numeric rating scale or vomiting at 24 hours after surgery. Secondary outcomes, including symptom severity, participant global assessments and satisfaction, quality of life, physiological recovery, use of medication and length of hospital stay, will be assessed. Adverse events and postoperative complications will be measured for 1 month after surgery. Ethics and dissemination All participants will provide written informed consent. The study has been approved by the institutional review board (IRB). This pilot trial will inform a full

  1. Prevention and Treatment of Palonosetron and Dexmedetomidine for Laparoscopic Postoperative Nausea and Vomiting%帕洛诺司琼联合右美托咪定对腹腔镜术后恶心呕吐的预防与治疗

    Institute of Scientific and Technical Information of China (English)

    郝聚达; 于松杨; 张克艳

    2016-01-01

    Objective To discuss the effect of palonosetron and dexmedetomidine for the prevention and treatment of postoperative nausea and vomiting after laparoscopic surgery.Methods Comparative analysed preventive effect on postoperative nausea and vomiting in control group (n=50, dexmedetomidine) and study group (n=50, palonosetron and dexmedetomidine).Results The study group had better effect (P<0.05), a lower incidence of postoperative nausea and vomiting.Conclusion Palonosetron and dexmedetomidine used to prevent and treat postoperative nausea and laparoscopic vomiting have good effect.%目的:分析腹腔镜手术采取帕洛诺司琼联合右美托咪定预防与治疗术后恶心呕吐的效果。方法对比对照组(n=50,右美托咪定处理)与研究组(n=50,帕洛诺司琼联合右美托咪定处理)对术后恶心呕吐的预防效果。结果研究组效果更优(P<0.05),即术后恶心呕吐发生率更低。结论帕洛诺司琼联合右美托咪定预防与治疗腹腔镜术后恶心呕吐效果良好。

  2. PROSPECTIVE, RANDOMIZED, DOUBLE BLIND STUDY TO COMPARE THE EFFICACY AND SAFETY OF GRANISETRON VERSUS ONDANSETRON IN PREVENTION OF POST OPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Vijayalakshmi

    2015-09-01

    Full Text Available OBJECTIVE : To compare the efficacy and safety of Granisetron versus Ondansetron in prevention of post - operative nausea and vomiting in patients undergoing elective Laparoscopic Cholecystectomy under general anaesthesia. MATERIALS AND METHODS: After the approval from IEC, the study was started and conducted over a period of two years i.e., from 2010 - 2012. Data was c ollected from 100 ASA I and II patients scheduled for laparoscopic cholecystectomy aged between 20 - 60 years at Government General Hospital, Kakinada. Both the study groups were selected from these patients. Written informed consent was taken from all patie nts . Preanesthetic medication was given with Ranitidine 150mg and Lorazepam 1mg, the night before and morning of surgery. Patients were randomly allocated into 2 groups. Group A - R eceived Inj. Ondansetron 8mg diluted in 5ml of normal saline . Group B - R ec eived Inj. Granisetron 1mg diluted in 5ml of normal saline . INJ. Glycopyrolate 0.01mg/kg & INJ. Fentanyl (1 - 2μ/Kg given intravenously 5min prior to induction of anaesthesia. All the vital data values recorded before & throughout surgery at 15 min interval for 2 hours. Patients were observed at 0 - 2hrs, 2 - 6hrs, 6 - 12hrs post operatively for episodes of PONV. RESULTS: At the end of the study , a complete response i.e., no PONV and no need for another rescue antiemetic was attained in 92 % of patients who received Granisetron and 68% of patients who received Ondansetron. No differences in adverse events were observed in the two groups. CONCLUSION: The incidence of PONV after laparoscopic cholecystectomy is large. In view of the proven advan tage of serotonin antagonists, we decided to study the antiemetic efficacy of Granisetron. After premedication, patients were administered the study drugs intravenously prior to the induction and balanced general anaesthesia was administered. Patients were observed for nausea and vomiting after the procedure at 0 - 2hrs, 2 - 6

  3. Palonosetron versus other 5-HT₃ receptor antagonists for prevention of chemotherapy-induced nausea and vomiting in patients with hematologic malignancies treated with emetogenic chemotherapy in a hospital outpatient setting in the United States.

    Science.gov (United States)

    Craver, Chris; Gayle, Julie; Balu, Sanjeev; Buchner, Deborah

    2011-01-01

    This study evaluated the rate of uncontrolled chemotherapy-induced nausea and vomiting (CINV) after initiating antiemetic prophylaxis with palonosetron versus other 5-HT₃ receptor antagonists (RAs) in patients diagnosed with hematologic malignancies (lymphoma and leukemia) and receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC) in a hospital outpatient setting. Patients aged ≥ 18 years and diagnosed with hematologic malignancies initiating HEC or MEC and antiemetic prophylaxis with palonosetron (Group 1) and other 5-HT₃ RAs (Group 2) for the first time in a hospital outpatient setting between 4/1/2007 and 3/31/2009 were identified from the Premier Perspective Database. Within each cycle, CINV events were identified (in the hospital outpatient, inpatient, and emergency room settings) through ICD-9 codes for nausea, vomiting, and/or volume depletion (from each CT administration day 1 until the end of the CT cycle), or use of rescue medications (day 2 until the end of the CT cycle). Negative binomial distribution generalized linear multivariate regression model estimating the CINV event rate on CT, specific CT cycles, and cancer diagnosis (leukemia/lymphoma)-matched groups in the follow-up period (first of 8 cycles or 6 months) was developed. Of 971 identified patients, 211 initiated palonosetron (Group 1). Group 1 patients comprised of more females [50.2 vs. 41.4%; p = 0.0226], Whites [74.4 vs. 70.4%, and Hispanics [7.6 vs. 6.3%; all races p = 0.0105], received more HEC treatments [89.6 vs. 84.2%; all CT types p = 0.0129], and had more lymphoma diagnosed patients [89.6 vs. 76.3%; all cancer types p = 0.0033] at baseline. After controlling for differences in several demographic and clinical variables, the regression model predicted a 20.4% decrease in CINV event rate per CT cycle for Group 1 versus Group 2 patients. Study limitations include potential lack of generalizability, absence of data on certain

  4. Chemotherapy-induced nausea and vomiting and antiemetic prophylaxis with palonosetron versus other 5-HT3 receptor antagonists in patients with cancer treated with low emetogenic chemotherapy in a hospital outpatient setting in the United States.

    Science.gov (United States)

    Schwartzberg, Lee; Morrow, Gary; Balu, Sanjeev; Craver, Chris; Gayle, Julie; Cox, David

    2011-08-01

    The incidence of overall (acute and delayed) chemotherapy-induced nausea and vomiting (CINV) events among patients treated with single- and multi-day low emetogenic chemotherapy (LEC) is not well established. We studied a cohort of patients receiving LEC and antiemetic prophylaxis with palonosetron (Group 1) versus other 5-HT(3) receptor antagonists (5-HT(3)-RAs) (Group 2), to determine the overall rate of CINV and the proportion of patients experiencing delayed CINV (days 2-7 of a CT cycle) in a hospital outpatient setting. Patients aged ≥18 years with cancer diagnosis initiating single-day and multi-day LEC for the first time between 4/1/2007 and 3/31/2009 were identified from the Premier Perspective database. CINV events (ICD-9-CM codes for nausea, vomiting, or volume depletion or CINV-related rescue medications) were assessed descriptively. A generalized linear multivariate regression model was developed, estimating the overall CINV event rate among Group 1 and 2 patients in the follow-up period (first of eight chemotherapy [CT] cycles or 6 months). In the follow-up period, out of a total of 10,137 overall CINV events (single-day and multi-day LEC), 8783 events (86.6%) were identified in single-day LEC treated patients. Within single-day LEC treated events, in the first cycle, of 3184 events, 2996 (94.1%) events were delayed. Average number of delayed events per patient remained consistent throughout the eight cycles (3.1 [1st cycle] vs. 2.9 [8th cycle]; P = 0.842]). Among 2439 patients on antiemetic prophylaxis with a 5-HT(3)-RA, 10.1% (n = 247) initiated palonosetron. Regression analysis indicated that Group 1 patients (versus Group 2) had a 15.2% reduction in CINV event rate per CT cycle; P = 0.0403. Study limitations include potential lack of generalizability, absence of data on certain confounders including alcohol consumption and prior history of motion sickness, potential underestimation of incidence of uncontrolled CINV, and inability to

  5. Use oropharyngeal snorkel and applied when comparing two clear airway vomiting methods%使用口咽通气管并发生呕吐时两种清理呼吸道方法的应用比较

    Institute of Scientific and Technical Information of China (English)

    梁佳

    2015-01-01

    Objective: To investigate patients with oropharyngeal snorkel vomiting, two clear airway approach and compare the clinical effect. Methods: First Affiliated Hospital of Guangxi Medical University Emergency Department in October 2011 - October 2014 diagnosis and treatment of consciousness and placed oropharyngeal snorkel ventilatory treatment, 60 patients vomiting during use oropharyngeal snorkel, randomly divided into control group of 30 patients, 30 cases of the observation group, take two methods to clean up the respiratory tract and compare application results. Results: The method of application of the clear airway take effect than the control group. Conclusion: The study group used a better method to clean up the respiratory tract, the operation success rate, fewer patient complications, reduce the difficulty of the operation, the operation time is shortened, and reduce costs.%目的:探讨使用口咽通气管的患者发生呕吐时,两种清理呼吸道的方法,并比较临床应用效果。方法:选取广西中医药大学第一附属医院急诊科2011年10月~2014年10月诊治的意识障碍并放置口咽通气管进行通气救治,在使用口咽通气管期间发生呕吐的患者60例,随机分为对照组30例,观察组30例,采取两种方法清理呼吸道并比较应用效果。结果:观察组所采取清理呼吸道方法应用效果优于对照组。结论:观察组所采用清理呼吸道方法较好,其操作成功率高、病人出现并发症少、操作难度降低、操作时间缩短、成本降低。

  6. 以呕吐、腹痛为急诊症状患儿的临床分析%Clinical analysis of children with acute symptoms of vomiting and abdominal pain

    Institute of Scientific and Technical Information of China (English)

    王林霞; 李昌崇; 单小鸥

    2010-01-01

    Objective To provide the practical basis for clinical diagnosis and treatment of patients who were admitted by green channel because of vomiting and abdominal pain. Method 268 cases with vomiting andabdominal pain ( from January 2007 to December 2008 ) who were admitted into the emergency observation unit through green channel were retrospectively analyzed, and various risk factors were considered with logistic regression model. Result Among 268 cases, 34 kinds of different diseases were found,while gastrointestinal diseases were the greatest proportion [60. 1% (161/268)] and gastroenteritis was most common reason 77.6%( 125/161 ). Between different age groups ( ≤ 3-year-old group and>3-yearold group), the overall incidence of various diseases and the profile of disease was different (P3岁组)病种分布及各种疾病总体发病率不同(P<0.05),其中在消化道疾病、感染性疾病及外科疾病发病率上两组之间差异有统计学意义(P<0.05).住院组患儿年龄、发热、皮疹、休克、症状持续时间<1 d、血常规、肝功能、血Na+、血/尿淀粉酶及ECG异常率与非住院组比较,差异均有统计学意义(P<0.05).logistic回归分析,除血常规外,其余8项差异均为住院发生的高危因素,并得出各变量的OR值和95%可信区间.结论 以呕吐、腹痛为主诉患儿中以消化道系统疾病发病率最高;≤3岁患儿中感染性疾病及外科性疾病发病率高,伴发热、休克及实验室检查如肝功能、血Na+、血/尿淀粉酶、心电图异常时可引起较高的住院率.

  7. Addition of the Neurokinin-1-Receptor Antagonist (RA) Aprepitant to a 5-Hydroxytryptamine-RA and Dexamethasone in the Prophylaxis of Nausea and Vomiting Due to Radiation Therapy With Concomitant Cisplatin

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    Jahn, Franziska, E-mail: franziska.jahn@uk-halle.de [Department of Hematology/Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Riesner, Anica [Department of Gastroenterology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Jahn, Patrick [Nursing Research Unit, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Sieker, Frank; Vordermark, Dirk [Department of Radiation Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Jordan, Karin [Department of Hematology/Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany)

    2015-08-01

    Purpose: To assess, in a prospective, observational study, the safety and efficacy of the addition of the neurokinin-1-receptor antagonist (NK1-RA) aprepitant to concomitant radiochemotherapy, for the prophylaxis of radiation therapy–induced nausea and vomiting. Patients and Methods: This prospective observational study compared the antiemetic efficacy of an NK1-RA (aprepitant), a 5-hydroxytryptamine-RA, and dexamethasone (aprepitant regimen) versus a 5-hydroxytryptamine-RA and dexamethasone (control regimen) in patients receiving concomitant radiochemotherapy with cisplatin at the Department of Radiation Oncology, University Hospital Halle (Saale), Germany. The primary endpoint was complete response in the overall phase, defined as no vomiting and no use of rescue therapy in this period. Results: Fifty-nine patients treated with concomitant radiochemotherapy with cisplatin were included in this study. Thirty-one patients received the aprepitant regimen and 29 the control regimen. The overall complete response rates for cycles 1 and 2 were 75.9% and 64.5% for the aprepitant group and 60.7% and 54.2% for the control group, respectively. Although a 15.2% absolute difference was reached in cycle 1, a statistical significance was not detected (P=.22). Furthermore maximum nausea was 1.58 ± 1.91 in the control group and 0.73 ± 1.79 in the aprepitant group (P=.084); for the head-and-neck subset, 2.23 ± 2.13 in the control group and 0.64 ± 1.77 in the aprepitant group, respectively (P=.03). Conclusion: This is the first study of an NK1-RA–containing antiemetic prophylaxis regimen in patients receiving concomitant radiochemotherapy. Although the primary endpoint was not obtained, the absolute difference of 10% in efficacy was reached, which is defined as clinically meaningful for patients by international guidelines groups. Randomized phase 3 studies are necessary to further define the potential role of an NK1-RA in this setting.

  8. Total Intravenous Anaesthesia with High-Dose Remifentanil Does Not Aggravate Postoperative Nausea and Vomiting and Pain, Compared with Low-Dose Remifentanil: A Double-Blind and Randomized Trial

    Directory of Open Access Journals (Sweden)

    Seong-Hyop Kim

    2014-01-01

    Full Text Available The study was designed to investigate postoperative nausea and vomiting (PONV in low- and high-dose remifentanil regimens for total intravenous anaesthesia (TIVA in adult female patients with American Society of Anaesthesiologists physical status classification I undergoing local breast excision. Propofol and remifentanil 5 ng·mL−1 (L group or 10 ng·mL−1 (H group were administered for anaesthesia induction and maintenance. Propofol was titrated within range of 0.1 μg·mL−1 to maintain bispectral index (BIS values between 40 and 60. Haemodynamic parameters during the intra- and postoperative periods and 24 h postoperative visual analogue scale (VAS and PONV were evaluated. Each group with 63 patients was analyzed. The H group showed higher use of remifentanil and lower use of propofol, with similar recovery time. Mean systemic arterial blood pressure (MBP, heart rate, and BIS did not differ significantly before and after endotracheal intubation in the H group. However, significant increases in MBP and BIS were apparent in the L group. Postoperative VAS, PONV incidence and scale, and Rhodes index did not differ significantly between the two groups. In conclusion, TIVA with high-dose remifentanil did not aggravate PONV with similar postoperative pain, compared with low-dose remifentanil. Furthermore, high-dose remifentanil showed more haemodynamic stability after endotracheal intubation. This trial is registered with KCT0000185.

  9. Comparison of incidence of postoperative nausea and vomiting (PONV between children of smoker parent and children of non-smoker parents after surgery in Imam Khomeini and Children Medical Center Hospitals

    Directory of Open Access Journals (Sweden)

    Ghazi Saeidi K

    2001-10-01

    Full Text Available Postoperative nausea and vomiting is a common complication that all anesthesiologist are familiar with the problems of its consequences. Although continued research on the recognition of factors affecting the incidence of PONV is being done but they are not sufficient and the need for research along with advances in anesthesiology and newer drugs are considered. In this prospective cohort study 400 children of 3 to 12 age who has been operated for general surgery (other than eye, thorax and upper abdomen and orthopedic surgery in the Imam Khomeini and Children Medical Center Hospital has been evaluated. Of these, 200 children who had smoking parent and according to definition were passive smokers and the other 200 children had no smoking parents. Both the groups were matched for sex, age, and type of operation. With the analysis of data we noted that the incidence of PONV in both groups was 19.5 and there was no significant difference between the two groups. (Passive smoker 19 percent and non-passive smoker 20 percent. We also noted a relation between the duration and the incidence of PONV. So operation with more than 2 hours had higher incidence of PONV. There was also positive relation between PONV and controlled ventilation. However, there was no significant difference as the sex and type of operation was concerned. In conclusion, children of smoker parents suffer more PONV than children of non-smoker parents if operation takes longer than two hours or the patient is mechanically ventilated during operation.

