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Daniel I Sessler - One of the best experts on this subject based on the ideXlab platform.

  • does neostigmine administration produce a clinically important increase in Postoperative Nausea and vomiting
    Anesthesia & Analgesia, 2005
    Co-Authors: Chingrong Cheng, Daniel I Sessler, Christian C. Apfel
    Abstract:

    Neostigmine is used to antagonize neuromuscular blocker-induced residual neuromuscular paralysis. Despite the findings of a previous meta-analysis, the effect of neostigmine on Postoperative Nausea and vomiting remains unresolved. We reevaluated the effect of neostigmine on Postoperative Nausea and vomiting while considering the different anticholinergics as potentially confounding factors. We performed a systematic literature search using MEDLINE, Embase, Cochrane library, reference listings, and hand searching with no language restriction through December 2004 and identified 10 clinical, randomized, controlled trials evaluating neostigmine's effect on Postoperative Nausea and vomiting. Data on Nausea or vomiting from 933 patients were extracted for the early (0-6 h), delayed (6-24 h), and overall (0-24 h) Postoperative periods and analyzed with RevMan 4.2 (Cochrane Collaboration, Oxford, UK) and multiple logistic regression analysis. The combination of neostigmine with either atropine or glycopyrrolate did not significantly increase the incidence of overall (0-24 h) vomiting (relative risk, 0.91; 95% confidence interval, 0.70-1.18; P = 0.48) or Nausea (relative risk, 1.24; 95% confidence interval, 0.98-1.59; P = 0.08). Multiple logistic regression analysis indicated that there was not a significant increase in the risk of vomiting with large compared with small doses of neostigmine. Contrasting a previous analysis, we conclude that there is insufficient evidence to conclude that neostigmine increases the risk of Postoperative Nausea and vomiting.

  • consensus guidelines for managing Postoperative Nausea and vomiting
    Anesthesia & Analgesia, 2003
    Co-Authors: Tricia A Meyer, Anthony L Kovac, Beverly K Philip, James Temo, Peter J. Davis, Christian C. Apfel, Steve Eubanks, Daniel I Sessler, Frances Chung, Martin R Tramer
    Abstract:

    IMPLICATIONS: We present evidence-based guidelines developed by an international panel of experts for the management of Postoperative Nausea and vomiting.

  • supplemental oxygen reduces the incidence of Postoperative Nausea and vomiting
    Anesthesiology, 1999
    Co-Authors: Robert Greif, Sonja Laciny, Brigitta Rapf, Randy S Hickle, Daniel I Sessler
    Abstract:

    BACKGROUND: Despite new anesthetic drugs and antiemetics, particularly 5-hydroxytryptamines, the incidence of Postoperative Nausea or vomiting remains between 20% and 70%. The authors tested the hypothesis that supplemental perioperative oxygen administration reduces the incidence of Postoperative Nausea or vomiting. METHODS: Patients undergoing colon resection were anesthetized with fentanyl and isoflurane. During and for 2 h after surgery they were randomly assigned to (1) 30% oxygen, balance nitrogen (n = 119); or (2) 80% oxygen, balance nitrogen (n = 112). The incidence of Nausea or vomiting during the first 24 Postoperative hours was evaluated by nurses blinded to group assignment and oxygen concentration. Data were analyzed with unpaired t or Mann-Whitney U tests. Results are presented as means +/- SD; P < 0.05 was considered significant. RESULTS: Factors known to influence Nausea and vomiting were comparable in the two groups. Perioperative oxygen saturation was well within normal limits in each treatment group; saturations the first Postoperative morning were comparable in each group. Supplemental oxygen reduced the incidence of Postoperative Nausea or vomiting from 30% in the patients given 30% oxygen to 17% in those given 80% oxygen (P = 0.027). CONCLUSIONS: Supplemental oxygen reduced the incidence of Postoperative Nausea or vomiting nearly twofold after colorectal surgery. The mechanism by which oxygen administration reduces the incidence of these Postoperative sequelae remains unknown but may be related to subtle intestinal ischemia. Because oxygen is inexpensive and essentially risk-free, supplemental oxygen appears to be an effective method of reducing Postoperative Nausea and vomiting.

