Tong J Gan

..We sought to determine whether the use of transdermal scopolamine (TDS) in combination with IV ondansetron (OND) is more effective than one alone for reducing PONV in outpatient settings...

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..To compare anesthetic management and postoperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP) and radical retropubic prostatectomy (RRP) with general anesthesia...

..Although promethazine is effective, commonly used doses are associated with sedation. This study investigates the combination of low doses of granisetron and promethazine for the prevention of PONV...

..0001, time x treatment P = 0.3056) and at rest (17%-32% reduction) for up to 6 h (treatment vs placebo P = 0.0003, time x treatment P = 0.0130)...

..The primary aim of this multicenter study was to determine the dose-response profile of adenosine with respect to perioperative analgesia...

..We hypothesized that the preoperative application of a 7 mg nicotine patch would result in reduced postoperative analgesic requirements in patients undergoing radical retropubic prostatectomy (RRP) under general anesthesia...

..There are little data on the efficacy of antiemetics for treating postoperative nausea and vomiting (PONV) in patients who received prior PONV prophylaxis...

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..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...

..To determine the practice of members of the Society of Ambulatory Anesthesia (SAMBA) in the management of postoperative nausea and vomiting (PONV) before and after the Food and Drug Administration (FDA) black box warning on droperidol...

..We investigated whether N(2)O results in a dose-response increase in PONV...

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..This is the first study evaluating the efficacy and tolerability of the neurokinin-1 receptor antagonist, aprepitant, for the prevention of postoperative nausea and vomiting...

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..In patients who failed prophylaxis with droperidol, dimenhydrinate was also more effective than droperidol for the treatment of established PONV in the postoperative anesthesia care unit...

..We evaluated the dose response for rolapitant for the prevention of PONV in subjects at high risk for this condition, and rolapitant's effects on preventing delayed PONV were explored up to 5 days after surgery...

..This retrospective study compares the safety and efficacy of hepatic parenchymal transection using vascular staplers (VS) and the crush-clamp (CC) technique...

..This supports the contention that combinations of structurally dissimilar neuromuscular blocking drugs result in a synergistic effect...

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..The combination of small-dose G administered just before tracheal extubation plus D given at induction of anesthesia is an effective alternative to O+D in preventing vomiting during the 0- to 2-h interval after tracheal extubation...

..To determine how much money patients are willing to pay to avoid postoperative muscle pains associated with succinylcholine...

..CONCLUSIONS: PONV remain a significant problem postoperatively and often persists beyond PACU discharge. The presence of PONV is associated with increased length of PACU stay and greater resource utilization and costs...

..The aerosol is of high purity (≥98%) at a particle size (1 to 3.5 microns) shown to be best for pulmonary absorption...

..Given the multifactorial nature of postoperative nausea and vomiting, a multimodal approach to reduce or eliminate risk factors will be most successful in its management...

..Further studies are required to determine the place of the administration of neostigmine by these routes...

..There was also no difference between the two groups in nausea scores, number of vomiting episodes, or patient satisfaction with postoperative nausea and vomiting management...

..Stimulation at P6 also has analgesic effects...

..CONCLUSION: PONV are common after anesthesia and surgery. We provided evidence-based guidelines for the management of this problem based on the available literature...

..We concluded that intraoperative fluid resuscitation with colloid, when compared with crystalloid administration, is associated with an improvement in the quality of postoperative recovery...

..Scheduled prophylactic administration of antiemetic therapy during the first 48 hours after infratentorial craniotomy should be evaluated for efficacy and safety...

..To assess the effect of noise-cancelling headphones with or without music on patient pain and anxiety associated with routine, office-based transrectal ultrasound (TRUS)-guided prostate biopsy in a prospective randomized study...

..In this review, we will describe these new devices including the technology, studies on their efficacy and the limitations of their use...

..If these changes are not due to artifact, dosing of hypnotic or anesthetic drugs might be warranted. Use of these drugs during DCD based primarily on processed EEG values has never been addressed...

..Current drugs for induction and maintenance of sedation in mechanically ventilated patients in the intensive care unit have limitations. Fospropofol, a prodrug of propofol, has not been studied as a sedative in the ICU setting...

..The concepts we have articulated here are related to resection and avoidance of positive margins, limited intraoperative blood loss and pain control, which allow equivalence in these outcome areas, regardless of technique...

..IMPLICATIONS: Ondansetron orally disintegrating tablet reduces postdischarge nausea and vomiting and improves patient satisfaction with postoperative nausea and vomiting management...

..The objective of this prospective, randomized study was to assess the effect of goal-directed intraoperative fluid administration on length of postoperative hospital stay...

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..To determine how much patients are willing to pay to avoid intraoperative awareness?..

..58; 95% CI 0.39-0.86) and pruritus (Peto OR 0.27; 95% CI 0.10-0.74). In conclusion, gabapentin has an analgesic and opioid-sparing effect in acute postoperative pain management when used in conjunction with opioids...

..To determine anesthetic drug utilization in different age groups...

..This review discusses the pharmacology and clinical uses of propofol and fospropofol, as well as the benefits and disadvantages of the two drugs when used for sedation...

..However, extensive research shows the pharmacologic activity of diclofenac goes beyond COX inhibition, and includes multimodal and, in some instances, novel mechanisms of action (MOA)...

..To evaluate the safety of intravenous (IV) fospropofol when used to provide minimal to moderate sedation in patients undergoing minor surgical procedures...

..Finally, recommendations for the prophylaxis and treatment of PONV will be discussed...

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

..Anesthetic techniques used in vascular access surgery (monitored anesthesia care, regional blocks, and general anesthesia) may affect these characteristics and fistula failure...

..Finally, the role of anesthesiologists in managing POI in the context of a multimodal approach is discussed...

..These effects are generally well tolerated and transient. Further studies are warranted to investigate the full potential of adenosine as a non-opioid analgesic in the perioperative setting...

..To compare patient and nurse satisfaction with intravenous patient-controlled analgesia (IV-PCA) to their prospective satisfaction with patient-controlled transdermal delivery system (PCTS) technology...

..Advances in the delivery of sedation, including the development of new sedative agents, have the potential to further improve the provision of moderate sedation for a variety of invasive procedures...

..Several analgesic adjuncts have been investigated, and many have proved to have a useful analgesic effect. This article reviews the literature regarding use of analgesic adjuncts in the perioperative period...

..This review discusses the pharmacological profiles of dolasetron, granisetron, ondansetron and tropisetron, and the clinical implications of differences in their profiles...

..Patient education, early diagnosis of symptoms and aggressive treatment of pain using an integrative approach, combining pharmacotherapy as well as complementary technique, should serve us well in dealing with this complex problem...

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..A successful PONV management strategy includes: (i) identifying patients at risk; (ii) keeping the baseline risk low; and (iii) using a combination of antiemetics acting on different receptors in moderate- to high-risk patients...

..01. CONCLUSIONS: Preoperative administration of intravenous diclofenac 75 mg or ketorolac 60 mg significantly reduces morphine requirements and associated side effects after major orthopedic surgery...

..The objective of this retrospective study was to determine if addition of bevacizumab to iri/oxal preoperative chemotherapy increases morbidity after hepatic resection...

..Other sections will highlight central nervous system and renal complications, postoperative nausea and vomiting, hypothermia, injuries and perioperative mortality. More details on specific problems will be covered later in the series...