  10. Evaluation of Pentravan(®), Pentravan(®) Plus, Phytobase(®), Lipovan(®) and Pluronic Lecithin Organogel for the transdermal administration of antiemetic drugs to treat chemotherapy-induced nausea and vomiting at the hospital.

    Science.gov (United States)

    Bourdon, F; Lecoeur, M; Leconte, L; Ultré, V; Kouach, M; Odou, P; Vaccher, C; Foulon, C

    2016-12-30

    The objective of this study was to evaluate five commercial ready-to-use transdermal vehicles (Phytobase(®), Lipovan(®), Pentravan(®), Pentravan(®) Plus and Pluronic Lecithin Organogel (PLO)), for the compounding of three antiemetic drugs (ondansetron, dexamethasone and aprepitant) and their administration in combination to treat chemotherapy-induced nausea and vomiting (CINV) at the hospital. Drugs were individually formulated in these vehicles and in mixture in Pentravan(®) Plus using different penetration enhancers. Quality control of the forms has demonstrated that formulation process was mastered and convenient for the hospital (time required: 20min). Diffusion experiments through synthetic membranes and pig ear epidermis performed using Franz-type diffusion cells, have shown that the release and permeation process were greater for ondansetron than for dexamethasone and aprepitant, with a release step not limiting. As permeation of aprepitant was too low, it was discarded of the study. When ondansetron and dexamethasone were compounded in combination in Pentravan(®) Plus, the most efficient vehicle, a permeation decrease was observed. Finally, the use of tween 20 instead of EtOH as chemical enhancer has led to 2-fold factor increase in the flux of dexamethasone, resulting in fluxes convenient for transdermal administration of ondansetron to a child, but insufficient for an adult and for dexamethasone.

  11. The Efficacy of Palonosetron for Prevention of Concurrent Radiochemotherapy Induced Nausea and Vomit in Patients with Locally Advanced Nasopharyngeal Carcinoma%帕洛诺司琼在局部晚期鼻咽癌同步放化疗中止吐作用研究

    Institute of Scientific and Technical Information of China (English)

    童琴; 何振宇; 孙家媛; 李凤岩; 管迅行

    2012-01-01

    [目的]观察帕洛诺司琼在局部晚期鼻咽癌同步放化疗中的止吐疗效.[方法] 54例采用每周顺铂方案进行同步放化疗的局部晚期鼻咽癌患者随机分为帕洛诺司琼组和托烷司琼组,比较两组患者恶心、呕吐及其他不良反应的发生情况.[结果]帕洛诺司琼组和托烷司琼组急性恶心和急性呕吐发生率无明显差异(P>0.05);而延迟性恶心和呕吐发生率帕洛诺司琼组(78.91% 、62.50%)均低于托烷司琼组(88.37% 、80.62%)( P<0.05).其他不良反应包括便秘、腹胀、头痛及头晕,两组无明显差异(P>0.05).[结论]帕洛诺司琼能有效预防局部晚期鼻咽癌同步放化疗引起的恶心呕吐,尤其对迟发性呕吐有较好的治疗效果.%[Purpose] To investigate the efficacy of palonosetron for prevention of concurrent ra-diochemotherapy induced nausea and vomit in patients with locally advanced nasopharyngeal carcinoma. [Methods] Fifty-four cases with locally advanced nasopharyngeal carcinoma were randomly divided into palonosetron group and tropisetron group. The incidence rates of nausea, vomit and other side effects were observed and calculated.[Results] Incidence rates of acute nausea and acute vomit had no significant difference between palonosetron group and tropisetron group (P>0.05), while the incidence rates of chronic nausea and chronic vomit were lower in palonosetron group (78.91% and 62.50%) than that in tropisetron group(88.37% and 80.62%)(P0.05). [Conclusion] Palonosetron is effective for prevention of nausea and vomit induced by concurrent ra-diochemotherapy in patients with locally advanced nasopharyngeal carcinoma, especially for prevention of chronic nausea and vomit.

  12. 神经外科患者麻醉恢复期恶心呕吐的情况分析及护理%Incidence and nursing of postoperative nausea and vomiting following neurosurgery in the postanesthesia care unit

    Institute of Scientific and Technical Information of China (English)

    侯春梅; 张雪梅; 王会文; 韩如泉

    2012-01-01

    Objective To analyze incidence and nursing strategies of postoperative nausea and vomiting after different neurosurgery in the postanesthesia care unit (PACU).Methods 5 078 adult patients who had undergone neurosurgery enrolled into PACU were retrospectively investigated. The incidence and nursing strategies of postoperative nausea and vomiting were analyzed.Results The overall incidence of PONV following neurosurgery was 15.7% (798 cases).The incidence of PONV in patients undergoing craniopharyngioma was 28.4% ( 25/88),ventricular tumor 26.7% (35/131 ),infratentorial craniotomy 24.2% ( 157/650),intracranial aneurysm and arteriovenous malformation 20.8% (87/4 i 8 ),supratentorial tumor 19.3% (297/1 535 ),epilepsy 15.8% ( 16/101 ),transsphenoidal surgery of pituitary tumor 8.8% ( 88/991 ),spinal cord tumor 8.4%(52/619) and others 7.5% respectively.Conclusions The overall incidence of PONV in PACU following neurosurgery was approximately 16%.These results indicate that the incidence of PONV following neurosurgery is different and craniopharyngioma,ventricular tumor and posterior fossa tumor are high risk for PONV.Nursing strategies for the prevention of PONV following neurosurgery are required.%目的 探讨不同神经外科手术患者麻醉恢复期恶心呕吐的发生情况及护理对策.方法 回顾性分析5078例神经外科手术患者的临床资料,对其麻醉恢复期恶心呕吐的发生情况及护理对策进行总结.结果 5078例神经外科患者中,麻醉恢复期发生恶心呕吐798例,发生率为15.7%.其中颅咽管瘤组28.4%(25/88)、脑室肿瘤组26.7% (35/131)、后颅窝肿瘤组24.2% (157/650)、脑血管病组20.8%(87/418)、幕上肿瘤组19.3%(297/1535)、癫痫组15.8%( 16/101)、经蝶垂体瘤组8.8%(88/991)、脊髓肿瘤组8.4%(52/619).全部病例经及时治疗和护理均得到有效控制.结论 神经外科不同部位的手术患者麻醉恢复期恶心呕吐的发生情况不

  13. 水果芳香疗法对缓解妇癌患者常用化疗药物后恶心呕吐反应的观察%Clinical Analysis of Nausea and Vomiting in Gynecologic Cancer Patients Commonly Used Chemotherapeutic Drugs after the Fruit Aroma Therapy to Alleviate

    Institute of Scientific and Technical Information of China (English)

    张吴花; 史迎春

    2014-01-01

    目的:通过对妇科恶性肿瘤患者化疗时采用水果芳香疗法,探讨水果芳香疗法对改善化疗过程中恶心呕吐反应的应用价值。方法随机选择45例已经过1~3疗程化疗的妇科肿瘤患者,在临床常用化疗药物治疗的基础上配合水果芳香的使用,观察患者恶心呕吐反应的改善情况。结果水果芳香疗法可以有效改善妇科肿瘤患者化疗过程中的恶心呕吐反应。结论水果芳香疗法经济实惠,可以有效改善化疗过程中的恶心呕吐反应,减轻患者痛苦。%Objective To investigate value of the use of fruits aromatherapy when patients with gynecologic malignancies in chemotherapy to improve nausea and vomiting during chemotherapy response. Methods We randomly selected 45 cases with gynecological cancer who have received 1 to 3 cycles of chemotherapy to observe improvement of nausea and vomiting based on clinical commonly used chemotherapy drugs with fruit aroma of use. Results Fruit aromatherapy can ef ectively improve nausea and vomiting to gynecological cancer patients in chemotherapy. Conclusion Fruit aromatherapy is af ordable,it can be ef ective in improving nausea and vomiting during chemotherapy and al eviate the suf ering of patients.

  14. 内关穴揿针防治胃镜检查所致恶心、呕吐的临床研究%Clinical Study of Point Neiguan Thumbtack Needle Prevention and Treatment of Gastroscopy-induced Nausea and Vomiting

    Institute of Scientific and Technical Information of China (English)

    孙敏; 曾旭燕; 汪真真; 刘静

    2015-01-01

    目的:观察内关穴揿针防治胃镜检查所致恶心、呕吐的临床疗效。方法将200例符合纳入标准的患者随机分为治疗组和对照组,每组100例。两组均采用利多卡因胶浆于胃镜检查前口服,治疗组配合内关穴揿针。观察两组患者在胃镜检查过程中恶心、呕吐的反应。结果两组治疗后恶心、呕吐程度及患者满意度比较,差异均具有统计学意义(P<0.05)。结论内关穴揿针能减轻胃镜检查所致的恶心、呕吐,能增加患者满意度。%Objective To investigate the clinical efficacy of point Neiguan thumbtack needles in preventing and treating gastroscopy-induced nausea and vomiting.Methods Two hundred patients meeting the inclusion criteria were randomly allocated to treatment and control groups, 100 cases each. Before gastroscopy, both groups took lidocaine mucilage and the treatment group received point Neiguan thumbtack needle therapy additionally. Nausea and vomiting were observed in both groups of patients during gastroscopy.Results There were statistically significant post-treatment differences in nausea and vomiting severity and patients’ satisfaction between the two groups (P<0.05).Conclusions Point Neiguan thumbtack needle therapy can relieve gastroscopy-induced nausea and vomiting and raise patients’ satisfaction.

  15. 帕洛诺司琼联合地塞米松预防腹腔镜胆囊切除术后恶心呕吐的临床观察%Clinical observation of palonosetron combined with dexamethasone in prevention of postoperative nausea and vomiting in laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    洪叶; 唐祖芝; 蔡萍

    2015-01-01

    Objective To observe effect by palonosetron combined with dexamethasone in prevention of postoperative nausea and vomiting (PONV) in laparoscopic cholecystectomy.Methods A total of 120 patients receiving laparoscopic cholecystectomy were randomly divided into palonosetron group, dexamethasone group, and combined group, with 40 cases in each group. Incidences of nausea and vomiting within 24 h after operation were observed.Results Incidence of postoperative nausea and vomiting was obviously lower in the combined group than in palonosetron group and dexamethasone group. Their difference had statistical significance (P<0.05). Conclusion Combination of palonosetron and dexamethasone is more effective than single drug in prevention of postoperative nausea and vomiting in laparoscopic cholecystectomy. This method is worth promoting and applying.%目的 观察帕洛诺司琼联合地塞米松预防腹腔镜胆囊切除术后恶心呕吐(PONV)的效果.方法 120 例择期行腹腔镜胆囊切除术患者随机分为帕洛诺司琼组、地塞米松组、联合组, 每组40 例.观察手术后24 h内恶心呕吐发生率.结果 联合组术后恶心呕吐的发生率显著低于帕洛诺司琼组和地塞米松组, 差异有统计学意义(P<0.05).结论 帕洛诺司琼联合地塞米松预防腹腔镜胆囊切除术后恶心呕吐较单药更为有效, 值得临床推广应用.

  16. Randomized phase III trial of APF530 versus palonosetron in the prevention of chemotherapy-induced nausea and vomiting in a subset of patients with breast cancer receiving moderately or highly emetogenic chemotherapy.

    Science.gov (United States)

    Boccia, Ralph; O'Boyle, Erin; Cooper, William

    2016-02-26

    APF530 provides controlled, sustained-release granisetron for preventing acute (0-24 h) and delayed (24-120 h) chemotherapy-induced nausea and vomiting (CINV). In a phase III trial, APF530 was noninferior to palonosetron in preventing acute CINV following single-dose moderately (MEC) or highly emetogenic chemotherapy (HEC) and delayed CINV in MEC (MEC and HEC defined by Hesketh criteria). This exploratory subanalysis was conducted in the breast cancer subpopulation. Patients were randomized to subcutaneous APF530 250 or 500 mg (granisetron 5 or 10 mg) or intravenous palonosetron 0.25 mg during cycle 1. Palonosetron patients were randomized to APF530 for cycles 2 to 4. The primary efficacy end point was complete response (CR, no emesis or rescue medication) in cycle 1. Among breast cancer patients (n = 423 MEC, n = 185 HEC), > 70 % received anthracycline-containing regimens in each emetogenicity subgroup. There were no significant between-group differences in CRs in cycle 1 for acute (APF530 250 mg: MEC 71 %, HEC 77 %; 500 mg: MEC 73 %, HEC 73 %; palonosetron: MEC 68 %, HEC 66 %) and delayed (APF530 250 mg: MEC 46 %, HEC 58 %; 500 mg: MEC 48 %, HEC 63 %; palonosetron: MEC 52 %, HEC 52 %) CINV. There were no significant differences in within-cycle CRs between APF530 doses for acute and delayed CINV in MEC or HEC in cycles 2 to 4; CRs trended higher in later cycles, with no notable differences in adverse events between breast cancer and overall populations. APF530 effectively prevented acute and delayed CINV over 4 chemotherapy cycles in breast cancer patients receiving MEC or HEC. Clinicaltrials.gov identifier: NCT00343460 (June 22, 2006).

  17. Genetics Home Reference: cyclic vomiting syndrome

    Science.gov (United States)

    ... affected people have developmental delay or intellectual disability. Autism spectrum disorders, which affect communication and social interaction, ... North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. North American Society for Pediatric Gastroenterology, Hepatology, and ...

  18. Drugs to Treat Nausea and Vomiting

    Science.gov (United States)

    ... that are easy on your stomach, such as ginger ale, toast, and crackers; and eating small meals throughout the day. Evaluating the Oral 5-HT3 Antagonists: Drugs Used to ... provided by Wolters Kluwer Health, Pharmaceutical Audit Suite®. Wolters Kluwer Health is not ...

  19. Nausea and Vomiting in Infants and Children

    Science.gov (United States)

    ... Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well- ...

  20. Cyclic Vomiting Syndrome and Migraine in Children

    Directory of Open Access Journals (Sweden)

    Yi-Pei Lin

    2011-06-01

    Conclusion: Results of the study show that younger onset age and headache during CVS attacks may have increased risk of migraine development. Large-scale prospective studies are warranted to further clarify the relationship between CVS and migraine.

  1. Managing Chemotherapy Side Effects: Nausea and Vomiting

    Science.gov (United States)

    ... boiled, without the skin ••White rice ••White toast ••Bananas ••Canned fruit such as applesauce, peaches, and pears •• ... has a series of 18 Chemotherapy Side Effects Sheets at: www.cancer.gov/chemo-side-effects

  2. 帕洛诺司琼预防妇科手术术后恶心呕吐的临床效果%Randomized controlled trial of palonosetron in preventing postoperative nausea and vomiting in gyneco-logical surgeries

    Institute of Scientific and Technical Information of China (English)

    韩嫱; 王学仁; 陈晔凌; 罗爱林

    2016-01-01

    目的:比较术前单次注射帕洛诺司琼或托烷司琼对预防妇科手术术后恶心呕吐(PONV)的效果。方法选择 Apfel 评分≥3分,择期全麻下行妇科大手术的患者60例,随机分为帕洛诺司琼组(P 组)和托烷司琼组(T 组),每组30例。麻醉采用气管插管全麻,术前分别单次静脉注射帕洛诺司琼0.25 mg 或托烷司琼5 mg,术后使用氢吗啡酮自控镇痛,随访72 h。记录患者术后恶心呕吐程度,并计算完全有效率(CR)和完全控制率(CC)。结果 P 组患者术后0~24 h 及24~48 h 恶心呕吐程度均明显低于 T 组(P <0.05),48~72 h 恶心呕吐程度两组差异无统计学意义。P组共5例(17%)发生呕吐,治疗失效时间为(19.6±9.4)h,无一例补救治疗;T 组共 19 例(63%)发生呕吐,治疗失效时间(20.6±4.5)h,补救治疗3例次。术后0~24 h、24~48 h 和0~72 h P 组 CR和 CC 明显高于 T 组(P <0.05),而术后48~72 h 两组 CR 和 CC 差异无统计学意义。结论术前单次静脉注射帕洛诺司琼0.25 mg 预防妇科手术 PONV 的疗效在术后48 h 内明显优于单次注射托烷司琼5 mg。%Objective To compare the effects of a single injection of palonosetron and tropise-tron to prevent postoperative nausea and vomiting (PONV ) in gynecological surgeries. Methods Sixty patients undergoing elective major gynecological surgeries with general anesthesia (Apfel score ≥ 3 ) were included and randomized to group P (palonosetron ) and group T (tropisetron),30 patients in each group.All patients received general anesthesia with tracheal intuba-tion,and palonosetron 0.25 mg or tropisetron 5 mg were injected before anesthesia respectively in two groups.Intravenous hydromorphine was delivered for postoperative analgesia in all patients. PONV were evaluated and followed up for 72 hours.The degree of PONV was recorded and the com-plete response rate (CR)and complete control rate (CC)were calculated.Results The degree of PONV in 0-24 h and 24-48 h was

  3. 盐酸帕洛诺司琼对预防含顺铂方案化疗所致恶心呕吐患者的疗效观察%Effect observation of Palonosetron hydrochloride on preventing nausea and vomiting with chemotherapy including cisplatin

    Institute of Scientific and Technical Information of China (English)

    段琼玉; 吴荣

    2012-01-01

    目的 探讨分别应用盐酸帕洛诺司琼、盐酸格拉司琼预防含顺铂方案化疗所致恶心呕吐的疗效.方法 将60例接受含顺铂方案化疗的肿瘤患者随机分为观察组(盐酸帕洛诺司琼组)及对照组(盐酸格拉司琼组),每组各30例,比较两组对预防化疗所致呕吐的临床疗效、用药后不同时间恶心的完全控制率以及恶心治疗后的有效率.结果 观察组急性呕吐的总有效率(83.3%)明显高于对照组(66.7%),两组延迟性呕吐的总有效率分别为70.0%和53.3%,差异有统计学意义(χ2=14.127,P 0.05).结论 盐酸帕洛诺司琼在预防含顺铂方案化疗所引起的恶心呕吐的疗效优于盐酸格拉司琼,安全性好,值得临床推广.%Obejective To investigate and compare effects of Palonosetron hydrochloride and granisetron hydrochloride were used to prevent the nausea and vomiting caused by chemotherapy with cisplatin. Methods 60 patients receiving chemotherapy including cisplatin were randomly divided into the observation group (palonosetron hydrochloride Group)and the control group(granisetron hydrochloride group),each group contained 30 cases. The occurrence of acute emesis, delayed vomiting, and Nausea complete control rate, nausea treatment efficiency after treatment different times were compared between two groups. Results The acute vomiting total effective rate in observation group (83.3%) was significantly higher than the control group (66.7%). Delayed vomiting total efficiency of two groups was 70.0% and 53.3% respectively, the difference was statistically significance (x2=14.127, P 0.05). Conclusion The efficacy of Palonosetron hydrochloride in the prevention and treatment of nausea and vomiting caused by chemotherapy including cisplatin is superior to the efficacy of aranisetron hydrochloride, and Palonosetron hydrochloride has its own priorities, such as convenient use, good safety and worthy of clinical application.

