Perioperative effects of caudal and transversus abdominis plane (TAP) blocks for children undergoing urologic robot-assisted laparoscopic surgery
Mark A. FaasseBruce W. LindgrenBrendan T. FraineyC.R. MarcusDorota SzczodryAlexander P. GlaserSanthanam SureshEdward M. Gong
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Ketorolac Tromethamine
Endogenous opioid
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ABSTRACT Background: Postoperative nausea and vomiting is a common complication of anaesthesia and surgery. It is considered the most common cause of morbidity following anaesthesia and has significant effects on patient satisfaction and cost. Despite modern anaesthetic and surgical techniques, the incidence of PONV remains high. Objective: The objective of this study was to determine the incidence of postoperative nausea and vomiting and associated factors. Methods: A cross-sectional study was conducted from January 1 to May 30, 2019. A total of 355 adult elective patients who were operated on this period were included in the study. Results: The incidence of postoperative nausea and vomiting was 17.2% within 24 h after operation. Factors that were associated with postoperative nausea and vomiting were history of motion sickness (AOR = 6.0, CI = 2.51–14.49), previous history of postoperative nausea and vomiting (AOR = 13.55, CI = 6.37–28.81) and long duration of surgery (AOR = 10.1, CI = 3.97–25.92). Conclusion: and recommendations: The incidence of postoperative nausea and vomiting was still high compared with most studies conducted in the world. However, when it compared to the previous study done in the study area, it showed significant reduction in the incidence of PONV by 19%.We suggest that the use of anti-emetic prophylaxis and the introduction of postoperative nausea and vomiting treatment protocols. Highlights:
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Summary Postoperative nausea and vomiting is one of the most common complications of inpatient and day case surgical procedures. In a climate where total cost of an illness is becoming increasingly important, postoperative nausea and vomiting is a major contributor to direct and indirect costs for both the hospital and patient. In patient terms, the impact of increased recovery room stays and extra nursing time required by PONV patients has been estimated to range from 96–576 more surgical procedures which may be performed in an‘average’day case surgery centre. Postoperative nausea and vomiting is perceived by patients to account for equal or more debilitation than surgery itself and may cause them to lose wages due to absence from work. Reducing the incidence of nausea and vomiting and its associated problems may therefore provide opportunities to improve patient care, decrease the size of waiting lists and improve utilisation of scarce healthcare resources.
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Objective To observe the effects of Shudan on preventing postoperative nausea and vomiting (PONV) after pediatric strabotomy. Methods 40 children were randomly divided into two groups. Shudan was used during operation in Group A , while none of anti-vomiting agent was used in Group B, General anesthesia were used in all patients. The rates of postoperative nausea and vomiting in 24 hours were recorded in both groups, MAP, HR,SPO2 were measured before and after administration. Results The rate of postoperative nausea and vomiting in Group A was significantly lower than that in Group B ( P 0.05). Conclusion Shudan can effectively prevent postoperative nausea and vomiting (PONV) after pediatric strabotomy and is smooth in patients.
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This study was done to compare a new analgesic ketorolac with ibuprofen in post-operative and post-laparoscopy pain. A total of 40 patients were recruited for the study of which 20 were post-operative and 20 were post-laparoscopy cases. Medication was given over a period of 48 hours after surgery and a pain score based on subjective symptoms was monitored at fixed intervals after each dose. The analgesic efficacy of ketorolac was found to be comparable to that of ibuprofen and the drug was well tolerated in the doses used without any extra medication being required.
