Statins in critical care: to give or not to give?

Omar, Amr S; Hanoura, Samy; Al-Janubi, Haifa; Mahfouz, Ahmed

doi:10.23736/s0375-9393.16.11493-2

Cited by 6 publications

(1 citation statement)

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“…Although neostigmine is used to counteract residual neuromuscular block, co-administration of anticholinergics, such as atropine, are required because neostigmine given alone exerts cholinergic effects on the gastrointestinal tract (increased motility) and on the heart (bradycardia) 10) . Reportedly, intrathecal neostigmine in doses ranging from 0.15 to 0.75 mg in human volunteers causes nausea and vomiting in a dose-dependent manner, probably via action on the brainstem 11) , whereas intrathecal atropine in a small dose (0.1 mg) quite effectively prevents PONV induced by intrathecal morphine in patients undergoing cesarean section 12) . Further, it is known that intravenous atropine can cross the blood-brain barrier to cause central effects 13) .…”

Section: Discussionmentioning

confidence: 99%

Historical Changes in Anesthesia Practice for Laparoscopic Gynecological Surgery at Juntendo University Hospital – A Retrospective Observational Study Focusing on Factors Affecting the Incidence of Postoperative Nausea and Vomiting

Kudoh

Hayashida

2022

Juntendo Medical Journal

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Objective: Previously, we reported that antiemetics (droperidol and/or dexamethasone) could significantly reduce the incidence of postoperative nausea and vomiting (PONV) after laparoscopic gynecological surgery (LGS). We retrospectively investigated anesthesia practice during the era earlier than the above-mentioned report to identify factors affecting PONV. Methods:We investigated 1,221 patients who underwent LGS at Juntendo University Hospital between 2007 and 2009. Effects of nine covariates likely to affect PONV on the actual incidence of PONV were examined with the multivariate logistic regression analysis. Results:The actual incidence of PONV developing until nine hours after the transfer to the ward was 47.3% (577/1,221) in the total cohort. The multivariate logistic regression analysis revealed that longer duration of anesthesia (in hours) was associated with the increased incidence of PONV (odds ratio [OR], 1.170; 95% confidence interval [CI], 1.000-1.360; p = 0.0467), the use of the reversal agent neostigmine co-administrated with atropine was associated with the lower incidence of PONV (OR, 0.746; 95% CI, 0.585-0.950; p = 0.0177), and no use of PCA and the use of fentanyl PCA without droperidol were associated with the higher incidence of PONV, compared with the use of fentanyl PCA with droperidol (OR, 1.810; 95% CI, 1.250-2.640; p = 0.0019; and OR, 2.500; 95% CI, 1.880-3.310; p < 0.0001; respectively).Conclusions: Longer duration of anesthesia was associated with the increased incidence of PONV. Addition of droperidol to the PCA infusate and the use of reversal agent neostigmine co-administrated with atropine were associated with the reduced incidence of PONV.

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