  4. Clinical Study on Dolasetron Mesylate and Granisetron Hydrochloride in Preventing Postoperative Nausea and Vomiting%甲磺酸多拉司琼与盐酸格拉司琼预防术后恶心呕吐的临床对照研究

    Institute of Scientific and Technical Information of China (English)

    李炯

    2016-01-01

    Objective To study dolasetron mesylate and granisetron hydrochloride in preventing postoperative nausea and vomiting.Methods From January 2014 to December 2015, 78 cases of surgical patients admitted in our hospital. Patient grouping: block randomization. 78 patients were divided into two groups: group J and group Y. J group was treated with dolasetron mesylate; Y group received granisetron hydrochloride. The incidence rate of postoperative nausea and vomiting, nausea and vomiting were compared between two groups.ResultsThe incidence rate of postoperative nausea and vomiting, nausea and vomiting in group J were lower those than in group Y,P<0.05. ConclusionComppared with Dolasetron mesylate and granisetron, application of dolasetron mesylate has better effect of prevention of postoperative nausea and emesis.%目的:研究甲磺酸多拉司琼与盐酸格拉司琼预防术后恶心呕吐的临床对照。方法试验对象:我院2014年1月~2015年12月收治的78例手术患者。78例患者分为J组和Y组两个组别。J组给予甲磺酸多拉司琼;Y组给予盐酸格拉司琼。对比两组术后恶心呕吐发生率、恶心发生分级、呕吐症状。结果 J组患者术后恶心呕吐发生率和恶心发生分级、呕吐程度低于Y组,P<0.05。结论甲磺酸多拉司琼与盐酸格拉司琼预防术后恶心呕吐的临床效果比较,甲磺酸多拉司琼效果较好。

  5. 乳腺癌化疗患者预期性恶心呕吐与其自我效能感及应对方式的研究%Study on the relationship between expectancy of nausea and vomit and self-efficacy and coping styles among patients received chemotherapy

    Institute of Scientific and Technical Information of China (English)

    张树琪

    2008-01-01

    Objective To observe the relationship between expectancy of nausea and vomit and self-efficacy and coping styles among patients received chemotherapy,so as to provide the evidence for psychological therapy and intervention.Methods 60 cases under such condition were investigated with the Nausea and Vomit Questionnaire,General Self-Efficacy Scale and Trait Coping Style Questionnaire.Results 41.67% of the patients showed expectancy of nausea and vomit,whose score of self-efficacy and positive coping styles were lower than those with no expectancy of nausea and vomit,while the passive coping styles was higher.The degree of expectancy of nausea and vomit indicated the negative correlation with positive coping styles and the positive correlation with the netive coping styles.Conclusions There are close correlation between expectancy of nausea and vomit and patients self-efficacy.Nurses should encourge the patients to lessen the degree of expectancy of nausea and vomit with potive coping styles, thereby to improve the levels of merital health.%目的 观察乳腺癌化疗患者预期性恶心呕吐发生情况与患者的一般自我效能感及应对方式之间的关系,为今后的心理治疗和干预提供依据.方法 采取恶心呕吐凋查表、-般自我效能感量表、特质应对方式问卷,对60例经过1~2个化疗周期的乳腺癌患者进行调查.结果 发生预期性恶心呕吐患者占41.67%,其自我效能得分、积极应对得分均低于未发生的患者,消极应对得分高于未生发生组(P<0.01).相关性分析发现,预期性恶心程度与自我效能及积极应对呈负相关(P<0.05),与消极应对呈正相关(P<0.05).结论 发生预期性恶心呕吐与患者自我效能感及应对方式有密切的关系,护理人员可运用此特点鼓励患者采用积极的应对方式来减轻预期性恶心呕叶的程度,提高其心理健康水平.

  6. 昂丹司琼单用与联用地塞米松预防腹部术后恶心呕吐效果的Meta分析%Meta-analysis of Ondansetron and Ondansetron combined with Dexamethasone for preventing postoperative nausea and vomiting after abdominal surgery

    Institute of Scientific and Technical Information of China (English)

    黄轶婷

    2013-01-01

    目的 评价昂丹司琼单用与联用地塞米松预防腹部术后恶心、呕吐的效果.方法 通过检索PubMed、中国知网和万方数据库,搜集以昂丹司琼单用与联用地塞米松预防腹部术后恶心呕吐的随机对照试验研究(random controlled trial,RCT).以昂丹司琼单用组为对照组,以昂丹司琼单用与联用地塞米松组为试验组,采用Meta分析评价昂丹司琼联用地塞米松预防术后恶心、呕吐的效果.结果 共纳入11篇文献,共1 021例腹部手术患者,其中试验组509例,对照组512例.Meta分析结果显示,试验组预防腹部术后恶心、呕吐效果均优于对照组(P < 0.05).预防恶心和呕吐合并效应比值比(odd ratio,OR)及95%可信区间(confidence interval,CI)分别为2.73(1.71,4.34)和3.20(1.86,4.92).结论 昂丹司琼联用地塞米松能够有效预防腹部术后恶心、呕吐的发生,但是仍需要严格、标准、高质量、大样本、长期随访证实昂丹司琼联用地塞米松的安全性和有效性.%Objective To evaluate the efficacy of Ondansetron combined with Dexamethasone for preventing postoperative nausea and vomiting after abdominal surgery. Methods PubMed, CNKI and Wanfang electronic databases were searched to collected randomized controlled trials (RCT) that were interfere in Ondansetron or Ondansetron combined with Dexamethasone in controlling postoperative nausea and vomiting, Ondansetron was taken as control group, Ondansetron combined with Dexamethasone was taken as test group, The efficacy of Ondansetron combined with Dexamethasone for preventing postoperative nausea and vomiting after abdominal surgery with Meta-analysis was evaluated. Results 11 RCT and 1 021 patients with abdominal surgery were included. There was 509 cases in test groups and 512 cases in control group, Meta analysis showed that the test group was better than the control group in improving the incidence of the total postoperative nausea and vomiting (P < 0

  7. Professor WEI Pin-kang's Experience in Treating Chemotherapy Induced Nausea and Vomiting: an Analysis of Herbal Medication%魏品康教授防治化疗导致恶心呕吐用药规律研究

    Institute of Scientific and Technical Information of China (English)

    施俊; 魏品康

    2012-01-01

    Objective To summarize the herbal medication by Professor WEI Pin-kang's prescriptions in treating chemotherapy induced nausea and vomiting (CINV). Methods On the basis of outpatient and inpa-tients' medical records concerning CINV from case-database (keywords: chemotherapy and vomiting), data of 143 patients and 143 effective prescriptions were collected. The herbs and those category, nature, flavor and meridian distribution were summarized by frequency method using SPSS 13.0 Software. The couple herbs were analyzed by hierarchical cluster analysis. Results A total of 144 herbs were used (2 353 frequencies). Six groups of herbs [frequency >5%, cumulative relative frequency (CRF) 58.89% ] were used frequently as follow : the herbs for regulating qi (17.81%), resolving phlegm (13.51%), invigorating qi (8.07%), relieving food retention (7.44%), calming Gan to stop endogenous wind (7.05%), and warming the interior (5.01%). The most frequently used herbs ( >20 frequencies, CRF 77.31 %) had 31 species as follow: the herbs for regulating qi (6 species), calming Gan to stop endogenous wind (4 species), resolving phlegm (3 species), external application (2 species), invigorating qi (2 species), warming the interior (2 species), activating blood and removing blood stasis (2 species), promoting diuresis and resolving dampness (1 species), purgation (1 species) , invigorating blood (1 species), relieving exterior syndrome with pungent-warm property (1 species), relieving exterior syndrome with pungent-cool property (1 species), astringent (1 species), resolving dampness with aromatic property (1 species), calming the mind (1 species), eliminating heat and dampness (1 species), relieving food retention (1 species). Frequency of Rhizoma Pinelliae was 127 including Rhizoma Pinetliae (processed with ginger) 83 (65.35%). Frequency of prepared Radix et Rhizoma Rhei was 85 (95.51% of Prea- praed Rhizoma Rhei). These herts were mostly of warm nature (43.99%). The total frequency of

  8. 耳穴电刺激对剖宫产术后镇痛及恶心呕吐的影响%EFFECTS OF EAR ACUPOINT ELECTROSTIMULATION ON POST-SESAREAN SECTION ANALGESIA AND NAUSEA AND VOMITING

    Institute of Scientific and Technical Information of China (English)

    李井柱; 李晓征; 王明山; 李界平; 时飞; 于海芳

    2013-01-01

    目的 比较经皮电刺激耳神门穴与耳眼点穴对剖宫产术后产妇镇痛效果及恶心呕吐发生率影响.方法 腰麻-硬膜外联合阻滞麻醉下择期剖宫产产妇160例,术后均采用自控硬膜外镇痛(PCEA),随机分为经皮电刺激耳神门穴组(S组,n=80)、经皮电刺激耳眼点穴组(E组,n=80).S组术前行经皮电刺激耳神门穴,E组术前行经皮电刺激耳眼点穴,强度由产妇自己控制,刺激30 min后麻醉,术后4、10、22 h各重复刺激1次.观察并比较两组术后6、12、24、48 h(T1、T2、T3、T4)静息痛、宫缩痛及动态痛的视觉模拟评分(VAS),PCEA总按压次数与有效按压次数,硬膜外镇痛复合液用量,术后48 h内恶心及呕吐发生率,甲氧氯普胺使用率,瘙痒发生率,肛门首次排气时间及术后6h出血量,其他并发症情况.结果 与E组比较,S组术后T1、T2、T3、T4时静息痛、宫缩痛及动态痛VAS评分、PCEA总按压次数与有效按压次数比值及镇痛复合液用量显著降低(t=2.788~5.021,P<0.01),恶心及呕吐发生率和甲氧氯普胺使用率显著降低(x2=14.107~22.747,P<0.01),瘙痒发生率、肛门排气时间及术后6h出血量两组之间比较差异无显著性(P>0.05).两组均未出现其他相关副作用.结论 经皮电刺激耳神门穴较耳眼点穴可明显提高剖宫产术后镇痛效果,并降低恶心呕吐发生率.%Objective To compare the effects of transcutaneous electrical stimulation of auricular Shenmen point and Eye point on analgesia and postoperative nausea and vomiting in women undergoing cesarean section. Methods This study consisted of 160 women received cesarean section under combined spinal-epidural anesthesia. Postoperatively, all the women were offered patient-controlled epidural analgesia (PCEA) , who were then equally randomized to transcutaneous electrical stimulation of auricular Shenmen point (group S) and Eye point (group E). Before operation, women in group S received

  9. 右美托咪定对肿瘤化疗患者睡眠、焦虑及恶心呕吐的影响%Effect of dexmedetomidine on sleep,anxiety,nausea and vomiting in cancer patients undergoing chemotherapy

    Institute of Scientific and Technical Information of China (English)

    陈肖衣; 任卓如; 晓寰; 陈利

    2016-01-01

    Objective To observe the effect of dexmedetomidine on sleep,anxiety,nausea and vomiting in cancer patients who re-ceived chemotherapy.Methods A hundred and twenty cancer patients suffering from sleep disorders,anxiety symptoms,nausea and vomiting who received chemotherapy from February to May 2015 were selected.Patients were randomized into treatment group (n =60) and control group (n =60).Patients in treatment group were treated with intravenous drip of 0.5 μg·kg -1 dexmedetomidine.Patients in control group were given saline with the same dose and at the same time.Pittsburgh sleep quality index (PSQI),self -rating anxiety scale (SAS),Rhodes index of nausea and vomiting (INVR)were used to assess the sleep quality,anxiety,the number of patients with nausea and vomiting of patients before and the 3rd day after the administration of dexmedetomidine.Results Compared with status be-fore administration of dexmedetomidine,the PSQI scores,SAS scores and the incidence of nausea and vomiting of treatment group were significantly lower in the 3rd day after the administration of dexmedetomidine (t =37.145,7.112,10.407,P =0.000,0.000,0.000, respectively).Conclusions Dexmedetomidine may improve sleep quality and alleviate anxiety,nausea and vomiting symptoms in cancer patients undergoing chemotherapy.%目的:观察右美托咪定对肿瘤化疗患者睡眠、焦虑及恶心呕吐的影响。方法选取采取化疗治疗的肿瘤患者120例,采用分层随机分组设计方法,随机数表法分为治疗组(n =60)和对照组(n =60)。治疗组于每晚入睡前持续静脉滴注0.5μg· kg -1右美托咪定。对照组给予相同剂量和滴注时间的生理盐水。分别利用匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、中文版恶心呕吐症状评估量表(INVR)评估患者用药前和用药第3天晚上的睡眠、焦虑情况及恶心呕吐症状严重程度。结果相比治疗前,用药第3天,治疗组患者

  10. 阿扎司琼联合氟哌利多预防妇科腹腔镜手术后恶心呕吐%Clinical research of azasetron combined with droperidol in the prevention of gynecological laparoscopic postoperative nausea and vomiting

    Institute of Scientific and Technical Information of China (English)

    霍为国

    2012-01-01

    目的 分析阿扎司琼联合氟哌利多在预防妇科腹腔镜手术后恶心、呕吐中的临床疗效.方法 88例妇科行腹腔镜手术患者,随机分为A、B、C、D组,每组22例.麻醉诱导前10 min分别静脉注射生理盐水、氟哌利多、阿扎司琼、阿扎司琼+氟哌利多.观察患者术后24 h恶心、呕吐发生率,记录术后24 h内第1次出现恶心的时间.结果 B、C组恶心、呕吐发生率低于A组,D组恶心、呕吐发生率低于B、C组,但差异无统计学意义(P>0.05).D组恶心、呕吐发生率为4.5%,明显低于A组(36.4%,P<0.05).B、C、D组初次恶心时间明显长于A组(P<0.05),D组初次恶心时间明显长于B、C组(P<0.05).结论 麻醉诱导前静脉注射阿扎司琼或氟哌利多均能有效预防手术后恶心呕吐,两药联合应用效果更好.%Objective To investigate the clinical efficacy of the azasetron combined with droperidol in the prevention of gynecological laparoscopic postoperative nausea and vomiting. Methods 88 cases of gynecologic laparoscopic surgery patients, which were randomly divided into group A, B, C, D, 22 cases in each group. 10 min before the induction of anesthesia, injected intravenously with saline, droperidol, azasetron, azasetron combined with droperidol in group A, B, C, D. After surgery, the rate of nausea and vomiting were observed within 24 h, first time of nausea within 24 h was recorded. Results The rate of nausea and vomiting in group B and C was lower than in group A, the rate of nausea and vomiting in group D was lower than in group B and C, but the difference was not statistically significant ( P > 0. 05 ) . In group D, the rate of nausea and vomiting was 4.5% , significantly lower than group A (36.4% ) (P<0.05). In group B and D, the first time of nausea was significantly longer than group A (P <0. 05). The first time of nausea in group D was significantly longer than group B and C (P <0.05). Conclusion Before the induction of