  • supplemental oxygen reduces the incidence of Postoperative Nausea and vomiting
    Anesthesiology, 1999
    Co-Authors: Robert Greif, Sonja Laciny, Brigitta Rapf, Randy S Hickle, Daniel I Sessler
    Abstract:

    BackgroundDespite new anesthetic drugs and antiemetics, particularly 5-hydroxytryptamines, the incidence of Postoperative Nausea or vomiting remains between 20% and 70%. The authors tested the hypothesis that supplemental perioperative oxygen administration reduces the incidence of Postoperative nau

Martin R Tramer - One of the best experts on this subject based on the ideXlab platform.

  • Management of Postoperative Nausea and Vomiting
    Seminars in Colon and Rectal Surgery, 2005
    Co-Authors: Martin R Tramer
    Abstract:

    Postoperative Nausea and vomiting are still frequent adverse effects of anesthesia and surgery. The origin of Postoperative Nausea and vomiting is multifactorial; factors that are related to the patients themselves, to the anesthetic and analgesic drugs that are used, and to the surgery all contribute to the baseline risk of Postoperative Nausea and vomiting. Significant progress toward improved control of Postoperative Nausea and vomiting has been achieved during recent years. Today, anesthetists try to identify patients at high risk preoperatively, using knowledge about specific risk factors. A stratified approach to optimized prophylaxis of Postoperative Nausea and vomiting may then be applied. In high risk patients, an anesthetic technique with a low emetogenic potency may help to keep the baseline risk of Postoperative Nausea and vomiting as low as possible. Additionally, a cocktail of antiemetic drugs is given prophylactically before emergence from anesthesia. Three classes of drugs have shown consistent antiemetic efficacy: 5-HT 3 receptor antagonists ("setrons"), dopamine antagonists (droperidol, haloperidol), and steroids (dexamethasone). These drugs can be used alone or, for improved efficacy, in combination.

  • Strategies for Postoperative Nausea and vomiting.
    Best practice & research. Clinical anaesthesiology, 2004
    Co-Authors: Martin R Tramer
    Abstract:

    Significant improvement towards a better control of Postoperative Nausea and vomiting have been achieved in recent years. Today, we understand better who is likely to vomit or to be nauseous after surgery. Significant amounts of the huge literature on anti-emetic interventions have been systematically reviewed, critically appraised and quantitatively synthesized. Thus, we know what anti-emetic interventions work, and how well they work, and we know their adverse effect profile. We also know which interventions have no worthwhile efficacy. A rational approach to Postoperative Nausea and vomiting includes three steps: identification of patients at risk, keeping the baseline risk low, and prophylactic administration of anti-emetics in those patients who are most likely to need them. For patients who are identified as high-risk patients, all measurements should be simultaneously initiated (multimodal anti-emesis).

  • Treatment of Postoperative Nausea and vomiting
    BMJ, 2003
    Co-Authors: Martin R Tramer
    Abstract:

    Better data, improved control have been achieved during recent years Postoperative Nausea and vomiting is a nuisance. The anaesthetist is usually blamed, despite evidence that Postoperative Nausea and vomiting results from several factors, some related to anaesthesia, others to surgery, and some to the patients themselves. The importance of Postoperative Nausea and vomiting is generally underestimated because it is self limiting, never becomes chronic, and almost never kills. However, its impact on the cost of health care is not negligible. Ten per cent of the population undergo general anaesthesia every year,1 and about 30% of them are affected by Postoperative Nausea and vomiting.2 This amounts to about two million people in the United Kingdom every year. About 1% of patients undergoing ambulatory surgery are admitted overnight because of uncontrolled Postoperative Nausea and vomiting.2 Surgical patients prefer to suffer pain rather than Postoperative Nausea and vomiting3 and would be willing to pay considerable amounts of money for an effective antiemetic.4 However, successful control of Postoperative Nausea and vomiting has proved elusive. A major obstacle to the development of an effective treatment has been the lack of a valid animal model for Postoperative Nausea and vomiting. New insights into pathways for emesis and efficacy of antiemetics have come from animal research with highly emetogenic chemotherapy. Extrapolation of these data to Postoperative Nausea and vomiting has been of …

