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At least 307 records · Page 17Linked to original sources
PubMed2005

Initiation of zinc treatment for acute childhood diarrhoea and risk for vomiting or regurgitation: a randomized, double-blind, placebo-controlled trial.

The childhood diarrhoea-management guidelines of the World Health Organization/United Nations Children's Fund (WHO/UNICEF) now include zinc treatment, 20 mg per day for 10 days. To determine if a dispersible zinc sulphate tablet formulation is associated with increased risk of vomiting or regurgitation following the initial, first treatment dose, a double-blind, placebo-controlled randomized clinical trial was carried out in the Dhaka hospital of ICDDR,B: Centre for Health and Population Research (n=800) and in an adjacent NGO outpatient clinic (n=800). Children were randomized to one of three groups: no treatment, placebo, or zinc sulphate tablet (20 mg). They were then observed for 60 minutes, and all vomiting or regurgitation episodes were recorded. When compared with placebo, zinc treatment resulted in an attributable risk increase of 14% for vomiting and 5.2% for regurgitation. The median time to vomiting among those receiving zinc was 9.6 minutes and was limited to one episode in 91.2% of the cases. Overall, the proportion of 60-minute post-treatment vomiting attributable to zinc, placebo, and the illness episode was estimated to be 40%, 26%, and 34% respectively. The dispersible zinc sulphate tablet formulation at a dose of 20 mg is associated with increased risks of vomiting and regurgitation. Both are transient side-effects.

Acute Disease↗
PubMedDate not supplied

Prophylactic gabapentin for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled study.

BACKGROUND: Gabapentin is an antiepileptic drug. Its antiemetic effect is demonstrated in chemotherapy-induced acute and delayed onset of nausea and vomiting in breast cancer patients. AIM: To evaluate the antiemetic effect of gabapentin on incidence and severity of postoperative nausea and vomiting in laparoscopic cholecystectomy. SETTINGS AND DESIGN: Double-blind, randomized, placebo-controlled study. MATERIALS AND METHODS: Two hundred and fifty patients of ASA physical status I and II, scheduled for laparoscopic cholecystectomy were randomly assigned into two equal groups to receive 600 mg gabapentin or matching placebo two hours before surgery. Standard anaesthesia technique was used. Fentanyl was used as rescue postoperative analgesic. Ondansetron 4 mg was used intravenously as rescue medication for emesis. The total number of patients who had nausea or vomiting, and its severity and total fentanyl consumption in the first 24 hours were recorded. STATISTICAL ANALYSIS: "Z test" was used to test the significance of severity of post-operative nausea and vomiting between groups. Fentanyl consumed in each group (Mean+/-SD) within 24 hrs was compared using student t test. P value < 0.05 was considered significant. RESULTS: There were no demographic difference between the two groups. Incidence of post-operative nausea and vomiting within 24 hrs after laparoscopic cholecystectomy was significantly lower in gabapentin group (46/125) than in the placebo group (75/125) (37.8% vs 60%; P =0.04). There was a significantly decreased fentanyl consumption in gabapentin group (221.2+/-92.4 microg) as compared to placebo group (505.9+/-82.0 microg; P =0.01). CONCLUSION: Gabapentin effectively suppresses nausea and vomiting in laparoscopic cholecystectomy and post-operative rescue analgesic requirement.

Adult↗
PubMed2006

Effectiveness of ginger for prevention of nausea and vomiting after gynecological laparoscopy.