  11. Efficacy of intravenous ondansetron for preventing nausea and vomiting caused by different reasons during ;or post-cesarean section%昂丹司琼防治联合麻醉下剖宫产不同原因恶心呕吐临床观察

    Institute of Scientific and Technical Information of China (English)

    张邓新; 王向兵; 季永; 高烨

    2013-01-01

    目的:观察5-羟色胺3受体拮抗剂昂丹司琼对腰硬联合麻醉下剖宫产术中及术后不同原因恶心呕吐的防治效果。方法择期及急诊剖宫产手术患者280例,随机分为对照组和昂丹司琼组,每组140例;昂丹司琼组在夹闭脐静脉即刻静脉注射昂丹司琼8 mg,对照组注射生理盐水4 ml,观察术中、术后恶心呕吐的发生率。结果与对照组相比,昂丹司琼组不但术中恶心呕吐总发生率显著下降(P<0.05),饱胃患者恶心呕吐发生率降低(P<0.05);而且术后恶心呕吐总发生率也显著下降(P<0.05),使用PCEA患者中、重度恶心呕吐发生率明显减少(P<0.05)。结论昂丹司琼可有效防治饱胃患者的术中恶心呕吐,同时可有效减少PCEA患者术后恶心呕吐的发生。%Objective To observe the efficacy of intravenous 5-hydroxytryptamine 3 receptor antagonist in the prevention of nausea and vomiting while and after cesarean section (CS). Methods A total of 280 pregnant women with American Society of Anesthesiologists (ASA) Physical Status Ⅰ-Ⅱ who underwent emergency and elective CS under combined spinal-epidural anesthesia (CSEA) were randomly divided into two groups (n=140):in clamping the umbilical vein immediately intravenous ondansetron 8 mg (ondansetron group) or 0.9% normal saline 4 ml (control group) were intravenously infused, respectively. The episodes of nausea and vomiting intraoperatively and postoperatively were observed. Results In ondansetron group, the incidence of intra- and post-operative nausea and vomiting reduced significantly compared with the control group, and the incidences of intraoperative severe nausea and vomiting in full stomach patients of ondansetron group were 6.5%, which were significantly lower than that in control group. The incidences of postoperative moderate and severe nausea and vomiting patients who using PCEA of ondansetron were significantly lower than that

  12. 抚触加穴位按摩联合非营养性吸吮治疗新生儿呕吐的效果观察%Effect of touch with point massage combined of nonnutritive sucking for the treatment of neonatal vomi-ting

    Institute of Scientific and Technical Information of China (English)

    王秀红

    2016-01-01

    目的:探讨抚触加穴位按摩联合非营养性吸吮对新生儿呕吐的影响。方法:对60例有呕吐症状的新生儿(排除消化道畸形新生儿)分为两组,对照组常规治疗如禁食、洗胃,少量多次喂养,斜坡卧位;研究组在常规治疗的基础上辅以新生儿抚触加穴位按摩联合非营养性吸吮,比较两组患儿再次呕吐次数、腹胀缓解时间、胎粪排净时间、肛门刺激排便次数、每天大便次数、恢复正常按需喂养时间及疗效。结果:两组新生儿呕吐均得到改善,研究组患儿再次呕吐次数、腹胀缓解时间、胎粪排净时间、肛门刺激排便次数、恢复正常按需喂养时间明显少于对照组,每日大便次数多于对照组,总有效率(93.5%)大于对照组(83.8%),差异有统计学意义(P <0.05);两组患儿在治疗期间均无明显不良反应。结论:抚触加穴位按摩联合非营养性吸吮对新生儿呕吐有明显的改善作用,值得临床推广。%Objective To investigate the effect of touch with point massage combine of nonnutritive sucking for the treatment of neonatal vomiting.Method 60 cases of vomiting newborns (excluding the digestive tract malformation newborns)were divided into two groups,The control group conventional treatment such as fasting,gastric lavage,repeated small feeding,slope lying position;The study group on the basis of conventional treatment with neonatal touch point massage combined of nonnutritive sucking,children a-gain vomiting,abdominal distension relief time,net meconium discharge time,anal stimulation in stool frequency,daily number of stool,achieve on -demand artificial feeding time and curative effect of two groups were compared.Results Two groups of neonatal vomiting were improved.Again vomiting,abdominal distension relief time,net meconium discharge time,anal stimulation defecation times,restore normal on -demand feeding time of children were

  13. 关联度最强药物配伍的中医止呕类方数据挖掘%Rule of Remedy for Vomiting in Science of Traditional Chinese Medicine Formu as by Data Mining Based on Both Association and Correlation Rule

    Institute of Scientific and Technical Information of China (English)

    黄颖琦; 贾恒; 何前松; 冯泳

    2012-01-01

    Objective: To look for the rules of compatibility of medicines in historical prescriptions which treat vomiting, mining out new knowledge in science of traditional Chinese medicine ( TCM ) formulas, providing support for making new TCM remedy for vomiting. Method: Created a TCM formulas database to treat vomiting by collecting 985 TCM formulas. A threshold level datamining method which based on both association and correlation rule is used, to mining rule of compatibility of medicines in database of historical prescriptions for vomiting. Result; The most used drug is Zingiber officinale, the using frequency of Z. officinale is 61.23%. The most association and correlation couple of drugs are Poria cocos ( Schw. ) Wolf and Pinellia ternate ( Thunb. ) Breit. the correlation - confidence of this couple is 0. 114 4. The most association and correlation group of drugs are Z. officinale and P. cocos and P. ternate, the correlation-confidence of this group is 0. 295 4, Conclusion; The group of drugs which contain Z. officinale. and P. ternate and P. cocos is most used to treat vomiting. The ternate added in the P. cocos soup, which is ancient famous TCM formulas created by ancient great doctor ZHANG Zhong-jing, is proved that it is the key compatibility of drugs to treat vomiting.%目的:在古今中医文献中寻找止呕方剂配伍规律与用药特点,为中药止呕新药的开发提供理论支持.方法:收录古今止呕类方剂985首建立止呕类方剂数据库,运用相关置信度规则,对中医止呕方剂药物配伍的数据进行挖掘,利用剪枝方法筛选关联度最强的数据.结果:最常用的单味药物为生姜使用频率高达61.23%.关联性最强的核心药对是茯苓配伍姜半夏,其相关置信度为0.1144.关联度最强的药组为生姜、姜半夏、茯苓.结论:生姜、姜半夏、茯苓,其相关置信度为0.2954是中医止呕方剂中最常合用的药物配伍,其3种药物间存在极强的关联性,张仲景创制

  14. 成年患者神经外科手术麻醉恢复期恶心呕吐的情况分析%Incidence of postoperative nausea and vomiting following neurosurgical procedures in postanesthesia care unit

    Institute of Scientific and Technical Information of China (English)

    王会文; 侯春梅; 张雪梅; 韩如泉

    2012-01-01

    目的 通过回顾性分析,探讨不同神经外科手术成年患者麻醉恢复期恶心呕吐的发生情况.方法 2009年5月至2011年3月麻醉恢复室( PACU)收治的神经外科术后成年患者5 078例,按肿瘤部位和手术种类分组.观察并记录患者恶心呕吐的发生情况.结果 5 078例患者中,发生术后恶心呕吐798例,发生率为15.7%.其中颅咽管瘤组占28.4%(25/88)、脑室肿瘤组26.7%(35/131)、后颅窝肿瘤组24.2%(157/650)、脑血管病组20.8% (87/418)、幕上肿瘤组19.3%(297/1535)、癫痫组15.8%(16/101)、经蝶窦垂体瘤组8.9% (88/991)、脊髓肿瘤组8.4%(52/619)及其他手术组7.5%(41/545).结论 神经外科不同部位手术患者术后恶心呕吐的发生情况不同,需针对不同的病种严密观察及时处理.%Objective To study the incidence of postoperative nausea and vomiting(PONV) after different neurosurgical procedures in the postanesthesia care unit (PACU).Methods 5 078 adult patients who had undergone neurosurgical procedures enrolled into PACU were divided nine groups.The incidence of PONV were recorded and treated.Results The overall incidence of PONV following neurosurgical procedures was 15.7%.The incidence of PONV in patients undergoing craniopharyngioma、ventricular tumor、infratentorial craniotomy、intracranial aneurysm and arteriovenous malformation、supratentorial tumor、epilepsy、transsphenoidal surgery of pituitary tumor、spinal cord tumor and others was 28.4% 、26.7%、24.2% 、20.8%、19.3%、15.8%、8.9%、8.4% and 7.5%,respectively.Conclusions The overall incidence of PONV in PACU following neurosurgical procedures is approximately 16%.The incidence of PONV following neurusurgical procedures is different and craniopharyngioma、ventricular tumor and posterior fossa tumor are high risk factors for PONV.Strategies for the prevention of PONV following neurusurgical procedures are required.

  15. 妇科腹腔镜患者发生术后恶心呕吐相关因素分析%Analysis of postoperative nausea and vomiting in patients with gynecologic laparoscopic procedures

    Institute of Scientific and Technical Information of China (English)

    郑俊奕; 翁秋瑾

    2015-01-01

    目的 分析妇科腹腔镜患者术后恶心呕吐(PONV)的情况,探寻其发生规律.方法 将广州中医药大学第一附属医院2013年5~12月收治的拟择期行妇科腹腔镜手术患者450例作为研究对象,统一麻醉方法,记录所有患者的一般资料、相关病史、PONV的相关危险因素及PONV发生情况,采用EpiData 3.0软件录入数据,并应用SPSS18.0统计软件进行相关分析. 结果 450 例患者PONV 的发生率为 39.3%(177/450),大部分发生在 24 h 内,与普遍适用的Apfel简化风险评分表四因素预测模型相比,不同危险因素对患者PONV 发生率的影响程度明显较小,非婚状态患者较易发生PONV,晕动病史者不明显增加PONV的风险.结论 妇科腹腔镜手术患者PONV发生率仍然近40.0%;Apfel简化风险评分表四因素预测模型对该类患者PONV的预测效能较差;婚姻状态可能影响PONV的发生率.%Objectives To analyze the postoperative nausea and vomiting (PONV) situation in the patients with gyneco-logical laparoscopy for investigating its occurrence rule. Methods 450 patients undergoing gynecologic laparoscopic operation in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from May to December 2013 were selected as the research subjects. The anesthesia method was unified and the general data, related disease history, PONV related risk fac-tors and PONV occurrence situation were recorded in all the cases. The data entry adopted the EpiData 3.0 software and the relat-ed analysis was performed by the SPS18.0 software. Results The incidence rate of PONV in 450 patients was 39.3%(177/450), which mostly occurred within 24 h after operation. Compared with the predicting model of the Apfel simplified risk evaluation scale, influencing degrees of different risk factors on the incidence rate of PONV were significantly smaller. The unmarried pa-tients were easier to develop PONV. However ,the patients with motion sickness

  16. Non - chemotherapy Intluence Factors tor Nausea and Vomiting among Hepatocellular Carcinoma Patients atter Transarterial Chemoembolization%肝癌患者肝动脉化疗栓塞术后恶心呕吐的非化疗影响因素分析

    Institute of Scientific and Technical Information of China (English)

    臧爽; 徐阳

    2015-01-01

    目的:分析影响肝癌患者肝动脉化疗栓塞术(TACE)后发生恶心呕吐的非化疗因素。方法采用整群抽样法,选取2012年10月—2013年10月在中国医科大学附属第一医院介入病房住院的符合纳入与排除标准的肝癌患者272例。记录患者年龄、性别、肿瘤是否转移、肿瘤大小、碘化油注射液剂量、疼痛程度、疼痛时间、介入手术次数、发热程度、发热天数、有无腹胀等,分析上述指标与 TACE 后恶心呕吐的关系。结果272例患者中恶心程度语言描述分级(NVSD)为0级169例(占62.1%),1级59例(占21.7%),2级44例(占16.2%)。年龄与恶心呕吐呈负相关性(r =-0.217,P ﹤0.05),疼痛程度、疼痛时间、腹胀与恶心呕吐呈正相关(r =0.333、0.538、0.188,P﹤0.05)。多因素 Logistic 回归分析显示,年龄高为患者 TACE 后恶心呕吐的保护因素〔OR =0.916,95% CI(0.841,0.998),P =0.044〕,疼痛时间长、有腹胀为患者 TACE 后恶心呕吐的独立危险因素〔OR =373.019,95% CI(8.197,16974.798),P =0.002;OR =3.677,95% CI(1.064,12.702),P =0.040〕。疼痛因素对恶心呕吐有直接正向效应(β=0.42,P ﹤0.01),恶心呕吐对腹胀有直接正向效应(β=0.77,P ﹤0.01);年龄对疼痛有负向效应(β=-0.01, P =0.072),对腹胀有正向效应(β=0.01,P =0.069);年龄及腹胀对恶心呕吐的效应均不显著(P ﹥0.05)。结论年龄、疼痛时间、腹胀均对TACE 后肝癌患者发生恶心呕吐有影响,患者恶心呕吐的发生是多因素共同作用的结果。%Objective To analyse non - chemotherapy influence factors for nausea and vomiting among hepatic carcinoma patients after transarterial chemoembolization( TACE). Methods According to Inclusion and exclusion criteria, 272 hepatic carcinoma patients who were admitted to Intervention Ward of

  17. Application of Zhenqi Fuzheng Granules Combined with Acupuncture and Acupressure for Nausea and Vomiting during the Procedure for Prolapse and Hemorrhoids%贞芪扶正颗粒联合针指法在痔上黏膜环切术恶心呕吐中应用

    Institute of Scientific and Technical Information of China (English)

    张迎宪; 张世卿

    2012-01-01

    目的 观察比较贞芪扶正颗粒联合针指法在痔上黏膜环切术恶心呕吐中的应用.方法 选择ASA Ⅰ~Ⅱ 66例手术患者,随机分为三组:贞芪针指治疗组(ZA组)、恩丹西酮对照组(OH组)和生理盐水空白组(NS组).三组均采用布比卡因腰麻或腰-硬联合阻滞麻醉,麻醉穿刺完毕后ZA组针刺双侧内关,推揉按压中脘穴及双侧足三里穴;OH组静脉注射恩丹西酮4~8 mg;NS组静脉注射生理盐水5 mL.三组实施术后镇痛(PCIA),术毕口服贞芪扶正颗粒15~30 g.结果 ZA组恶心、呕吐的发生率为4/22,2/22;OH组为3/22,1/22,VAS评分也基本相当,表明两组疗效相同,组间比较差异无统计学意义(P>0.05),与NS组比较,差异有统计学意义(P<0.01).但对于恶心呕吐程度较重且止呕显效慢者(ZA组持续恶心4例,反复呕吐2例),最好伍用抗呕吐药物.结论 在恶心呕吐防治中,贞芪扶正颗粒复合益气针指法适用于轻中度恶心呕吐;恩丹西酮适用于程度较重的持续性恶心呕吐.%Objective To observe the application of zhenqi fuzheng granules combined with acupuncture and acupressure for nausea and vomiting during the procedure for prolapse and hemorrhoids( PPH ). Methods 66 cases of ASA I to II were selected and divided into three groups, a zhenqi + acupuncture + acupressure group( ZA group ), an ondansetron hydrochloride group( OH group ) and a normal saline blank group( NS group ). Bupivacain spinal anesthesia or the combined spinal epidural anesthesia( CSEA )was a-dopted in three groups. After anesthetic puncture,in ZA group,acupuncture was applied to bilateral Neiguan ( PC6 )and the technique of pushing, kneading and pressing was to Zhongwan( CV12 )and bilateral Zusanli ( ST36 ); in OH group,the intravenous injection with ondansetron hydrochloride was used,4 to 8mg; in NS group, the intravenous injection of normal saline 5mL was provided. The patient controlled intravenous analge-sia( PCIA )was adopted after

  18. 帕洛诺司琼在鼻咽癌同步放化疗中防治恶心呕吐的疗效观察%Observation of Efficacy of Palonosetron in the Prevention and Treatment of Nausea and Vomiting in Nasopharyngeal Carcinoma(NPC) Treated with Chemoradiation

    Institute of Scientific and Technical Information of China (English)

