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Lois M Stallings-Welden, Mary Doerner, Elizabeth Libby Ketchem, Laura Benkert, Susan Alka, Jonathan D Stallings
PURPOSE: To determine effectiveness of aromatherapy (AT) compared with standard care (SC) for postoperative and postdischarge nausea and vomiting (PONV/PDNV) in ambulatory surgical patients. DESIGN: Prospective randomized study. METHODS: Patients (n = 254) received either SC or AT for PONV and interviewed for effectiveness of PDNV. Machine learning methods (eight algorithms) were used to evaluate. FINDING: Of patients (64 of 221) that experienced PONV, 52% were in the AT group and 48% in the SC group...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
U Bruderer, A Fisler, M P Steurer, M Steurer, A Dullenkopf
BACKGROUND: The incidence of post-discharge nausea and vomiting (PDNV) after ambulatory anaesthesia using total intravenous anaesthesia with a risk-stratified anti-emetic approach is not well documented in the literature. In this study, we outline such an approach. The goal was to achieve an acceptably low rate of PDNV both immediately and the day after surgery. METHODS: With ethics committee approval, adult patients undergoing outpatient surgery received a Propofol-based general anaesthetic plus standardised PONV-prophylaxis corresponding to their Apfel risk-score (0-4); ondansetron (risk-score 2), additional dexamethasone (risk-score 3), and additional droperidol (risk-score 4)...
August 2017: Acta Anaesthesiologica Scandinavica
Susan W Wesmiller, Catherine M Bender, Yvette P Conley, Dana H Bovbjerg, Gretchen Ahrendt, Marguerite Bonaventura, Susan M Sereika
PURPOSE: Postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) continue to be common and disturbing complications experienced after surgery, particularly in women and especially in women undergoing breast cancer surgery. The purpose of this study was to assess the incidence and risk factors associated with PONV and PDNV from preoperative to 48 hours postoperatively in 97 women scheduled for breast cancer surgery. DESIGN: Prospective, comparative design...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Xuezhao Cao, Paul F White, Hong Ma
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. PONV and PDNV can delay discharge and recovery and increase medical costs. The high incidence of PONV has persisted in part because of the tremendous growth in ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major operations. Pharmacological management of PONV should be tailored to the patients' risk level using the PONV and PDNV scoring systems to minimize the potential for these adverse side effects in the postoperative period...
August 2017: Journal of Anesthesia
Anthony L Kovac
Since the introduction of the serotonin 5-hydroxy tryptamine 3 (5-HT3 ) receptor antagonists in the early 1990s, the incidence of postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) has decreased, yet continues to be a problem for the surgical patient. The clinical application of the 5-HT3 receptor antagonists has helped define the approach and role of these antiemetics in the prevention and treatment of PONV and PDNV. Pharmacological and clinical differences exist among these medications resulting in corresponding differences in effectiveness, safety, optimal dosage, time of administration, and use as combination and rescue antiemetic therapy...
December 2016: Drugs
Jakob Walldén, Jesper Flodin, Magnus Hultin
BACKGROUND: In ambulatory surgery, post-discharge nausea and vomiting (PDNV) has been identified as a significant problem occurring in more than one-third of patients. OBJECTIVE: To validate a simplified PDNV score in a Swedish population. DESIGN: Prospective observational study. SETTING: Two county hospitals in Sweden: Sundsvall from June 2012 to May 2013 and Sunderbyn from January to October 2014. PATIENTS: Adult patients undergoing ambulatory surgery under general anaesthesia...
October 2016: European Journal of Anaesthesiology
Vallire D Hooper
No abstract text is available yet for this article.
October 2015: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Carolyn Dicus Brookes, Timothy A Turvey, Ceib Phillips, Vincent Kopp, Jay A Anderson
PURPOSE: To assess the prevalence of postdischarge nausea and vomiting (PDNV) after Le Fort I osteotomy with and without the use of a multimodal antiemetic protocol shown to decrease postoperative nausea and vomiting (PONV). MATERIALS AND METHODS: Consecutive patients undergoing Le Fort I osteotomy with or without additional procedures at a single academic institution formed the intervention cohort for an institutional review board-approved prospective clinical trial with a retrospective comparison group...
July 2015: Journal of Oral and Maxillofacial Surgery
S Löser, A Herminghaus, T Hüppe, W Wilhelm
Due to modern surgical and anesthesia techniques, many patients undergoing small or even medium surgical procedures will recover within minutes and can then be discharged after a few hours of monitoring. Aside from an optimized surgical technique, a precise and differentiated anesthesia concept is needed to guarantee rapid recovery and home readiness. Nowadays, remifentanil-propofol represents the standard regime in ambulatory anesthesia. The use of alfentanil, desfluran or sevofluran is also possible whereas other intravenous or inhaled anesthetics or other opioids are rarely used...
November 2014: Der Anaesthesist
Jan Odom-Forren, Vallire Hooper, Debra K Moser, Lynne A Hall, Terry A Lennie, Joseph Holtman, Melissa Thomas, Zohn Centimole, Carrell Rush, Christian C Apfel
PURPOSE: The purpose of this study is to determine patient management strategies and outcomes for self-care of postdischarge nausea and vomiting (PDNV). DESIGN: Prospective, comparative, descriptive, and longitudinal study. METHODS: The sample consisted of 248 patients aged 18 years or older undergoing a procedure requiring general anesthesia. Patients recorded incidence and severity of nausea and vomiting, the impact of symptoms, and actions taken to alleviate symptoms for 7 days postdischarge...
