Postoperative vomiting: a review and present status of treatment

Simonsen, Leif; Vandewater, S. L.

doi:10.1007/bf03021238

Cited by 8 publications

(1 citation statement)

References 30 publications

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“…This drug is not a phenothiazine, and it was hoped that it might be free from troublesome side effects. Large doses (400 mg) may be given with safety, and such doses are necessary for the effective control of postoperative vomiting (Blatchford, 1961;Simonsen and Vandewater, 1962).…”

Section: Treatment With Drugsmentioning

confidence: 99%

The Cure for Postoperative Vomiting

Parkhouse¹

1963

British Journal of Anaesthesia

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The routine use of drugs to prevent postoperative vomiting is hard to justify. This is not to say, however, that the possibility of vomiting should be given no thought until the patient is actually sick. Postoperative vomiting can be minimized, or prevented entirely, by intelligent ward care. Prevention and cure go hand in hand in the general management of the patient. When vomiting persists the day after operation, a full examination of the patient should be made to exclude a serious cause such as intestinal obstruction, acute dilatation of the stomach, acute gastric ulceration, uraemia, raised intracranial tension, or digitalis intoxication. Cerebral ischaemia is a common cause of nausea, and should always be suspected. Serious vomiting due to the anaesthetic agent is nowadays uncommon, but vomiting due to morphine and other analgesics is common. A general plan for the postoperative management of patients is outlined. If vomiting is troublesome, the phenothiazine drugs are nearly always effective: preferences vary, but perphenazine may be recommended. The new non-phenothiazine drug trimethoxybenzamide (Tigan) shows promise.

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Section: Treatment With Drugsmentioning

confidence: 99%

The Cure for Postoperative Vomiting

Parkhouse¹

1963

British Journal of Anaesthesia

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The Action of Inhalation Anesthetics on the Gastrointestinal Tract

Bennet¹,

Bass²

1972

Modern Inhalation Anesthetics

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Factors that influence postoperative vomiting

Purkis

1964

Can Anaes Soc J

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WE AVE ~r.T. famlhar with the observation that when two pahents undergo the same operalaon, one may vomit repeatedly, while the other may not even be nauseated Much interest has centred around the reasons underlying these differences, since many anaesthetists and surgeons are reluctant to gwe powerful ant:-emehe drugs unnecessarily to pataents who may not have vom:ted without them : If we could forecast accurately wh:ch of our pahents would vomit postoperahvely, and how severe the symptoms would be, then the unlus~fied risk Of routine anh-emetlc drugs could be avoided z However desirable :t m:ght be to the statist:clan or med:cal theorist, it is unhkely that such accuracy m predlctaon will ever be achieved, fortunately for all of us, people are dtfferent What we can do, following the lead of life insurance compames, is to pick out certain groups of patients m whom the mclc~ence of :nausea and vomiting postoperahvely :s hkely to be higher than that of the general population, and by careful assessment, to dec:de which of the pahents m t~hese h:gh-nsk groups are most hkely to be troubled by symptoms These patients may then lustlfiably be gaven a prophylact:c mlectmn of an antx-emehc drug The anatomy ~ and physiology 4 ofvomiting and the pharmacology of many of the ant:-emet:c drugs have been ably rewewed by others 4 5 ,~ The purpose of this paper is to rev:ew, the factors reported to influence the mc:dence and seventy of postoperat:ve nausea and vommng, and to present observahons, made durmg the course of a comparahve survey of four anh.emet:c drugs, concernmg the influence of these factors The effects of these drugs, methods of observation, and cnterm used have been reported elsewhere ~ It shoald be stressed that the method selected a standard premedlcatlon (meper!dme 50-100 mg and atropine 0 2-~ 6 mg) and ten representahve surgical operatmr~s, dlugs and anaesthetics were allocated to pahents to achieve an even d~strlbutmn of valuables between groups Th:s method resulted m the selectmn of a h~gher than average ratao of female to male pahents m order to prowde a greater challenge to the anh-emetic drugs The observatmns reported here deal with 17] 3 pat:ents m this survey who received the standard premedlcataon, and only one m]echon of an ant:-emetic drug durmg the postoperahve period For convemence of presentahon, the factors reported to influence the mc:denc e of postoperahve vommng are consldered under the following headings (1) those varying with the patient, (2) those m couneclaon with the anaesthetic, (3) those concerned with the operatmn, and (4) those related to the postoperatave permd

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Postoperative vomiting: a review and present status of treatment

Cited by 8 publications

References 30 publications

The Cure for Postoperative Vomiting

The Cure for Postoperative Vomiting

The Action of Inhalation Anesthetics on the Gastrointestinal Tract

Factors that influence postoperative vomiting

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