    张芸; 韦燕; 龚建忠; 陈彦帆

    2016-01-01

    目的:对接受同步放化疗的鼻咽癌患者采用帕洛诺司琼预防恶心呕吐,观察其治疗效果。方法将行同步放化疗的鼻咽癌患者80例随机分为2组,分别采用帕洛诺司琼和昂丹司琼止吐治疗,观察并比较2组患者发生急性、延迟性恶心呕吐及其他不良反应的情况。结果帕洛诺司琼组急性恶心发生率为57.5%、急性呕吐32.5%,昂丹司琼组急性恶心、呕吐的发生率为62.5%、35.0%,2组比较差异无统计学意义(P>0.05);帕洛诺司琼组延迟性恶心、延迟性呕吐发生率分别为80.0%、62.5%,昂丹司琼组延迟性恶心、呕吐的发生率为87.5%、80.0%,帕洛诺司琼组明显降低,差异有统计学意义(P<0.05)。除恶心、呕吐的消化道反应外,2组患者均出现头晕、口干、头痛、乏力、低热、便秘、焦虑、腹泻等放化疗相关不良反应,2组的不良反应发生率无明显差异(P>0.05)。结论对接受同步放化疗的鼻咽癌患者采用帕洛诺司琼,能够预防放化疗引起的急性及延迟性恶心呕吐,尤其是能够有效控制延迟性恶心呕吐的发生,且不良反应轻微,值得在临床上推广使用。%Objective To study the efficacy of palonosetron in the prevention and treatment of nausea and vomiting in nasopharyngeal carcinoma ( NPC) treated with chemoradiation .Methods 80 cases of NPC treated with chemoradiation were ran-domly divided into 2 groups , and respectively adopted palonosetron and ondansetron anti-nausea treatments , acute and delayed nausea and vomiting and other adverse reactions of the 2 groups were observed and compared .Results Acute nausea in palono-setron group was 57.5%,acute vomiting was 32.5%,in ondansetron group,the incidence of acute nausea and vomiting were 62.5%and 35.0%, there had no statistical difference between the 2 groups(P>0.05);In palonosetron group,delayed nausea was 80

  19. Ondansetrona oral na prevenção de náuseas e vômitos pós-operatórios The effect of oral ondansetron in the prevention of postoperative náusea and vomiting

    Directory of Open Access Journals (Sweden)

    Elaine Milani Lewaschiw

    2005-02-01

    Full Text Available OBJETIVOS: Em passado não remoto, a incidência de náuseas e vômitos no pós-operatório (NVPO ainda alcançava 40% a 50%. Publicações mais recentes indicam que a freqüência desta complicação ainda é considerável: 20% a 30%. O presente estudo teve como objetivo avaliar, em pacientes submetidos à anestesia geral, o impacto da administração oral de ondansetrona na incidência de NVPO. MÉTODOS: Foram incluídos 178 pacientes em estudo prospectivo, randomizado, controlado e duplo-cego, divididos em dois grupos (ondansetrona=89 e placebo= 89, utilizando-se comprimidos de dissolução oral rápida, especialmente preparados para este estudo. A medicação foi administrada entre 30 e 60 minutos antes da indução anestésica. Anotou-se fatores que pudessem influenciar o evento, como gênero, idade, antecedentes de discinesia ou NVPO, tabagismo, tipo de cirurgia, índice de massa corpórea, reversão do bloqueio neuromuscular com neostigmine e intensidade da dor pós-operatória. RESULTADOS: Não houve diferença significativa entre os grupos referentes aos fatores anotados, exceto tabagismo e índice de massa corpórea, que prevaleceu no grupo placebo. Estes fatores não interferiram na análise dos resultados. Observou-se NVPO em 23 (26% pacientes do grupo ondansetrona e 38 (43% pacientes do grupo placebo (pOBJECTIVES: Not so many years ago, the incidence of postoperative nausea and vomiting used to reach 40% to 50%. More recent publications indicate that this complication still reaches considerable frequency: 20 to 30%. The present study had the objective of evaluating the impact of oral administration of ondansetron on the incidence of postoperative nausea and vomiting among patients submitted to general anesthesia. METHODS: This was a prospective, randomized, controlled, double-blind study. It included 178 patients divided into two groups: Ondansetron (n = 89 and Placebo (n = 89. Fast-dissolving oral tablets specially prepared for

  20. Analysis of Perioperative Risk Factors for Postoperative Nausea and Vomiting Following Scoliosis Surgery%脊柱侧弯矫形术后恶心呕吐的围手术期危险因素分析

    Institute of Scientific and Technical Information of China (English)

    贺秋兰; 刘卫锋; 舒海华; 杨军林; 魏明; 刘宽智; 黄文起

    2011-01-01

    [Objective]To investigate the risk factors for postoperative nausea and vomiting (PONV) after scoliosis surgery undergoing general anesthesia and set the predictive equation so as to provide clinical evidence for management of PONV.[Methods]The perioperative data of all patients undergoing scoliosis surgery under general anesthesia from July 2006 to December 2009 in the First Affiliated Hospital of Sun Yat-sen University were analyzed via univariate analysis and multivariate logistic regression.The potential perioperative risk factors of PONV within 24 h following scoliosis procedures were screened out.Predictive model was established and its efficacy was evaluated by the areas under receptor operating curve.[Results]A total of 199 of 215 patients undergoing scoliosis surgery were eligible.The incidence of PONV was 22.6% (45/199).Logistic regression has shown that the risk factors included intraoperative lower median blood pressure (LMAP), marked hemoglobin gap before and after operation (ΔHb),lower body temperature (LT) and administration of morphine or fentanyl as postoperative analgesic (M/FPA).Predictive model was P = 1/[1+exp (-0.42 × LMAP + 0.087 × ΔHb + 2.263 × LT - 3.069 × M/FPA ± 20.829)].The areas under curve of predictive equation were 0.969 ± 0.011.[Conclusion]Patients with lower MAP, vast Hb loss and lower body temperature during their scoliosis surgery are more likely to suffer PONV.The use of potent opioids may increase the risk of PONV.%[目的]分析全身麻醉下脊柱侧弯矫形术后患者恶心呕吐(PONV)的危险因素并构建预测模型.[方法]对中山大学附属第一医院2006年7月至2009年12月间全身麻醉下行脊柱侧弯矫形术患者进行围术期变量的单因素比较和多因素前进法Logistic回归分析.筛选术后24 h内发生PONV的危险因素,并构建预测模型,计算危险因素的ROC曲线下面积(AUC).[结果]回顾检索收集到215患者,共有199例患者符合标准,其中45

  1. A clinical study of aprepitant for prevention of chemotherapy-induced vomiting induced by highly-moder-ately emetogenic chemotherapy%阿瑞匹坦预防中重度致吐性方案所致化疗相关性呕吐的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈诚; 王晓华; 邓荣; 梅静峰; 许红霞

    2015-01-01

    目的:观察和评价阿瑞匹坦联合帕诺洛司琼、地塞米松预防和控制中重度致吐性化疗药物引起的化疗相关性呕吐的疗效。方法选择2014年1月至2014年12月在我院肿瘤内科和放疗科接受含多天中重度致吐性方案化疗的肿瘤患者,筛选应用帕诺洛司琼(0�25 mg iv,qod)+地塞米松(8 mg iv,qd)止吐后,呕吐达到2级或2级以上且需追加其他止吐药物解救治疗的患者共120例,于第2个周期同一方案化疗期间给予加用阿瑞匹坦(125 mg po,d1,80 mg po,d2~d3)止吐,并进行自身对照研究,比较患者应用阿瑞匹坦前后呕吐发生情况及耐受性。结果入组的所有患者在第1个周期均出现2级以上呕吐,第2个周期加用阿瑞匹坦后患者首次发生呕吐时间明显延迟,差异有统计学意义( P<0�01)。第2个周期与第1个周期的无呕吐率为59�2%(71/120)和0,而1、2、3级的呕吐发生率分别为29�2%(35/120)和0、9�1%(11/120)和60�8%(73/120)、2�5%(3/120)和39�2%(47/120),第2个周期的呕吐发生率低于未加用阿瑞匹坦的第1个周期( P<0�01)。主要不良反应包括食欲减退、乏力和便秘,均为1级。结论阿瑞匹坦与帕诺洛司琼及地塞米松联合用于治疗中重度致吐性方案化疗引起的严重消化道反应,可以显著改善化疗药物诱发的呕吐,且具有良好的耐受性。%Objective To evaluate the efficacy of aprepitant for prevention of highly⁃moderately emetogenic chemotherapy⁃in⁃duced vomiting. Methods Amomg the cancer patients underwent highly⁃moderately emetogenic chemotherapy from the January 2014 to December 2014 in the Department of Medical Oncology and Radiotherapy, 120 patients with vomiting of grade 2 or greater and requi⁃ring additional antiemetic drugs after treatment with palonosetron plus dexamethasone were chosen during the

  2. EFFECT OF MISCARRIAGE PREVENTION AND ANTI-VOMIT RECIPE COMBINED WITH ACUPOINT INJECTION ON HYPEREMESIS GRAVIDARUM%应用安胎定呕方联合穴位注射治疗妊娠剧吐的效果分析

    Institute of Scientific and Technical Information of China (English)

    熊丽丽

    2015-01-01

    Objective To observe the curative effect of acupoint injection combined with miscarriage prevention and anti -vomit recipe on hyperemesis gravidarum.Methods 88 patients with hyperemesis gravidarum in our hospital from February 2013 to February 2014 were selected and randomly divided into the control group and treatment group with 44 cases in each.The control group was given conventional western medicine therapy;and the treatment group was given acupoint injection combined with miscarriage pre-vention and anti-vomit recipe additionally.The two groups were compared in terms of the time of vomit stopping, treatment duration of hyperemesis gravidarum, number of people with normal dieting after treatment, number of people with normal electrolyte level, fre-quency of daily vomiting, curative effect of hyperemesis gravidarum, ketone levels before and after treatment and carbon dioxide com-bining power indicators of the two groups.Results The time of vomiting stopping and treatment duration of hyperemesis gravidarum of the treatment group were significantly shorter than those of the control group; the ketone values before and after treatment of the treatment group improved significantly compared with the control group; the number of people with normal dieting after treatment and normal electrolyte level of the treatment group was significantly larger than that of the control group .The average frequency of vomit of the treatment group was significantly smaller than that of the control group; and the curative effect of hyperemesis gravidarum of the treatment group was significantly better than the control group (p<0.05).Conclusion Acupoint injection combined with miscar-riage prevention and anti-vomit recipe in the treatment of patients with hyperemesis gravidarum is clinically effective and is worthy of clinical application and promotion.%目的 观察联合应用穴位注射与安胎定呕方治疗妊娠剧吐的临床效果. 方法 选择2013年2月~2014年2

  3. 全息按摩疗法治疗肺癌化疗性恶心呕吐的疗效观察%Curative effect observation of holographic massage therapy in the treatment of chemotherapy-induced nausea and vomiting of lung cancer

    Institute of Scientific and Technical Information of China (English)

    宫素红

    2014-01-01

    Objective To apply holographic massage therapy in curing the chemotherapy-induced nausea and vomiting in lung cancer treatment, on the basis of the TCM meridian basic theory and holographic therapy.Methods Paitents with lung cancer while receiving the same kind of chemotherapy, 120 cases in all, were randomly divided into two groups. There were 60 cases in the control group receiving drug antiemetic therapy, and the other 60 cases in the experimental group were receiving face, ears, limbs, chest and abdomen holographic acupoint massage therapy.Results The total effective rate of treating nausea and vomiting in the experimental group was higher than that of the control group (P<0.01). Asitia, hiccup, headache, dizziness, abdominal distension, diarrhea, constipation and other side effects were lower than those in the control group (P<0.01).Conclusion Holographic massage therapy in treating chemotherapy-induced nausea and vomiting of lung cancer has good effect and few side effects.%目的:依据中医经络基本理论和全息治疗学的理论,运用全息按摩疗法达到治疗肺癌化疗性恶心呕吐的目的。方法120例肺癌并接受同一种化疗方案的患者随机分为两组,对照组60例采用药物止吐治疗;实验组60例进行面部、耳部、四肢,胸腹部全息穴位按摩治疗。结果实验组治疗恶心呕吐总有效率均高于对照组(P<0.01),厌食、打嗝、头痛、头晕、腹胀、腹泻、便秘等副作用均低于对照组(P<0.01)。结论全息按摩疗法治疗肺癌化疗性恶心呕吐效果好,副作用少,值得临床推广。

  4. 1例胃癌术后患者化学治疗所致恶心呕吐药学服务%Pharmaceutical Care in the Management of Nausea and Vomiting Induced by Adjuvant Chemotherapy for a Postoperative Patient with Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    刘宇; 邱峰; 李欣宇

    2015-01-01

    Objective To provide reference for clinical pharmacist participating in management of nausea and vomiting induced by tumor chemotherapy. Methods The process of pharmaceutical care for a patient with severe vomiting caused by adjuvant chemotherapy after gastric cancer operation was described. Antiemetic application and drug adverse reactions were analyzed. A new treatment plan was given by clinical pharmacist. Results The suggestions were adopted by clinician. The vomiting was controlled and drug adverse reactions were dealt with. Conclusion To reduce the risk and improve the income of antiemetic,clinical pharmacists should pay more attention to clinical practice guideline,drug interaction and adverse reactions, provide the most suitable suggestions for clinicians according to pharmacology and evidence-based medicine.%目的:为临床药师参与化学治疗(化疗)所致恶心呕吐的管理提供参考。方法临床药师参与1例胃癌术后辅助化疗导致严重呕吐病例的监护过程。对化疗所致呕吐的预防和治疗药物应用、止吐药物不良反应识别和处理进行分析,并基于药理学与临床指南提出药物治疗建议。结果医师采纳药师建议,患者呕吐得到有效控制,止吐药物所致不良反应得到缓解。结论临床药师参与化疗所致恶心呕吐的管理,应注意对临床指南的理解和掌握,加强对止吐药物相互作用和不良反应的关注,并基于药理学和循证医学提供最佳的药物治疗建议,以保障患者用药的安全有效。

  5. 阿扎司琼不同给药时间对患者术后自控镇痛所致恶心呕吐的预防%Effects of Different Administration Time of Azasetron on Prevention of Nausea and Vomiting in Postoperative Patient-controlled Analgesia

    Institute of Scientific and Technical Information of China (English)

    耿吉青

    2012-01-01

    目的:探讨阿扎司琼不同时机给药对术后静脉自控镇痛恶心、呕吐的预防效果.方法:120例全麻行腹部手术后接受静脉自控镇痛的患者,随机分为预防组、术后给药组和对照组(n=40).预防组于麻醉诱导前静脉注射阿扎司琼10 mg;术后给药组于手术结束、接镇痛泵前静脉注射阿扎司琼10 mg;对照组不使用阿扎司琼.3组镇痛泵药物配方及使用参数相同.分别于术后4、12、24、48 h观察并记录患者的疼痛视觉模拟评分(VAS)、Ramsay镇静状态评分、恶心呕吐发生率及评分.结果:各组患者镇痛后12~48 h的VAS与4h内比较,差异有统计学意义(P<0.05或P<0.01);均无嗜睡或镇静过深.镇痛后预防组各时段恶心呕吐发生率低于对照组,(P<0.05或P<0.01);术后给药组仅4~12 h明显低于对照组(P<0.01).结论:全麻诱导前静脉预注阿扎司琼能有效预防患者术后静脉自控镇痛所致恶心、呕吐的发生.%Objective To explore the effects of Azasetron at different timing of administration on the prevention of nausea and vomiting in postoperative patient-controlled analgesia. Methods Total 120 patients of general anesthesia undergone abdominal surgery were accepted self-controlled analgesia after operation. All patients were randomly divided into prevention group, postoperative administration group and control group ( n =40). Azasetron were intravenous injection with a dose of 10 mg before induction of anesthesia in prevention group,and azasetron was given in postoperation but before the access of analgesia pump by the same dosage regimen in postoperative administration group. No azasetron was given in control group. The drug components and parameters of analgesia pump in three groups were the same. The visual analog scale of pain, Ramsay sedation score, incidence and score of nausea and vomiting in three groups were recorded at4,12,24,48 h in postoperation, respectively. Results Compared with4

  6. Influence of auricular buried seeds combined with emotional management on bad mood and quality of life of anticipatory nausea and vomiting patients%耳穴埋籽配合情绪管理对预期性恶心呕吐病人不良情绪及生活质量的影响1)

    Institute of Scientific and Technical Information of China (English)