August 2014: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
M Stephen Melton, Karen C Nielsen, Marcy Tucker, Stephen M Klein, Tong J Gan
In a growing outpatient surgical population, postdischarge nausea and vomiting (PDNV) is unfortunately a common and costly anesthetic complication. Identification of risk factors for both postoperative nausea and vomiting and PDNV is the hallmark of prevention and management. New pharmacologic interventions with extended duration of action, including palonosetron and aprepritant, may prove to be more efficacious.
June 2014: Anesthesiology Clinics
Susan W Wesmiller, Catherine M Bender, Susan M Sereika, Gretchen Ahrendt, Marguerite Bonaventura, Dana H Bovbjerg, Yvette Conley
PURPOSE/OBJECTIVES: To examine the association of the serotonin transport gene and postdischarge nausea and vomiting (PDNV) in women following breast cancer surgery. DESIGN: A cross-sectional study. SETTING: A comprehensive cancer center in Pittsburgh, PA. SAMPLE: 80 post-menopausal women treated surgically for early-stage breast cancer. METHODS: Data were collected using standardized instruments after surgery but before the initiation of chemotherapy...
March 1, 2014: Oncology Nursing Forum
Charles C Horn, William J Wallisch, Gregg E Homanics, John P Williams
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...
January 5, 2014: European Journal of Pharmacology
Jan Odom-Forren, Leena Jalota, Debra K Moser, Terry A Lennie, Lynne A Hall, Joseph Holtman, Vallire Hooper, Christian C Apfel
STUDY OBJECTIVE: 1) To quantify the incidence and severity of postdischarge nausea and vomiting (PDNV) for 7 days in adults undergoing outpatient surgeries with general anesthesia; 2) to evaluate whether a risk model previously developed for the first two postoperative days may be used to predict the patient's risk of PDNV for 7 days; and 3) to verify whether the same risk factors are applicable in the 3 to 7 day period. DESIGN: Prospective study. SETTING: Two university-affiliated centers...
November 2013: Journal of Clinical Anesthesia
Danielle Cruthirds, Pamela J Sims, Patrick J Louis
Patients have rated severe nausea to be worse than postoperative pain. The overall incidence of postoperative nausea and vomiting (PONV) is 25%-30% and can lead to delayed discharge and unanticipated hospital admission. After outpatient surgery, the overall incidence of postdischarge nausea has been reported to be 17% and of vomiting 8%, higher than nausea and vomiting reported during the procedure or recovery. Patients who experienced postdischarge nausea and vomiting (PDNV) were unable to resume normal daily activities as quickly...
May 2013: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
J Lance Lichtor
PURPOSE OF REVIEW: The purpose of this review is to highlight postoperative nausea and vomiting (PONV), to discuss why it occurs, how it might be prevented and then how it can be treated. RECENT FINDINGS: PONV/postdischarge nausea and vomiting (PDNV) is a problem that patients identify as one of the worst, if not the worst problem that can occur after surgery. Therapy is not perfect, yet there are anaesthesia techniques that can help minimize the problem and drugs that can be used both to prevent and also treat the problem once it occurs...
December 2012: Current Opinion in Anaesthesiology
Christian C Apfel, Beverly K Philip, Ozlem S Cakmakkaya, Ashley Shilling, Yun-Ying Shi, John B Leslie, Martin Allard, Alparslan Turan, Pamela Windle, Jan Odom-Forren, Vallire D Hooper, Oliver C Radke, Joseph Ruiz, Anthony Kovac
BACKGROUND: About one in four patients suffers from postoperative nausea and vomiting. Fortunately, risk scores have been developed to better manage this outcome in hospitalized patients, but there is currently no risk score for postdischarge nausea and vomiting (PDNV) in ambulatory surgical patients. METHODS: We conducted a prospective multicenter study of 2,170 adults undergoing general anesthesia at ambulatory surgery centers in the United States from 2007 to 2008...
September 2012: Anesthesiology
Ivan Parra-Sanchez, Rania Abdallah, Jing You, Alex Z Fu, Martin Grady, Kenneth Cummings, Christian Apfel, Daniel I Sessler
BACKGROUND: One-third of surgical outpatients experience postoperative nausea and vomiting (PONV) during their hospital stay or post-discharge nausea and vomiting (PDNV) after hospitalization. We determined the incremental costs of PONV/PDNV in ambulatory patients with this time-and-motion study. METHODS: In 100 ambulatory surgery patients, we evaluated the incidence of PONV, time staff spent with patients, use of PONV-related supplies, recovery duration, PONV rescue treatments, and quality-of-life through to the third postoperative morning...
April 2012: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
M Stephen Melton, Stephen M Klein, Tong J Gan
PURPOSE OF REVIEW: Although there are extensive studies of postoperative and postdischarge nausea and vomiting (PONV/PDNV) up to 24  h, few investigate 'delayed PDNV'. With an increasing outpatient surgical population, specific 'delayed PDNV' risk identification and management is necessary for improving outcomes and helping patients after discharge. This review will discuss possible PDNV specific risk factors, successful prevention and management of PDNV following ambulatory anesthesia and the principles and pharmacology of these interventions...
December 2011: Current Opinion in Anaesthesiology
Jeanna D Blitz, Michael Haile, Richard Kline, Lola Franco, Sorosch Didehvar, H Leon Pachter, Elliot Newman, Alex Bekker
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) are common occurrences (50%-80%) after laparoscopic surgery. Palonosetron (Pal), the newest 5-HT3 antagonist, is an effective antiemetic that has advantages in treating PDNV due to its prolonged duration of action. We hypothesized that a combination of Pal and dexamethazone (Dex) could further improve the efficacy of the treatment in comparison to Pal alone in patients at high risk for PONV. Patients scheduled to undergo laparoscopic surgeries under general anesthesia were randomized to receive 8-mg dexamethasone + 0...
September 2012: American Journal of Therapeutics
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