  • Treatment of Postoperative Nausea and vomiting
    BMJ, 2003
    Co-Authors: Martin R Tramer
    Abstract:

    Better data, improved control have been achieved during recent years Postoperative Nausea and vomiting is a nuisance. The anaesthetist is usually blamed, despite evidence that Postoperative Nausea and vomiting results from several factors, some related to anaesthesia, others to surgery, and some to the patients themselves. The importance of Postoperative Nausea and vomiting is generally underestimated because it is self limiting, never becomes chronic, and almost never kills. However, its impact on the cost of health care is not negligible. Ten per cent of the population undergo general anaesthesia every year,1 and about 30% of them are affected by Postoperative Nausea and vomiting.2 This amounts to about two million people in the United Kingdom every year. About 1% of patients undergoing ambulatory surgery are admitted overnight because of uncontrolled Postoperative Nausea and vomiting.2 Surgical patients prefer to suffer pain rather than Postoperative Nausea and vomiting3 and would be willing to pay considerable amounts of money for an effective antiemetic.4 However, successful control of Postoperative Nausea and vomiting has proved elusive. A major obstacle to the development of an effective treatment has been the lack of a valid animal model for Postoperative Nausea and vomiting. New insights into pathways for emesis and efficacy of antiemetics have come from animal research with highly emetogenic chemotherapy. Extrapolation of these data to Postoperative Nausea and vomiting has been of …

  • consensus guidelines for managing Postoperative Nausea and vomiting
    Anesthesia & Analgesia, 2003
    Co-Authors: Tricia A Meyer, Anthony L Kovac, Beverly K Philip, James Temo, Peter J. Davis, Christian C. Apfel, Steve Eubanks, Daniel I Sessler, Frances Chung, Martin R Tramer
    Abstract:

    IMPLICATIONS: We present evidence-based guidelines developed by an international panel of experts for the management of Postoperative Nausea and vomiting.

Robert Greif - One of the best experts on this subject based on the ideXlab platform.

  • supplemental oxygen reduces the incidence of Postoperative Nausea and vomiting
    Anesthesiology, 1999
    Co-Authors: Robert Greif, Sonja Laciny, Brigitta Rapf, Randy S Hickle, Daniel I Sessler
    Abstract:

    BACKGROUND: Despite new anesthetic drugs and antiemetics, particularly 5-hydroxytryptamines, the incidence of Postoperative Nausea or vomiting remains between 20% and 70%. The authors tested the hypothesis that supplemental perioperative oxygen administration reduces the incidence of Postoperative Nausea or vomiting. METHODS: Patients undergoing colon resection were anesthetized with fentanyl and isoflurane. During and for 2 h after surgery they were randomly assigned to (1) 30% oxygen, balance nitrogen (n = 119); or (2) 80% oxygen, balance nitrogen (n = 112). The incidence of Nausea or vomiting during the first 24 Postoperative hours was evaluated by nurses blinded to group assignment and oxygen concentration. Data were analyzed with unpaired t or Mann-Whitney U tests. Results are presented as means +/- SD; P < 0.05 was considered significant. RESULTS: Factors known to influence Nausea and vomiting were comparable in the two groups. Perioperative oxygen saturation was well within normal limits in each treatment group; saturations the first Postoperative morning were comparable in each group. Supplemental oxygen reduced the incidence of Postoperative Nausea or vomiting from 30% in the patients given 30% oxygen to 17% in those given 80% oxygen (P = 0.027). CONCLUSIONS: Supplemental oxygen reduced the incidence of Postoperative Nausea or vomiting nearly twofold after colorectal surgery. The mechanism by which oxygen administration reduces the incidence of these Postoperative sequelae remains unknown but may be related to subtle intestinal ischemia. Because oxygen is inexpensive and essentially risk-free, supplemental oxygen appears to be an effective method of reducing Postoperative Nausea and vomiting.