OBJECTIVE: To study the effectiveness of ginger for prevention of nausea and vomiting after gynecological laparoscopy. MATERIAL AND METHOD: From July 2005 to October 2005, 60 inpatients who underwent laparoscopic operations for non-cancer gynecologic conditions at Bangkok Metropolitan Administration Medical College or Vajira Hospital were randomized into Group A (n = 30) or Group B (n = 30). Group A received 3 capsules of ginger (1 capsule contained 0.5 g of ginger powder) while Group B received 3 capsules of placebo. Both groups received their medicine 1 hour prior the operation. Nausea and vomiting were assessed with the Visual Analogue Scores (VAS) and presence of vomiting at 2 and 6 hours after the operation. RESULTS: Median VAS at 2 hours post operation of Group A was not significantly different from that of Group B with the median of 0 (range, 0-5.4) and 0.15 (range, 0-10) respectively (95% CI from -2.59 to 0.90 and p = 0.142). At 6 hours post operation, the median VAS of Group A was significantly lower than group B, 0.55 (range, 0-7.4) versus 2.80 (range, 0-10) (95% CI from -3.61 to -0.73 and p = 0.015). Presence of vomiting at 2 hours was not different between the two groups, 10% in Group A and 20% in Group B (95% CI from -28% to 8% and p = 0.278). At 6 hours, 23.3% of group A had an episode of vomiting compared to 46.7% of group B (95% CI from -47% to 1% and p = 0.058). CONCLUSION: Ginger has shown efficacy for prevention of nausea and borderline significance to prevention vomiting after gynecological laparoscopy at 6 hour post operation.

Administration, Oral↗
PubMed1989

Comparison of droperidol 0.01 mg/kg and 0.005 mg/kg as a premedication in the prevention of nausea and vomiting in the outpatient for laparoscopy.

Patients undergoing outpatient laparoscopy and general anesthesia have a high incidence of postoperative nausea and vomiting. It is essential that anesthesia techniques accommodate the special needs of these outpatients. Droperidol is an effective antiemetic but larger doses above 1-1.25 mg may cause unwanted side effects which may prolong recovery and discharge. The current trend is to decrease the dose of droperidol to prevent side effects while still retaining the antiemetic properties. This experimental study compares droperidol 0.010 mg/kg and 0.005 mg/kg as a premedication for the prevention of nausea and vomiting in 32 female outpatients undergoing laparoscopy and general anesthesia. The patients were randomized into two groups. Group I received droperidol 0.010 mg/kg and Group II received 0.005 mg/kg as a preoperative antiemetic in double-blind fashion. Both groups received the same anesthetic for induction and maintenance of anesthesia. The patients were observed in the postanesthesia room for the incidence of nausea and vomiting. They were transported to the outpatient department and were also observed for nausea and vomiting. The t-test was used to show that there were no significant differences between groups in population characteristics. Chi-square analysis was used to determine statistical significance in the incidence of nausea or vomiting between the two groups. Analysis showed there was no statistically significant difference in the incidence of nausea or vomiting in the postanesthesia room or the outpatient department, although there was a significant clinical difference between the groups especially in the incidence of nausea in the outpatient department.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

The histological appearance of peroral gastric biopsies in clinically healthy and vomiting dogs.

A survey of the histology of gastric biopsies in 501 dogs, consisting of 19 clinically healthy dogs and 482 vomiting dogs is presented. Whole stomachs of four young clinically healthy laboratory dogs were used as controls. Eleven percent of forceps biopsies were unsuitable for examination; all suction biopsies were of good quality. Slight to severe gastritis was found in 168 vomiting dogs (35%), whereas five dogs (26%) of the clinically healthy group showed a mainly slight gastritis. Superficial and diffuse gastritis were the most prominent findings in the 168 dogs with gastritis. A single type of gastritis was found in 114 dogs, a combination of different types in 54 dogs. Gastric atrophy was seen in 23 (5%) vomiting dogs and in three (15%) clinically healthy dogs, atrophy with a slight to severe fibrosis in 21 (4%) vomiting dogs, and in 84 (17%) vomiting dogs and two (11%) healthy dogs, gastric fibrosis was present. Carcinomas were seen in 26 vomiting dogs, of which 17 also had gastritis. A differential diagnosis of granulomatous gastritis/carcinoma had to be made in one case. Seven dogs showed a lymphosarcoma, and in six other dogs a differential diagnosis of lymphosarcoma and/or gastritis was made. One adenomatous polyp was seen. In one clinically healthy dog an adenomyoma was diagnosed. Ulceration was found in 24 dogs, but only five of these lacked other lesions. Other biopsy findings were pseudopyloric metaplasia, hyperplasia, cysts, calcification and edema. Some dogs showed "antralization".