    杜春玲; 王云; 张作芹; 李萍

    2014-01-01

    [目的]探讨耳穴埋籽配合情绪管理对预期性恶心呕吐(ANV)病人不良情绪及生活质量的影响。[方法]将60例发生预期性恶心呕吐病人随机分为干预组与对照组,对照组给予常规护理,干预组在常规护理基础上给予耳穴埋籽及情绪管理。干预前后采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估病人不良情绪,采用简明健康状况量表评估病人生活质量。[结果]干预后干预组病人 SAS、SDS 评分低于对照组;干预组生理功能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能评分均高于对照组;恶心呕吐程度轻于对照组。[结论]耳穴埋籽能有效降低病人预期性恶心呕吐的发生程度,缓解病人的不良情绪,提高病人的生活质量。%Obj ective:To probe into influence of auricular buried seeds com-bined with emotional management on negative bad mood and life quality of anticipatory nausea and vomiting(ANV)patients.Methods:A total of 60 ca-ses of patients with anticipatory nausea and vomiting were randomly divided into intervention group and control group,the patients in control group were given routine nursing,the patients in intervention group were given auricular buried seeds combined with emotional management on the basis of conven-tional care.Before and after the intervention,the self rating Anxiety Scale (SAS)and self rating Depression Scale(SDS)were used for assessment of patients with adverse bad mood,the short form health status scale was used to evaluate the quality of life of patients.Results:After intervention,the scores of SAS and SDS of patients in intervention group were lower than those of control group;the scores of physiological function,physiological role,bodily pain,general health,energy,social function,emotional function of the intervention group were higher than those in control group;the degree of nausea and vomiting was lighter than that in control

  7. Prevention of Nausea and vomiting caused by breast cancer chemotherapy with Palonosetron Hydrochloride and observation of curative effect.%盐酸帕洛诺司琼预防乳腺癌化疗所致恶心呕吐的疗效观察

    Institute of Scientific and Technical Information of China (English)

    冯云; 李蕾蕾; 李振宇

    2013-01-01

      目的观察盐酸帕洛诺司琼在预防乳腺癌患者化疗所致胃肠道反应的疗效和安全性,并与盐酸托烷司琼进行对照.方法采用随机自身交叉对照,120例乳腺癌患者分别为AB组60例和BA组60例,AB组第一周期应用盐酸帕洛诺司琼,第二周期应用盐酸托烷司琼;BA组则相反.结果可评价患者120例,在化疗后0~24h盐酸帕洛诺司琼和盐酸托烷司琼对乳腺癌患者化疗引起的食欲不振、恶心和呕吐的有效率相似,在0~120h和24~120h,盐酸帕洛诺司琼对乳腺癌化疗引起的食欲不振、恶心和呕吐的有效率优于盐酸托烷司琼,差异有明显统计学意义(P<0.05).两种药物的不良反应相似,主要为头痛和便秘.结论盐酸帕洛诺司琼对延迟性恶心、呕吐的有效性优于盐酸托烷司琼,值得临床推广应用.%Objective This study was undertaken to compare the efficacy and safety of palonosetron hydrochloride and tropisetron hydrochloride on prevention of nausea and vomiting effects by the chemotherapeutic drugs of breast cancer. Methods Patients were randomly divided into 2 groups by self-cross comparison: AB group (palonosetron hydrochloride was given in the first cycle and tropisetron hydrochloride in the second) and BA group (the treatment was in an opposite way). Results A total 120 patients were evaluable. The amelioration of anorexia, nausea and vomiting within 0-24 hours treatment were similar in both groups. The inhibition of anorexia, nausea and vomiting in the palonosetron hydrochloride group was significantly obvious than that in the tropisetron hydrochloride treated groups, after the treatment of 0-120 hours and 24-120 hours (P<0.05). The most common adverse event was headache and constipation for these drugs. Conclusion Palonosetron hydrochloride is more effective on delaying nausea and vomiting than tropisetron hydrochloride and with less side effects, which is worth for the clinic use.

  8. 急性心肌梗死表现为突发剧烈头痛和呕吐一例报道并文献复习%Sudden Severe Headache and Vomit as the Sole Presenting Symptoms of Acute Myocardial Infarction:A Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    季政; 袁敏; 许伟源; 许富康; 孟立平; 周昌钻; 刘龙斌; 彭放; 郭航远

    2015-01-01

    急性心肌梗死需要通过其典型的临床症状———胸痛尽早确诊。右心室心肌梗死可严重影响急性血流动力学过程,且是低血压或休克的主要原因,其处理原则不同于左心室功能障碍引起的心源性休克。下壁心肌梗死伴右心室心肌梗死较单纯下壁心肌梗死者预后更差。以头痛和呕吐为表现的急性下壁心肌梗死在临床上罕见,而以头痛和呕吐为表现起病的急性下壁心肌梗死合并右心室心肌梗死更为罕见。本文报道1例由绍兴市人民医院心内科收治,以严重后枕部疼痛和呕吐为主诉且无任何胸部不适症状的急性 ST 段抬高型心肌梗死的罕见患者,患者接受经皮冠状动脉介入术后头痛即刻得到缓解,并进一步详细探讨以头痛和呕吐作为急性心肌梗死唯一临床表现的病理生理学机制,旨在加强临床医师对该病的认识。%Acute myocardial infarction should be diagnosed as early as possible based on typical symptoms. As is known to all,right ventricular myocardial infarction can seriously affect the acute hemodynamic process,and it is the major cause of hypotension or shock. Its treatment principle is very different from cardiogenic shock caused by left ventricular dysfunction. The patients with inferior myocardial infarction who have right ventricular myocardial involvement appear to have worse prognosis than those who only have inferior myocardial infarction. Headache and vomit are unusual symptoms in patients with acute myocardial infraction. Headache and vomit as the only presenting symptoms of acute inferior myocardial infarction complicating right ventricular infarction are extremely uncommon phenomenon. We reported a patient with ST - segment elevation acute myocardial infarction who was admitted into the cardiology department of Shaoxing People's Hospital and who complained of severe occipital headache and vomit without any chest discomfort. After the

  9. Uso da mirtazapina no tratamento da náusea e vômito refratários a terapia habitual após derivação gástrica em Y de Roux Intractable nausea and vomiting following Roux-en-Y gastric bypass controlled with mirtazapine

    Directory of Open Access Journals (Sweden)

    Alexandre Coutinho Teixeira de Freitas

    2008-03-01

    Full Text Available RACIONAL: A cirurgia bariátrica é procedimento com significativa morbidade. A náusea a vômito geralmente ocorrem devido à presença de complicações mecânicas como as estenoses das anastomoses. Alguns casos apresentam sintomas importantes na ausência dessas complicações. OBJETIVO: Relato do uso da mirtazapina no pós-operatório de cirurgia bariátrica em um paciente com náuseas de vômitos refratários ao tratamento clínico habitual, na ausência de complicações mecânicas. RELATO DO CASO: Paciente portador de obesidade mórbida foi submetido à derivação gástrica em Y de Roux laparoscópica. Evoluiu com náusea persistente associada a episódios de vômitos refratários a ondansetron, metoclopramida e bromoprida. Não foram identificadas causas mecânicas para o quadro. Foi iniciado mirtazapina (Remeron® via oral na dose de 30mg por dia durante 60 dias. Após dois dias do início da medicação foi observado melhora total do quadro. A mirtazapina é um antidepressivo que apresenta efeito antiemético através do bloqueio de receptores para a serotonina (5-HT3 no centro do vômito no tronco cerebral. CONCLUSÃO: A mirtazapina pode ser útil nos casos de náusea e vômito refratários à terapia antiemética habitual no pós-operatório de derivação gástrica em Y de Roux, quando causas mecânicas são excluídas.BACKGROUND: Bariatric surgery is related to significant morbidity. Mechanical complications such as stricture of the anastomotic sites are the most common causes of persistent nausea and vomiting. Some patients present such symptoms in the absence of these complications. AIM: To report the use of mirtazapine in a patient submitted to bariatric surgery, presenting persistent nausea and vomiting in the absence of mechanical complications, and unresponsive to conventional antiemetic drugs. CASE REPORT: A morbidly obese patient submitted to laparoscopic Roux-en-Y gastric bypass presented persistent nausea and vomiting

  10. 腹腔镜胆囊切除术中刺激内关穴对术后恶心呕吐的影响%Effect of transcutaneous electrical stimulation at Neiguan (P6) on postoperative nausea and vomiting after laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    刘建新; 赵成文; 徐咏梅

    2012-01-01

    目的 本研究旨在探讨在腹腔镜胆囊切除术中经皮电刺激内关穴对术后恶心呕吐的影响.方法 随机将ASA Ⅰ~Ⅱ级的97例行腹腔镜下胆切除囊术的患者分为四组.空白组(20例):整个手术过程中无任何干预措施;经皮电刺激组(23例):全麻诱导后用电刺激仪以强度100 mA,频率为124 Hz刺激内关穴,直至手术结束;格拉司琼组(34例):于手术开始10 min后静脉注射格拉司琼3 mg;联合组(20例):静脉注射格拉司琼3 mg同时给予上述电刺激强度与频率.观察两组患者术后恶心呕吐的发生率.结果 空白组呕吐发生率为20.0%,恶心发生率为45.0%,格拉司琼组呕吐发生率为11.8%,恶心发生率为11.8%,皮电刺激组呕吐发生率为8.7%,恶心发生率为12.6%,联合组呕吐发生率为5.0%,恶心发生率为15.0%.空白组的恶心、呕吐发生率与其他三组比较差异均有统计学意义(均P 0.05).结论 术中对内关穴持续经皮电刺激可以降低术后恶心呕吐的发生率,其作用与预防性应用3 mg格拉司琼相似,经皮电刺激与格拉司琼组在预防恶心呕吐中无协同作用.%Objective To study the effect of transcutaneous electrical stimulation at Neiguan (P6) on postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods 97 ASA I - ?undergoed elective laparoscopic cholecystectomy were divided into four groups and control group (20 cases); transcutaneous electrical stimulation group (23 cases), transcutaneous electrical stimulation at P6 point was performed from induction of general anesthesia and maintained until the end of surgery with stimulation at frequency of 124 Hz and intensity of 100 mA; Granisetron group (34 caese); combination group (20 cease). The incidence of postoperative nausea and vomiting were followed-up within 24 h after the operation. Results The incidence of nausea was 45.0% and that of vomiting was 20.0% in control group. The incidence of nausea was 11.8% and

  11. Clinical Observation of Aprepitant Triple Therapy on Prevention of Nausea and Vomiting Caused by Anthracycline Combined Cyclophosphamide Chemotherapy Regimen for Breast Cancer%阿瑞匹坦三联用药预防乳腺癌蒽环类药物联合环磷酰胺化疗致恶心呕吐的效果观察

    Institute of Scientific and Technical Information of China (English)

    童雅兰; 韩涛; 宋树玺; 郑振东; 屈淑贤; 邱佳宁; 刘兆喆; 郭放; 谢晓冬

    2016-01-01

    Objective To investigate the effect of combined therapy consisting of aprepitant, tropisetron and dexam-ethasone in prevention of nausea and vomiting induced by breast cancer chemotherapy based on anthracycline and cyclophos-phamide. Methods A total of 62 cases of breast cancer collected from Oncology Department in General Hospital of Shenyang Military Area Command during January 2014 and June 2015 were selected, and those patients all underwent chemotherapy consisting of anthracycline (epirubicin or doxorubicin) combined cyclophosphamide and they were divided into experimental group ( n=31 ) and control group ( n =31 ) by CINV ( chemotherapy-induced nausea and vomiting ) regimen. The control group was given tropisetron and dexamethasone combined regimen in prevention of CINV while the experimental group was added with aprepitant based on the drug used by the control group. The effect and adverse reaction of two groups in acute phase (0-24 h) and delay period (24-120 h) on preventing nausea and vomiting were observed. Results The complete re-sponse rate and the control rate of acute phase had no statistical difference between the two groups (Z=-1. 579, P=0. 114);however, for the delayed vomiting, the complete response rate and control rate of the experimental group were higher than that of the control group and there was significant statistical difference (Z=-2. 196, P=0. 028). Adverse reactions were mild and tolerable with no significant differences between the 2 groups (P>0. 05). Conclusion The combined therapy of aprepitant is definitely effective for the delayed vomiting induced by anthracycline combined cyclophosphamide chemotherapy regimen of breast cancer, and the toxic reaction is tolerable.%目的:评估阿瑞匹坦、托烷司琼、地塞米松三联方案预防乳腺癌蒽环类药物联合环磷酰胺化疗致恶心呕吐的效果及安全性。方法选择2014年1月—2015年6月沈阳军区总医院肿瘤科收治的接收蒽环类药物(表柔

  12. 内关穴按压联合生姜敷贴缓解妇科恶性肿瘤化疗患者恶心呕吐症状的效果%A research of the effect of external use of ginger combined with acupressure on neiguan acupuncture point in preventing chemotherapy-induced nausea, vomiting and retching in gynecologic cancer patients

    Institute of Scientific and Technical Information of China (English)

    朱洁明; 陈加云

    2015-01-01

    目的:探讨内关穴按压联合内关穴生姜敷贴对缓解妇科恶性肿瘤化疗患者恶心呕吐干呕症状( chemotherapy-induced nausea, vomiting and retching,CINV)的效果。方法选择2009年1月至2014年6月在广州市荔湾区第二人民医院治疗的249例妇科恶性肿瘤患者的临床资料,按照是否接受内关穴位按压( A因素)和内关穴位生姜敷贴( B因素)分为4组:联合干预组62例、穴位按压组62例、生姜敷贴组62例、安慰剂对照组63例。采用R-INVR量表在干预前、干预后12 h、24 h评估患者的恶心、呕吐、干呕症状,采用析因设计的方差分析评价内关穴位按压与内关穴位生姜敷贴的主效应及交互效应。结果4组患者干预前CINV基线评分比较差异无统计学意义( P>0.05);在析因方差分析中,内关穴位按压在干预后12 h、24 h的恶心、呕吐症状的主效应均无统计学意义( P >0.05);但干呕症状在干预后12 h、24 h的主效应均有统计学意义(P<0.05)。生姜敷贴在干预后12 h、24 h的恶心、呕吐症状的主效应均有统计学意义(P<0.05),但在干呕维度中12 h、24 h主效应均无统计学意义( P>0.05)。结论内关穴位处姜片敷贴对于缓解妇科恶性肿瘤患者化疗后的恶心和呕吐症状有较好的效果,内关穴位处按压对于缓解妇科恶性肿瘤患者化疗后的干呕症状有较好的效果。%Objective To explore the effect of ginger combined with acupressure on neiguan acupuncture point to alleviate chemotherapy-induced nausea, vomiting and retching in gynecologic cancer patients.Methods Clinical data of 249 gynecologic cancer patients in The Second People's Hospital of Liwan District from Jan 2009 to Jun 2014 were collected, who were divided into 4 groups:combined intervention group (n=62), acupressure group (n=62), ginger applicator group (n=62), placebo group (n=63).Using R-INVR Scale before

  13. 沙利度胺用于预防化疗病人恶心、呕吐的临床疗效观察%Observation on clinical curative effect of thalidomide in prevention of nausea and vomiting in patients with chemotherapy

    Institute of Scientific and Technical Information of China (English)

    陈奕霖; 罗德红; 王美江

    2013-01-01

    目的 观察沙利度胺(Thalidomide反应停)用于缓解化疗病人恶心、呕吐的临床疗效.方法 将53例恶性肿瘤患者(包括乳腺癌、肺癌、大肠癌、胃癌、胰腺癌、软组织肉瘤患者),随机分为2组:试验组25例,采用各科肿瘤传统化疗方案与沙利度胺和5-HT3受体拮抗剂(托烷司琼剂)联合治疗;对照组28例,采用传统化疗方案只与5-HT3受体拮抗剂联合治疗.结果 试验组与对照组病例临床资料相比差异无统计学意义.两组的客观有效率差异无统计学意义(P>0.05).试验组对于恶心、呕吐的完全缓解率和有效率均高于对照组(P<0.05).结论 沙利度胺(反应停)联合5-HT3受体拮抗剂用于治疗化疗过程中病人的恶心、呕吐比单用5-HT3受体拮剂缓解率更高,起效更快,可提高化疗病人的依从性和生活质量.%OBJECTIVE To observe the use of thalidomide in relieving nausea and vomiting of patients with chemotherapy. METHODS 53 cases malignant tumors patients (including breast cancer, lung cancer, colorectal cancer, gastric cancer, pancreatic cancer and soft tissue sarcoma patients) were randomly divided into 2 group: trail group 25 cases, used jointed treatment of traditional chemotherapy programme and thalidomide and 5-HT3 receptor antagonist (Tropisetron) ; control group 28 cases, used jointed treatment of traditional chemotherapy programme and only 5-HT3 receptor antagonist. RESULTS There was no significant difference in trail group and control group. Objective effect rate in two groups was not different (P> 0.05). The complete remission rates of nausea and vomiting in trail group were higher than in control group. CONCLUSION Thalidomide (Thalidomide) and 5-HT3 receptor antagonist for the treatment of nausea and vomiting in chemotherapy patients has higher remission rates than 5-HT3 receptor antagonist, and works faster, improves compliance and life quality of patients undergoing chemotherapy.