  • supplemental oxygen reduces the incidence of Postoperative Nausea and vomiting
    Anesthesiology, 1999
    Co-Authors: Robert Greif, Sonja Laciny, Brigitta Rapf, Randy S Hickle, Daniel I Sessler
    Abstract:

    BackgroundDespite new anesthetic drugs and antiemetics, particularly 5-hydroxytryptamines, the incidence of Postoperative Nausea or vomiting remains between 20% and 70%. The authors tested the hypothesis that supplemental perioperative oxygen administration reduces the incidence of Postoperative nau

Colleen O'connell - One of the best experts on this subject based on the ideXlab platform.

  • Supplemental oxygen does not prevent Postoperative Nausea and vomiting after gynecological laparoscopy.
    Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2009
    Co-Authors: Dolores M. Mckeen, Ramiro Arellano, Colleen O'connell
    Abstract:

    Purpose Postoperative Nausea and vomiting are among the most common and distressing side effects of general anesthesia. Supplemental intraoperative 80% oxygen reduces Postoperative Nausea and vomiting following open and laparoscopic abdominal surgery. However, this benefit has not been observed in other patient populations. We undertook this study to evaluate the effect of 80% supplemental intraoperative oxygen on the incidence of Postoperative Nausea and vomiting following ambulatory surgery for laparoscopic tubal ligation.

Sonja Laciny - One of the best experts on this subject based on the ideXlab platform.

  • supplemental oxygen reduces the incidence of Postoperative Nausea and vomiting
    Anesthesiology, 1999
    Co-Authors: Robert Greif, Sonja Laciny, Brigitta Rapf, Randy S Hickle, Daniel I Sessler
    Abstract:

    BACKGROUND: Despite new anesthetic drugs and antiemetics, particularly 5-hydroxytryptamines, the incidence of Postoperative Nausea or vomiting remains between 20% and 70%. The authors tested the hypothesis that supplemental perioperative oxygen administration reduces the incidence of Postoperative Nausea or vomiting. METHODS: Patients undergoing colon resection were anesthetized with fentanyl and isoflurane. During and for 2 h after surgery they were randomly assigned to (1) 30% oxygen, balance nitrogen (n = 119); or (2) 80% oxygen, balance nitrogen (n = 112). The incidence of Nausea or vomiting during the first 24 Postoperative hours was evaluated by nurses blinded to group assignment and oxygen concentration. Data were analyzed with unpaired t or Mann-Whitney U tests. Results are presented as means +/- SD; P < 0.05 was considered significant. RESULTS: Factors known to influence Nausea and vomiting were comparable in the two groups. Perioperative oxygen saturation was well within normal limits in each treatment group; saturations the first Postoperative morning were comparable in each group. Supplemental oxygen reduced the incidence of Postoperative Nausea or vomiting from 30% in the patients given 30% oxygen to 17% in those given 80% oxygen (P = 0.027). CONCLUSIONS: Supplemental oxygen reduced the incidence of Postoperative Nausea or vomiting nearly twofold after colorectal surgery. The mechanism by which oxygen administration reduces the incidence of these Postoperative sequelae remains unknown but may be related to subtle intestinal ischemia. Because oxygen is inexpensive and essentially risk-free, supplemental oxygen appears to be an effective method of reducing Postoperative Nausea and vomiting.

  • supplemental oxygen reduces the incidence of Postoperative Nausea and vomiting
    Anesthesiology, 1999
    Co-Authors: Robert Greif, Sonja Laciny, Brigitta Rapf, Randy S Hickle, Daniel I Sessler
    Abstract:

    BackgroundDespite new anesthetic drugs and antiemetics, particularly 5-hydroxytryptamines, the incidence of Postoperative Nausea or vomiting remains between 20% and 70%. The authors tested the hypothesis that supplemental perioperative oxygen administration reduces the incidence of Postoperative nau