Animals↗
PubMed1986

Superiority of methylprednisolone sodium succinate over low dose metoclopramide hydrochloride in the prevention of nausea and vomiting produced by cancer chemotherapy.

Methylprednisolone sodium succinate and metoclopramide were compared for their efficacy, tolerance, and safety in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy in patients with cancer. Previously untreated patients about to receive at least 2 cycles of identical chemotherapy were entered into a study using a randomized, double-blind, crossover design. Patients were given either 250 mg of methylprednisolone or 10 mg of metoclopramide intravenously before the first cycle of chemotherapy and were then crossed over to receive the alternate medication before the second cycle of chemotherapy. Prochlorperazine was prescribed in both cycles for postchemotherapy nausea and vomiting. After each treatment cycle patients recorded the degree of nausea, drowsiness and anxiety, the number of episodes of vomiting experienced, and the amount of prochlorperazine taken. After the second treatment cycle patients recorded their preference for either the first or the second antiemetic medication with respect to nausea, vomiting, and overall effectiveness. Of 157 patients entered into the study, 115 were fully appraisable. Methylprednisolone was superior to metoclopramide in preventing nausea and vomiting and in decreasing anxiety and the amount of prochlorperazine used. A majority of the patients expressing a preference preferred methylprednisolone to metoclopramide for control of nausea (p = 0.003), control of vomiting (p = 0.0006), and overall effectiveness (p = 0.00004). There were few side-effects. We conclude that methylprednisolone may have some utility as an antiemetic in patients receiving moderately emetogenic chemotherapy, and who are treated as outpatients.

Antineoplastic Agents↗
PubMed1987

Adaptation and habituation of motion-induced vomiting in squirrel monkeys.

Nonrestrained adult squirrel monkeys were found to be prolific vomiters when rotated in the horizontal plane for at least 1 h with visual cues available. When multiple daily spins were given, monkeys who vomited early during the first session tended to habituate during subsequent rotations. Subjects who vomited late during the first spin tended to vomit increasingly earlier for several days before the trend reverted to habituation. When a single rotation was continued for up to 8 h, emetic waves occurred with a high probability density for about 2 h, then ceased for many hours with an occasional animal exhibiting isolated emetic episodes. Adaptation effects were transient; when retested beyond a week, most subjects vomited in less time than did inexperienced monkeys on their first exposure to rotation. Attempts to confirm the findings using sinusoidal vertical acceleration were unsuccessful because of failure to induce vomiting using this type of motion.

Adaptation, Physiological↗
PubMed1984

Cisplatin-induced vomiting eliminated by ablation of the area postrema in cats.

Cisplatin-induced emesis was characterized using the cat as an experimental model. The incidence, latency, and number of vomiting episodes which occurred over an 8-hour period were determined for iv doses ranging from 3 to 10 mg/kg. Oscillographic recording of physiologic pressures which produce vomiting served to document the observation that 7.5 mg/kg iv was the most effective dose. This dose produced vomiting in seven animals with a latency of 71 +/- 7.04 minutes (mean +/- SE) and subsequent emetic episodes (averaging 3.86/animal) followed a linear relationship with respect to the logarithm of time. The larger dose of 10 mg/kg appeared to be less effective, because not all animals responded. Those animals that vomited in response to this dose did so only after a significantly increased latency. Four animals with longstanding lesions of area postrema were tested with cisplatin (7.5 mg/kg); all four failed to vomit during a 6-hour observation period. In addition, none of the animals exhibited the sustained malaise associated with cisplatin administration to intact animals and only one displayed any prodromal emetic signs. These findings demonstrate that the area postrema, the anatomic site of the chemoreceptor trigger zone for emesis, is essential for cisplatin-induced vomiting. Elucidation of this action suggests a possible mechanism for other emetogenic anticancer agents.

Animals↗
PubMed1983

Recurrent vomiting in adults. A syndrome?