Ibuprofen
Ketorolac Tromethamine
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Now-a-days, there is a need for newly, non-addicted and effective analgesics with less side effects. Therefore, the present study evaluated the analgesic, antipyretic and anti-inflammatory efficacy of ketorolac in 7–21 days old broiler chicks and its possible application in the related field. The analgesic median effective dose (ED50) of ketorolac that caused analgesia in 50% of the chicks was 9.1 mg/kg, intramuscular (IM). Ketorolac caused analgesic and antipyretic effects at multiple doses (5, 10 and 20 mg/kg, IM) in a dose dependent manner, whereas these percentages were significantly higher when ketorolac was injected @ 10 and 20 mg/kg, IM. All times recorded (15, 30, 60 and 120 min) for evaluating the analgesic effect of ketorolac produced analgesia while the higher and better analgesic efficacy was observed at 15 min after ketorolac injection. The injection of ketorolac @ 20 mg/kg, IM exerted anti-inflammatory activity by significantly reducing the right paw thickness of the chicks as a result of formaldehyde injection in comparison to control. There was no liver damage, impaired metabolism and function may be attributed to the ketorolac treatment in the chicks which was evaluated through estimation of serum AST and ALT concentrations. The study suggests the benefit of using ketorolac as an analgesic, antipyretic and antiinflammatory drug in the field of veterinary medicine due to its good, reliable and efficient efficacy.
Antipyretic
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Numerous studies about postoperative nausea and vomiting management are available and meta-analyses have helped to define the appropriate doses of the effective drugs. Almost all recent papers include some economical considerations. In order to rationalize the therapeutic protocols, strategies including systematic prophylaxis, treatment of established postoperative nausea and vomiting only, targeted prophylaxis, treatment combinations aimed at secondary prophylaxis, and global management have all been proposed. Published data are not always valid for every clinical setting and a cost-effective policy needs an evaluation effort from the local care providers (incidence of immediate and delayed postoperative nausea and vomiting, cost of an emetic episode, indirect impact of postoperative nausea and vomiting). This is the only way to avoid improper use of conclusions possibly drawn in totally different medical and economical circumstances. Patients consider postoperative nausea and vomiting as the worst postoperative symptom. This translates into the sizeable amount of money patients are willing to pay in order to avoid this major side effect.
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Background: Postoperative nausea and vomiting (PONV) is a highly observed feature postoperatively. The type of surgery, the technique, medication, duration of anesthesia, and various patient factors all contribute to the condition.Objectives: To evaluate and compare the effect of halothane and propofol on early postoperative nausea and vomitingPatients and methods: A randomized clinical trial was conducted on 80 patients who scheduled for hernioplasty during the 1st of October/ 2010 to the 5th of February/ 2012 in Baghdad Teaching Hospital / Medical City Complex / Baghdad / Iraq. All patients were allocated into two groups randomly (40 patients each), group(A) were received 1-2 mg/Kg propofol as induction and used for maintenance of anesthesia and group (B) were receive anesthetizing dose of thiopentone 3-5 Mg/Kg, and maintained on halothane. Presence of nausea and vomiting episodes were recorded at 4 time schedule (recovery, 2 hours, 4 hours and 6 hours) postoperatively in both groups.Result: the incidence of nausea and vomiting were more among cases who received halothane, and along the time from recovery to 6 hours post operatively nausea and vomiting were absent in all cases of propofol group.
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Propoxyphene
Acetaminophen
Ibuprofen
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Background: Pain due to dental extraction, particularly after the third molar extraction causes discomfort to patients. Different types of analgesics used to manage pain in such cases include nonsteroidal anti-inflammatory drugs and opioids. Objectives: To evaluate the pre-emptive analgesic effectiveness of oral ketorolac and intramuscular (IM) tramadol following lower third molar surgeries. Materials and Methods: A total 60 subjects with impacted mandibular third molars were included in our study. They were randomized into two treatment groups, each with 30 patients. Group A: oral ketorolac 10 mg and IM placebo (1 mL saline solution); Group B: oral placebo (tablet similar to oral ketorolac) and IM tramadol 50 mg diluted in 1 mL saline solution. The treatment regimen were given half an hour before the start the surgery. The parameters evaluated were pain intensity, the time of first analgesic rescue medication and total analgesic consumption. Results: We found that the time of first rescue analgesic medication was longer in oral ketorolac group than IM tramadol group (P=0.01). Group A patients experienced less pain than Group B patients. Conclusion: We found that oral ketorolac group of patients had an enhanced analgesic effectiveness and a longer time of first rescue analgesic than those taking intramuscular tramadol.
Ketorolac Tromethamine
Intramuscular injection
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