  14. 旋覆代赭汤加味防治肿瘤化疗后恶心呕吐随机对照试验的Meta分析%Prevention and curing of modified decoction of Inulae and haematitium for nausea and vomiting after chemotherapy: A Meta-analysis of randomized controlled trials

    Institute of Scientific and Technical Information of China (English)

    史国军; 山广志; 王海荣; 董晶; 杨华锋

    2011-01-01

    目的:评价旋覆代赭汤加味防治肿瘤化疗引起的恶心、呕吐的疗效.方法:计算机检索中国期刊全文数据库和维普中文期刊数据库、万方学术期刊全文数据库2001-01-2010-12的相关文献,收集中药旋覆代赭汤预防肿瘤化疗引起的恶心、呕吐的随机对照试验(RCT).按纳入排除标准筛选试验、评价研究质量、提取有效数据,并采用RevMan 5.0进行统计分析.结果:最终纳入12个RCTs,Meta分析显示,有效率(RR)为1.20,95%CI(1.13~1.27),差异有统计学意义,P<0.01.进行敏感性分析,结果稳定.漏斗图显示不对称,提示纳入评价的文献存在发表性偏倚.结论:中药旋覆代赭汤预防肿瘤化疗引起的恶心、呕吐有效,但由于本系统评价纳入研究的方法学质量较低,尚需开展更多设计合理、执行严格的多中心大样本且随访时间足够长的RCTs验证其疗效及安全性.%OBJECTIVE:To evaluate the efficacy of modified decoction of inulae and haematitium for prevention and curing of nausea and vomiting after chemotherapy. METHODS: CNKI, VIP.WanFang (2001 to 2010) were searched for randomized control trials about modified decoction of inulae and haematitium prevention and curing of nausea and vomiting after chemotherapy. Trial screening, quality assessment of included trials, and data extract were conducted. Statistical analysis was con-ductedby using RevMan 5. 0 software. RESULTS: A total of 12 randomized controlled trials(RCTs)in the Chinese language were included. Meta analysis showed that the effective rate CRR = 1. 20,95%CI(1. 13 -1.27), P<0. 013, between the two groups was statistically significant. Sensitivity analysis showed the result was stable. Funnel plot was asymmetric that indicates publication bias. CONCLUSION:Modified decoction of inulae and haematitium is effective in prevention and curing of nausea and vomiting after chemotherapy, more large-scale multi-center randomized trials are needed.

  15. Clinical investigation of intravenous low-dose metoclopramide in acute gastroenteritis of frequent vomiting children%小剂量静脉应用甲氧氯普胺治疗急性胃肠炎患儿呕吐急症的疗效

    Institute of Scientific and Technical Information of China (English)

    郑虹; 王威

    2013-01-01

    Objective To investigate the clinical efficacy and safety of low-dose metoclopramide injection for treating acute gastroenteritis of frequent vomiting children. Methods One hundred and twenty cases of acute gastroenteritis of frequent vomiting children in the emergency department of our hospital from February 2012 to January 2013 were randomly divided into the treatment group and the control group, 60 cases in each group. The treatment group was treated with low-dose motoclopramide injection.Results The total effective rate was 100% in the treatment group and significantly higher than 83.33% in the control group with statistical difference between the two groups.Conclusion The clinical efficacy of low-dose metoclopramide injection for treating acute gastroenteritis is rapid and good without significant adverse reactions.%  目的探讨小剂量静脉应用甲氧氯普胺治疗以频繁呕吐而无法口服给药为主要表现的急性胃肠炎的临床疗效。方法选择2012年2月~2013年3月本院儿科急诊就诊的频繁呕吐的急性胃肠炎患儿120例,随机将患儿分为治疗组60例和对照组60例。均给予补液、护胃、止泻等常规治疗,治疗组在对照组基础上静脉应用甲氧氯普胺治疗,比较两组疗效。结果治疗组总有效率为100%,对照组为83.33%,差别有统计学意义(P均<0.01)。结论小剂量静脉应用甲氧氯普胺治疗急性胃肠炎频繁呕吐效果明显,不良反应小。

  16. 免气腹悬吊式腹腔镜与常规腹腔镜胆囊切除术术后呕吐的研究%A Comparative Study of Vomiting after Gasless Laparoscopic Cholecystectomy of Abdominal Wall Lifting and Conventional Laparoscopic Cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    王淑贤; 于跃利; 陈彪; 董玉红

    2014-01-01

    Objective:To compare and analyse the patients′ state of postoperative nausea and vomiting(PONV)after gas-less laparoscopic cholecystectomy of abdominal wall lifting(GLC)and convention laparoscopic cholecystectomy(CLC). Meth-ods:60 patients hospitalized for chronic cholecystitis,cholecystolithiasis and gall bladder polypi in the First Affiliated Hospital of Baotou Medical College from July 2009 to March 2010 were randomly divided into GLC group(group A)and CLC group(group B),with 30 patients in each group. Results:The incidence of PONV went down with time in two groups. The incidence of PONV in group B was higher than that in group A at various stages. There was significant difference( P ﹤ 0. 05)in the incidence of nausea within 24 hours after the operation,and significant difference( P ﹤ 0. 05)in the incidence of vomiting within 12 hours after the operation,between the two groups. Conclution:Compared with that in CLC,The incidence of PONV was lower in GLC.%目的:研究悬吊式免气腹腹腔镜胆囊切除术术后发生恶心、呕吐的情况。方法:随机选择包头医学院第一附属医院2009年5月至2010年5月患有胆囊炎、胆囊结石或胆囊息肉入院的患者,随机分为免气腹腹腔镜胆囊切除术组(A 组)30例、传统腹腔镜胆囊切除术组(B 组)30例。结果:术后两组恶心、呕吐发生率随时间而降低,B 组各时间段恶心、呕吐发生率均高于 A 组,在术后24 h 内两组恶心发生率差异均有统计学意义( P ﹤0.05),在术后12 h 内两组呕吐发生率差异均有统计学意义( P ﹤0.05)。结论:免气腹腹腔镜胆囊切除术恶心、呕吐发生率低于传统腹腔镜胆囊切除术。

  17. 我国关于肿瘤化疗患者预期性恶心呕吐干预性研究文献方法学质量评价%Methodology Quality Assessment on Intervention Studies on Anticipatory Nausea and Vomiting forCancer Patients with Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    王晓庆; 段培蓓; 张晓琴; 诸建华

    2014-01-01

    Objective To analyze the current intervention studies on anticipatory nausea and vomiting for cancer patients with chemotherapy and to provide reference for its future studies in China. Methods Literature review with anticipatory nausea and vomiting, gastrointestinal reaction and chemotherapy as key words was conducted in CNKI, Wanfang Data, VIP and CBM and EndNote X3 was applied for duplicate checking, improved Jadad score for methodological quality assessment for those included then comprehensive assessment of the literatures was formed through The CONSORT (Consolidated Standards of Reporting Trials) 2010 Statement. Results Ten literatures were included and interventions mentioned in the literatures involved TCM nursing, psychological intervention and music therapy. Average Jadad score of the literatures was less than two, which indicated poor quality of the literatures. Random number table was found in only one literature and no literature reporting the results with allocation concealment, blinding and withdraw/lost follow-up was found and all literatures lacked standardized writing. Conclusion With poor methodology quality and non-standardized writing, there are less intervention studies on anticipatory nausea and vomiting for cancer patients with chemotherapy in China. Methodology studies on anticipatory nausea and vomiting are in urgent need and more attention should be paid to standardized writing.%目的:分析我国肿瘤化疗患者预期性恶心呕吐干预性研究的现状,为今后的研究提供依据和方向。方法以“预期性恶心呕吐”、“胃肠道反应”、“化疗”为主题词,对中国期刊全文数据库(CNKI)、万方数据库、维普数据库(VIP)及中国生物医学数据库(CBM)关于肿瘤化疗患者预期性恶心呕吐研究的护理文献检索;采用EndNote X3软件查重,对符合纳入排除标准的文献采用改良后的Jadad量表进行方法学质量评价,采用 CONSORT声明2010

  18. 托烷司琼联合舒必利对顺铂方案化疗所致恶心、呕吐的影响%The effect of tropisetron combined with sulpiride on chemotherapy-induced cisplatin program nausea and vomiting

    Institute of Scientific and Technical Information of China (English)

    曹启军; 王海霞

    2014-01-01

    Objective To investigate the efficacy and safety of tropisetron combined with sulpiride in treatment of chemotherapy-induced cisplatin program nausea and vomiting,so as to explore the effect to motilin and gastrin.Methods A total of 84 patients with chemotherapy-induced cisplatin program nausea and vomiting were divided into study group (44 cases) and control group (40 cases) by random digits table method,the patients in two groups were given tropisetron hydrochloride intravenous injection,and the study group was added sulpiride.The efficacy and side effects and effect to motilin and gastrin were observed.Results The fully control rate and efficient rate in acute nausea was 59.09% (26/44),37.50% (15/40),and 90.91% (30/44),72.50% (29/40) in study group and control group,and there was significant difference (P < 0.05).The fully control rate and efficient rate in acute vomiting was 61.36 % (27/44),37.50% (15/40),and 88.64% (39/44),67.50% (27/40) in study group and control group,and there was significant difference (P <0.05).The fully control rate and efficient rate in delayed nausea was 54.54% (24/44),32.50% (13/40),and 79.55% (35/44),57.50% (23/40) in study group and control group,and there was significant difference (P < 0.05).The fully control rate and efficient rate in delayed vomiting was 45.45 % (20/44),22.50% (9/40),and 75.00% (33/44),52.50% (21/40) in study group and control group,and there was significant difference (P< 0.05).The plasma motilin after treatment was lower than that before treatment in study group and control group[(308.35 ± 14.59) ng/L vs.(370.59 ± 15.72) ng/L and(341.87 ± 18.38) ng/L vs.(365.36 ± 23.72) ng/L],gastrin was higher than that before treatment in study group and control group [(206.97 ± 12.29) ng/L vs.(164.56 ± 14.17) ng/L and (171.58 ± 13.53) ng/L vs.(158.42 ± 17.29) ng/L],and there was significant difference (P < 0.05).There was significant difference in the plasma motilin and

  19. Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.

    Science.gov (United States)

    Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

    2015-03-01

    The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV.

  20. Drinks to Prevent Dehydration in a Vomiting Child

    Science.gov (United States)

    ... Pediatrician Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial Developmental ... pediatrician immediately. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American ...

  1. Ginger effects on control of chemotherapy induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Seyyed Meisam Ebrahimi

    2013-09-01

    Full Text Available Background : Chemotherapy-induced nausea (CIN in the anticipatory and acute phase is the most common side effect in cancer therapy. The purpose of this study was to investigate the effect of ginger capsules on the alleviation of this problem. Methods : This randomized, double-blind, placebo-controlled clinical trial was performed on 80 women with breast cancer between August till December 2009 in Imam Khomeini Hospital, Tehran, Iran. These patients underwent one-day chemotherapy regime and suffering from chemotherapy-induced nausea. After obtaining written consent, samples were randomly assigned into intervention and control groups. Two groups were matched based on the age and emetic effects of chemotherapy drugs used. The intervention group received ginger capsules (250 mg, orally four times a day (1 gr/d and the same samples from the placebo group received starch capsules (250 mg, orally for three days before to three days after chemotherapy. To measure the effect of capsules a three-part questionnaire was used, so the samples filled every night out these tools. After collecting the information, the gathered data were analyzed by statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square using version 8 of STATA software. Results : The mean ± SD of age in the intervention and placebo groups were 41.8 ± 8.4 and 45.1 ± 10 years, respectively. Results indicated that the severity and number of nausea in the anticipatory phase were significantly lower in the ginger group compared with placebo group (P=0.0008, P=0.0007, respectively. Also, the intensity (P=0.0001 and number (P=0.0001 of nausea in the acute phase were significantly lower in the ginger group. On the other hand, taking ginger capsules compared with placebo did not result in any major complications. Conclusion: Consuming ginger root powder capsules (1 gr/d from three days before chemotherapy till three days after it in combination with the standard anti-emetic regimen can help to reduce the anticipatory and acute nausea.

  2. Revisiting transdermal scopolamine for postoperative nausea and vomiting

    OpenAIRE

    Pergolizzi, Jr.,Joseph; Taylor, Robert; Robert B. Raffa; Zampogna, Gianpietro; Annabi,Hani Michael; Pallaria,Thomas J.

    2015-01-01

    Joseph V Pergolizzi,1–3 Robert B Raffa,4 Gianpietro Zampogna,5 Hani Michael Annabi,6 Thomas J Pallaria,7 Robert Taylor,5,6 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 2Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA, 3Association of Chronic Pain Patients, Houston, TX, 4Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA, 5NEMA Research, Bonita Springs, FL, 6Public He...

  3. Post-operative Nausea and Vomiting at Mulago Hospital

    African Journals Online (AJOL)

    jen

    1Department of Surgery, 2Dept of Anaesthesia Mulago Hospital, Kampala – Uganda ... problem because it is transient and does not carry mortality implications. .... Breast. Others. 45 (50.0). 4 (10.8). 19 (59.4). 3 (25.0). 3 (27.3). 45 (50.0).

  4. Assessment of nausea and vomiting of pregnancy on antenatal ...

    African Journals Online (AJOL)

    admin

    occupational functioning and the states of maternal role. ... 0.5, the margin of error of 0.5 and 95% confidence level. Using a ... Addis Ababa, and permission to conduct the study in the ... No of alive children .... registration of symptoms than self report as in our study ..... Gazmarian JA, Peterson R, Jamieson DJ, Schild L,.

  5. Cyclic vomiting syndrome: a brain-gut disorder.

    Science.gov (United States)

    Li, B U; Misiewicz, Larry

    2003-09-01

    Despite the "black box" surrounding CVS, the authors' understanding of this clinical entity has advanced substantially in the last decade as a result of an international interdisciplinary clinical and research effort. Although CVS is now recognized as a unique clinical entity, patients still undergo innumerable hospitalizations and diagnostic tests. Although controlled therapeutic studies are lacking, reasonably effective empiric approaches have been developed by trial and error using anti-migraine, anti-emetic, and anti-epileptic regimens. The ongoing investigations of migraine mechanisms through NMR spectroscopy, mitochondrial DNA mutations and cellular energetics, corticotropin-releasing factor and gastric motility, and brainstem regulation of autonomic function may lead to breakthroughs in the understanding of and new therapies for CVS in the next decade.

  6. 格拉司琼单药与联合用药预防含顺铂方案化疗所致呕吐的随机对照研究%Randomized,controled study of granisetron versus granisetron plus dexamethasone,me-toclopramide and vitamin B6 for prevention of cisplatin-induced vomiting

    Institute of Scientific and Technical Information of China (English)

    王永兵; 程宏文; 青亮; 冉体斌; 江涛; 何苗; 骆明莲

    2014-01-01

    目的:探讨格拉司琼单药与联合多药预防含顺铂方案化疗所致恶心呕吐的疗效和不良反应。方法:采用随机分组、交叉设计、自身对照的研究方法。联合用药组给予格拉司琼+地塞米松+胃复安+维生素B6,单药组仅给格拉司琼。对比第一、二周期化疗后两组急性和延迟性呕吐的完全缓解率、进食状况和不良反应。结果:共入组100例患者,其中1例自动退出,1例因顽固性呃逆退出,98例可评价疗效。联合组和单药组对急性呕吐的完全缓解率分别为73.5%(72/98)和61.2%(60/98)(P=0.009);对延迟性呕吐的完全缓解率分别为49.0%(48/98)和40.8%(40/98)(P=0.015);食欲下降的发生率分别为20.4%(20/98)和45.9%(45/98)(P=0.001)。两组头痛、便秘、胃部不适以及呃逆的发生率差别无统计学意义(均P>0.05),但联合用药组的兴奋失眠患者较单药组多(10例vs 1例)(P=0.005)。结论:格拉司琼联合地塞米松、胃复安、维生素B6对缓解顺铂等强致吐方案化疗的药物性呕吐效果更优,并能改善食欲,是一个安全、有效、经济的一线治疗方案。%Objective:To investigate the efficacy and safety of granisetron single drug group and combined group in prevention of nausea and vomiting induced by cisplatin.Methods:To use a randomized,self-crossover clinical study with combined group received granisetron plus dexamethasone,metoclopramide and vitamin B6 ,and single drug group received granisetron only.The efficacy was evaluated by prevention of vomiting in aperiod of 5 days after chemo-therapy.Safety was assessed according to National Cancer Institute Common Toxicity Criteria version 3.0(NCI-CTC 3.0).Results:One hundred patients were enrolled,98 cases were assessable for efficacy.The complete response rates for combined group and single drug group were 73.5%versus

  7. 护理干预预防结直肠癌化疗患者恶心呕吐的疗效观察%Effect of a nursing Interventions on Preventing nausea and vomiting in Chemotherapy patients with colo-rectal cancer

    Institute of Scientific and Technical Information of China (English)

    王利平; 董会民; 张秀霞; 朱玉欣; 张红娟

    2013-01-01

    化疗是结直肠癌患者比较常用的一种治疗方法。但治疗中产生的副作用如恶心、呕吐常可引起脱水、代谢紊乱等不良后果,严重者会影响化疗的正常进行[1-2]。我们针对113例结直肠癌化疗患者进行了一系列综合干预措施(化疗前期作好护理评估,了解化疗经历,熟悉化疗方案,掌握心理状态,化疗期间给予患者适当心理疏导及饮食指导,创造良好进食环境,正确使用止吐药,严密观察副作用等)来预防其发生恶心的副反应。结果显示,113例患者中只有5例出现轻度恶心症状,护理干预措施有效。%Chemotherapy is a commonly treatment method of colon-rectal cancer patients. However, it is the side effects such as nausea and vomiting could cause dehydration, metabolic disorder and other adverse consequences, that can even discontinue the treatment. We used a series of nursing interventions(including:do a good nursing assessment before chemotherapy, knowing well the chemotherapy, master the patients’ mental state, supply mental nursing and dietary instruction, create good eating environment,master medication’s giving time, use the antiemetic properly , observe the side effects rigorously, and so on) to aim directly at 113 patients in Chemotherapy with colo-rectal cancer,who in order to prevent the side effects of nausea. The results showed that only five patients have mild-nausea, therefore nursing interventions have been effective in preventing nausea in Chemotherapy patients with colo-rectal cancer .

