Morbidity after day case laparoscopy. A comparison of two techniques of tracheal anaesthesia

Skacel, Marek; Sengupta, Pratim; Plantevin, O.M.

doi:10.1111/j.1365-2044.1986.tb13281.x

Cited by 16 publications

(6 citation statements)

References 10 publications

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“…In spite of these precautions, nearly all patients not receiving a prophylactic antiemetic experienced nausea and about 50% actually vomited. This is in keeping with the other reports of PONV in patients undergoing gynaecological surgery, particularly for laparoscopic procedures [4,7,15,23,24].…”

Section: Discussionsupporting

confidence: 92%

Prevention of nausea and vomiting after day case gynaecological laparoscopy

Paxton¹,

McKay²,

Mirakhur³

1995

Anaesthesia

112

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SummaryWe have compared the efficacy of ondansetron, metoclopramide, droperidol and placebo Key wordsAnaesthesia; gynaecological, laparoscopy .Vomiting; antiemetics, ondansetron, droperidol, metoclopramide. Nausea and vomiting are frequent postoperative events, the incidence ranging from 30 to 83% and is an important cause of unscheduled hospital stay in day case surgery [l-51. The aetiology of postoperative nausea and vomiting (PONV) is multifactorial and includes age, gender, the day of the menstrual cycle, type of surgery, and the anaesthetic technique [6-81. Ondansetron, a 5-HT, receptor antagonist, is a relatively new antiemetic drug which has been shown to be effective in reducing chemo-and radiotherapy induced sickness [9, lo]. More recent studies have shown that it is effective in the prevention and treatment of PONV when compared to placebo [I 1-13]. However, there are no direct comparative studies with other commonly used and well established antiemetic drugs, such as metaclopramide and droperidol in day stay laparoscopic surgery. The present investigation was carried out to make a direct comparison between ondansetron and these antiemetics in a placebo-controlled study. Patients and methodsFollowing approval by the local ethics committee and written informed consent, 140 patients undergoing diagnostic laparoscopy or laparoscopic sterilisation were included in the study. Patients were admitted to the Day Procedure Unit following an overnight fast of 8 to 10 h. At the pre-anaesthetic interview the patients were familiarised with a postoperative questionnaire and a scale (0-lOcm) for recording visual analogue scores (VAS). No premedication was administered. Patients were randomly allocated to receive one of the following by intravenous injection: ondansetron 4 mg, droperidol 1 mg, metoclopramide 10 mg, or placebo (0.90/, normal saline). A double-blind design was used and the drugs were administered 3 to 5min before induction of anaesthesia.Anaesthesia was induced with propofol 2-3 mg.kg-' and fentanyl 1-1.5 pg.kg-'. Atracurium 0.2-0.3 mg/kg-'

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Section: Discussionsupporting

confidence: 92%

Prevention of nausea and vomiting after day case gynaecological laparoscopy

Paxton¹,

McKay²,

Mirakhur³

1995

Anaesthesia

112

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“…Lonie and Harper [2] found also, in patients undergoing laparoscopy, a significantly reduced incidence of postoperative vomiting, still evident the day after operation, when nitrous oxide was omitted from the anaesthetic technique, but there was no difference in the incidence of nausea. The frequency of nausea and vomiting after day-case laparoscopy may exceed 80% [3] and might affect the patient's ability to resume normal activity. This study was designed to assess primarily the effect of nitrous oxide on nausea and vomiting and subsequent return to normal activity after day-case laparoscopy.…”

mentioning

confidence: 99%

Nitrous Oxide and Day-Case Laparoscopy: Effects on Nausea, Vomiting and Return to Normal Activity

Sengupta

Plantevin

1988

British Journal of Anaesthesia

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Patients admitted for day-case laparoscopy were assigned randomly to receive nitrous oxide-oxygen or oxygen, with enflurane, during a standard anaesthetic technique. Postoperative morbidity, in particular nausea and vomiting, and ability to resume normal activity were assessed over the ensuing 48 h. Supplementary administration of propofol during the operative procedure was required significantly more often (P less than 0.05) in the absence of nitrous oxide. There was no significant difference in the incidence of vomiting before discharge when nitrous oxide was omitted. The incidence and severity of nausea over the 48 h following operation was similar in both groups. There was no difference in analgesic or anti-emetic requirements before discharge and the time taken to resume normal activity was similar. It is concluded that nitrous oxide may be avoided readily in day-case laparoscopy without affecting postoperative morbidity or time taken to return to "street fitness" and normal activity.

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“…17 There are several reports about there being no need for a neuromuscular block during the creation of the pneumoperitoneum. [3][4][5][6] However, there is no controlled study in the mechanically ventilated patients whether major laparoscopic surgery is possible without supplemental muscle relaxation in total i.v. anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…2 However, several studies reported anesthetic management without muscle relaxants during a short laparoscopic procedure. [3][4][5][6] Residual neuromuscular blockade and subsequent respiratory insufficiency have been reported as severe morbidity and even mortality. 7,8 No administration of supplemental muscle relaxants may reduce residual paralysis 8 and be beneficial to the safe recovery of ambulatory laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%