  8. Recomendaciones de prevención y tratamiento de las náuseas y vómitos postoperatorios y/o asociados a las infusiones de opioides Recommendations for the prevention and treatment of postoperative and/or opioid infusion-related nausea and vomiting

    Directory of Open Access Journals (Sweden)

    J. I. Gómez-Arnau

    2011-02-01

    . El fármaco de elección en la prevención de las NV asociadas a infusión de opiáceos es droperidol.Postoperative nausea and vomiting (PONV causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Española de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1 Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2 Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3 Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1 who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach. 4 Dexamethasone, droperidol, and ondansetron (or other setrons have similar levels of efficacy; drug choice should be made based on individual patient factors. 5 The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6 Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7 The drug of choice for preventing OINV is droperidol.

  9. Effect of individualized music on the unhealthy emotion and copying styles of patients with anticipatory nausea and vomiting%个体化音乐干预对预期性恶心呕吐患者不良情绪及应对方式的影响

    Institute of Scientific and Technical Information of China (English)

    王云; 杜春玲; 王学梅

    2012-01-01

    目的 探讨个体化音乐干预对预期性恶心呕吐患者不良情绪与应对方式的影响.方法 选择60例发生预期性恶心呕吐的患者,按随机数字表法分为实验组与对照组各30例.两组均接受常规护理,实验组在常规护理的基础上运用个体化音乐干预,时间为21 d,干预前后观察两组患者恶心呕吐情况,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、简易应对方式问卷测定两组患者焦虑、抑郁、应对方式情况,并进行比较.结果 两组患者干预前预期性恶心呕吐程度差异无统计学意义(U=0.000,P=1.000);干预后两组患者恶心呕吐程度差异有统计学意义(U=2.583,P<0.05);干预前两组SAS、SDS、应对方式评分比较差异均无统计学意义(P>0.05);干预后实验组患者SAS、SDS、积极应对、消极应对评分分别为(40.34±4.49),(42.80 ±11.14),(27.57±5.99),(14.67±6.38)分,对照组分别为(46.86 ±4.73),(49.93±10.31),(23.53 ±6.76),(18.20±6.28)分,两组比较差异有统计学意义(t值分别为3.635,2.951,2.096,2.403;P<0.05).实验组患者干预前后SAS、SDS评分比较差异均有统计学意义(P<0.05).结论 个体化音乐干预可以改善ANV患者的不良情绪及应对方式,缓解患者焦虑、抑郁,减轻预期性恶心呕吐的程度,提高患者的生活质量.%Objective To observe the effect of individualized music on the unhealthy emotion and copying styles patients with anticipatory nausea and vomiting.Methods Totals of 60 patients suffered with ANV were selected and divided into the experimental group (n =30) and control group (n =30) according to the table of random number method.The control group received conventional care,while the experimental group received both conventional care and Individualized music.Self-rating anxiety scale (SAS),self-rating depression scale (SDS),simplified coping style questionnaire were used to investigate the patients before and after the intervention

  10. Effects of granisetron on vomiting, anti-depression and memory enhancement potential of rolipram%格拉司琼对咯利普兰致呕吐、抗抑郁及增强学习记忆能力的影响

    Institute of Scientific and Technical Information of China (English)

    李国熊; 周涛; 周恒; 许重远; 徐江平

    2011-01-01

    OBJECTIVE To assess the anti-emetic potential of granisetron(Gra) on mice vomiting induced by rolipram(Rol) and the effect of Gra on anti-depression and spatial memory enhancement of Rol.METHODS The anti-emetic potential of Gra was evaluated based on the duration of anesthesia in mice induced by the combination of xylazine/ketamine, which was determined as the time between the loss and regaining of the righting reflex.The depression models ( forced swimming test and tail suspension test ) and Morris water maze were used to assess the anti-depression and cognitive enhancement effects with the combination of Gra and Rol.RESULTS Rol 0.5 mg·kg-1 significantly reduced duration of anesthesia induced by xylazine/ketamine in KM mice from (48.6 ± 11.1)minto (30.0±8.6)min (P<0.05).Then Rol combined with Gra0.05, 0.5 and5 mg·kg-1 increased the duration of anesthesia compared with Rol as (39.5 ±15.5)min, (43.1 ± 17.7 ) min ( P < 0.05 ) and (42.1 ± 16.6 ) min ( P < 0.05 ).Forced swimming test and tail suspension test data showed Rol combined with Gra did not influence the immobility time.Meanwhile, Rol combined with Gra did not influence spatial memory performance in Morris water maze.CONCLUSION Rol combined with Gra can significantly reduce the emetic potential of Rol, without intervention in its antidepressant effects or cognitive enhancement.So the combination of Rol and Gra is a potential effective treatment for nausea and vomiting in pharmacodynamics.%目的 评价格拉司琼(Gra)对咯利普兰(Rol)潜在致恶心呕吐反应的影响,同时考察Gra对Rol抗抑郁作用及增强空间学习记忆能力的影响.方法 通过观察氯胺酮/赛拉嗪诱导的麻醉小鼠翻正反射恢复时间来间接评价Rol潜在的致恶心呕吐反应;采用强迫游泳实验、悬尾实验、Morris水迷宫考察Rol与Gra合用对小鼠抑郁样症状、空间学习记忆能力的影响.结果 Rol 0.5 mg·kg-1能显著地将氯胺酮/赛拉嗪诱导的小鼠翻正

  11. Náuseas e vômitos no pós-operatório: uma revisão do "pequeno-grande" problema Náuseas y vómitos en el posoperatorio: una revisión del "pequeño-grande" problema Postoperative nausea and vomiting: a review of the "minor-major" problem

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    Neusa Lages

    2005-10-01

    ños, éstos aún ocurren frecuentemente en grupos de riesgo elevado. La estrategia actual para la prevención y manoseo de NVPO permanece por establecer y las líneas de orientación de Gan deberán ser adaptadas a cada población de pacientes y a la institución hospitalaria.BACKGROUND AND OBJECTIVES: Notwithstanding continuous investigations and the development of new drugs and techniques, postoperative nausea and vomiting (PONV are frequent and may contribute to the development of complications, thus increasing hospital and human costs. This article aimed at reviewing physiological mechanisms, risk factors and therapeutic approaches available to manage PONV. CONTENTS: Several strategies to manage PONV are suggested in this article, but stress is given to guidelines published by Gan in 2003. They are the most recent contribution for risk stratification, prevention and treatment of PONV patients. CONCLUSIONS: Although the management of PONV has improved in recent years, it is still common among high-risk patients. Current strategy to prevent and treat PONV is not yet established and Gan guidelines should be adapted to each population and institution.

  12. Preliminary antigenic characterisation of an adult worm vomit preparation of Fasciola hepatica by infected human sera Caracterização antigênica preliminar de preparação de vômito de verme adulto de Fasciola hepatica por soros humanos infectados

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    María Alejandra De Almeida

    2007-02-01

    Full Text Available Fascioliasis is an emerging/re-emerging vector-borne disease with the widest known distribution. Approximately 17 million people are infected around the world, being the Andean region the most affected area. There is an important necessity to develop sensitive and specific diagnostic tools to treat patients early and to avoid complications. In this paper we evaluated the immune response of infected humans against two antigenic preparations: the total soluble extract (FhTSE and the adult worm vomit (FhAWV in order to identify antigenic fractions specific for Fasciola hepatica. Both preparations were processed by SDS-PAGE and Western blot with human sera with fascioliasis (F, other parasitosis and healthy individuals. In the immunoblot of FhTSE, sera F recognised 16 bands with MW between eight and 110 kDa, from which those of 8, 9, 10, 38, 45 and 57 kDa were specific. In the preparation FhAWV, sera F recognised nine bands with MW from eight to 85 kDa, from which those of 8, 12, 15 and 24 kDa were specific. Some bands of cross-reaction were evident with sera from patients with other parasitoses, more frequent with the FhTSE. Bands within the MW mentioned, particularly that of eight kDa, have been shown to be specific by others, and deserve additional characterisation for their potential use in immunodiagnosis.Fasciolíase é uma doença emergente/re-emergente transmitida por vetores com a distribuição sabidamente mais ampla. Existem aproximadamente 17 milhões de pessoas infectadas em todo mundo, sendo a região andina a área mais afetada. Há uma necessidade importante para desenvolver ferramentas diagnósticas sensíveis e específicas para tratar cedo os pacientes e para evitar complicações. Neste trabalho avaliamos a resposta imune de seres humanos infectados comparando a duas preparações antigênicas: o extrato solúvel total (FhTSE e o vômito (FhAWV do verme adulto a fim de identificar as frações antigênicas específicas para

  13. Profilaxia de náuseas e vômitos pós-operatórios em obesos mórbidos submetidos a gastroplastias por laparoscopias: estudo comparativo entre três métodos Profilaxis de náuseas y vómitos postoperatorios en obesos mórbidos sometidos a la gastroplastia por laparoscopías: estudio comparativo entre tres métodos Prophylaxis of postoperative nausea and vomiting in morbidly obese patients undergoing laparoscopic gastroplasties: a comparative study among three methods

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    Melissa Nespeca Mendes

    2009-10-01

    morbidez, aumentan el coste del ingreso y conllevan a la insatisfacción de los pacientes. El objetivo de este estudio, fue comparar diferentes esquemas para la prevención de náuseas y vómitos en el postoperatorio de gastroplastias videolaparoscópicas. MÉTODO: Estudio prospectivo hecho al azar con 77 pacientes sometidos a la gastroplastia videolaparoscópica. Fueron divididos en: grupo Cont, control (n = 19 sin administración de cualquier antiemético; grupo Dexa (n = 16 administrado dexametasona; grupo Onda (n = 20, ondansetrona; grupo Dexa + Onda (n = 22, asociación de las dos últimas medicaciones. Para todos los pacientes se aplicó una anestesia estandarizada y una analgesia postoperatoria con morfina por vía venosa. Se excluyeron del estudio aquellos que usaban protectores gástricos o antieméticos, como también portadores de hernia de hiato. Se registraron los datos demográficos, duración de la operación, dosis de morfina usada y el aparecimiento de náuseas y vómitos en el postoperatorio inmediato (hasta seis horas. RESULTADOS: No hubo diferencia estadística entre los grupos con relación a los datos demográficos y a las dosis de morfina usadas (One-way ANOVA. La incidencia de náusea y/o vómito en cada grupo fue: grupo Cont - 78,94%; grupo Dexa - 62,5%; grupo Onda -50% y grupo Dexa + Onda - 18,8% (p = 0,0002. CONCLUSIONES: La incidencia de náusea y/o vómito postoperatorios en gastroplastia videolaparoscópica queda reducida con la combinación de la ondansetrona y la dexametasona de forma más eficaz que con el uso aislado de esas mismas medicaciones.BACKGROUND AND OBJECTIVES: Videolaparoscopic bariatric surgeries are associated with a high incidence of postoperative nausea and vomiting. Those events can lead to significant morbidity, increase hospitalization costs, as well as patient dissatisfaction. The objective of this study was to compare different prophylaxis protocols of postoperative nausea and vomiting in videolaparoscopic

  14. Estudo comparativo de antieméticos e suas associações, na prevenção de náuseas e vômitos pós-operatórios, em pacientes submetidas a procedimentos cirúrgicos ginecológicos Estudio comparativo de antieméticos y sus asociaciones, en la prevención de náusea y vómito postoperatorios, en pacientes sometidas a procedimientos quirúrgicos ginecológicos Comparative study of anti-emetics and their association, in the prevention of postoperative nausea and vomiting in patients undergoing gynecologic surgeries

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    Taylor Brandão Schnaider

    2008-12-01

    . MÉTODO: Setenta pacientes, ASA I y II, fueron sometidas a procedimientos quirúrgicos ginecológicos, bajo bloqueo epidural asociado a la anestesia general. En el Grupo Metoclopramida (GM, se administró 20 mg; en el Grupo Dexametasona (GDe, se inyectó 8 mg; en el Grupo Droperidol (GDr se administró 1,25 mg; en el Grupo Ondansetron (GO se inyectó 8mg; en el Grupo Dexametasona-Ondansetron (GDeO se administró respectivamente 8 mg y 4mg; en el Grupo Droperidol-Ondansetron (GDrO se inyectó 1,25 mg y 4 mg; en el Grupo Dexametasona-Droperidol-Ondansetron (GDeDrO se administró 8mg, 0,625 mg y 4mg. La presencia de náuseas y vómitos fue observada en los momentos de 6, 12, 24 y 36 horas después del término de la operación. RESULTADOS: La incidencia total de episodios de náuseas fue de 4 en el GDeDrO, 6 en el GO, 6 en el GDrO, 11 en el GDe, 11 en el GDeO, 18 en el GM y 22 en el GDr. Al aplicar el test del Chi-cuadrado o el test de Fisher, se comprobó la diferencia estadística significativa entre el GDr y los grupos GDe, GDO, GDrO, GDeO, GDeDrO; entre el GM y los grupos GO, GDrO y GDeDrO; entre el GDeO y el grupo GDeDrO. La incidencia total de episodios de vómitos fue de 3 en el GO, 3 en el GDeDrO, 6 en el GDrO, 7 en el GDe, 7 en el GDeO, 10 en el GDr y 13 en el G. Se comprobó así mismo, la diferencia estadística significativa entre el GDr y los grupos GO y GDeDrO; entre el GM y los grupos GO y GDeDrO. CONCLUSIONES: La asociación dexametasona-droperidol-ondansetron y el ondansetron fueron más eficaces en la profilaxis de náuseas y vómitos.BACKGROUND AND OBJECTIVES: Prophylaxis of postoperative nausea and vomiting has been the subject of several studies. The objective of the present study was to compare anti-emetics, and their association, in the prevention of postoperative nausea and vomiting. METHODS: Seventy patients, ASA I and II, underwent epidural block associated with general anesthesia for gynecologic surgeries. Patients in the Metochlopramide Group

  15. Electrocardiographic Changes After Granisetron Administration for Chemotherapy Induced Nausea and Vomiting

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    Alidoosti Asadolah

    2009-10-01

    Full Text Available Cancer patient receive various cytotoxic drugs in association with antiemetic drugs such as 5HT3 receptor antagonists as their chemotherapy regimen. 5HT3 receptor antagonists have been reported to produce changes in ECG parameter. There are only a few studies about cardiovascular events of these drugs in patient receiving potentially cardiotoxic chemotherapies. The subject of this study is to evaluate ECG changes after administration of chemotherapeutic agents and granisetron (the most commonly used 5HT3 antagonist in Iran in adults with cancer. For this clinical trial study, all cancer patients referred to department of radiation oncology of Imam Hossein Hospital since August 2005 to March 2006 were evaluated if they had inclusion criteria. Granisetron (3 mg was infused intravenously over 30 seconds just a few minutes before chemotherapeutic agent administration. The 12-lead ECG recording was obtained before and 90 minutes after infusion of granisetron. One cardiologist determined PR, QRS, QTc intervals and heart rate of all ECGs. During the study period 54 patients fulfilled our criteria. With paired t-test, the PR and QTc intervals, but not QRS interval showed statistically significant prolongation after drug infusion (P < 0.0001, and heart rate showed statistically significant decrease (P < 0.0001. The ECG findings of chemotherapeutic agents and granisetron administration were prolongation of PR and QTc intervals and decrease of heart rate (P < 0.0001. Although these changes did not cause clinical signs, with keeping in mind that there may be possible drug-drug interactions and preexisting cardiac comorbidities in cancer patient, it seems reasonable and necessary to consider physical condition specifically cardiac condition and drug usage of each patient, while designing chemotherapy regimen and supportive drugs.

  16. Randomized clinical trial of preoperative dexamethasone on postoperative nausea and vomiting after laparoscopy for suspected appendicitis

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