Recurrent vomiting in adults is characterized by episodes of forceful vomiting which last several hours and recur at inconstant intervals; patients are free from symptoms between episodes. The series comprised 17 male and 14 female patients whose ages ranged from 14 to 69 years. In 10 patients, the vomiting attacks were accompanied by diarrhoea, and in 10 by abdominal pain. Eight patients suffered from bilious vomiting in childhood, and 11 patients had migraine. Five patients gave a family history of recurrent vomiting. Management necessitated a sympathetic approach and balanced investigation. Prochlorperazine administered by injection was helpful in the alleviation of an acute attack, but the possible value of more specific antimigraine therapy remains to be established. Evidence supports a link with migraine, which has an association with other gastrointestinal disorders such as irritable bowel and oesophageal reflux. In cases in which pain is prominent, cholelithiasis should be carefully excluded, but cholecystectomy did not always cure vomiting attacks.

Adolescent↗
PubMed1995

[Study on vomiting and the vestibulo-autonomic reflex].

When vestibular organs are abnormally stimulated, autonomic reactions such as nausea, vomiting, palpitation, etc., occur, indicating the existence of fiber connections from the vestibular organs to the autonomic centers. The relationship between the "vomiting center" in the medulla oblongata as described by Borison and Wang and the vestibular nucleus remains obscure. To investigate the central mechanism of vomiting caused by vestibular stimulation, the intragastric pressure, gastric peristalsis and respiration during electric stimulation of the medullary vomiting center and the semicircular canal nerve were recorded in 12 adult cats. Evoked potential was also recorded while electrically stimulating the semicircular canal nerve. When the peripheral labyrinth was stimulated, a conflicting result was founded, namely, that the pressure in the stomach increased or decreased. Retching or vomiting-like behavior was observed in several sites when the dorsolateral portion of the reticular formation of the medulla was stimulated. It was found that neural structures in the dorsolateral portion of the reticular formation of the medulla were associated with the semicircular canal nerve, but retching or vomiting-like behavior was not always observed during stimulation there.

Animals↗
PubMed1994

On the relationship between nausea and vomiting in patients undergoing chemotherapy. Italian Group for Antiemetic Research.

In comparative trials on antiemetic efficacy of different regimens, the positive correlation between the probabilities of vomiting and of nausea could hide some confounding effect. Our work seeks to detect such effects. The data from two large studies on prevention of cisplatin-induced emesis were re-analyzed using two multifactorial logistic models. The first study compared ondansetron + dexamethasone (Ond+Dex) with metoclopramide+dexamethasone+diphenhydramine (Mtc+Dex+Dip), the second compared Mtc+Dex+Dip with Mtc+prednisolone. A group of 267 patients in the first study and 343 in the second, all evaluable for clinical efficacy, were followed for three subsequent cycles of chemotherapy. The antiemetic regimen administered and the complete protection from acute vomiting and nausea were recorded. In the first study (cycle 1), after adjustment for the presence/absence of vomiting, the two therapies were no longer found significantly different on complete protection from nausea: the greater efficacy of Ond+Dex in preventing nausea was due to a confounding effect. Instead, in the second study, the greater efficacy of Mtc/Dex/Dip in preventing both nausea and vomiting was confirmed. The results indicate that, when a correlation between two responses is detected, multifactorial analyses should be performed to identify the possible presence of some confounding effect. The proof that the presence/absence of vomiting is a confounding factor for the relationship between the different efficacy of the two antiemetic regimens for complete protection from nausea, highlighting the same efficacy of the two therapies in preventing nausea, supports the hypothesis of the existence of two kinds of nausea, one independent of vomiting, the other concomitant with it.

Antiemetics↗
PubMed1997

[Epidural buprenorphine and epidural droperidol for post-operative nausea or vomiting].

For 120 young patients who had undergone reconstruction of anterior cruciate ligament of the knee, we investigated the effect of epidural administration of buprenorphine on the incidence of nausea or vomiting, and the anti-emetic effect of epidural administration of droperidol. In the group who had received bolus injection of buprenorphine 0.1 mg, nausea or vomiting occurred early most often, and the injection was not useful to prolong analgesic effect. In the another group who had received continuous epidural infusion of buprenorphine 0.3 mg, nausea or vomiting occurred late. Bolus injection of droperidol 2.5 mg was not useful to prevent nausea or vomiting caused by continuous epidural infusion of buprenorphine. While, continuous infusion of droperidol 5 mg was effective in decreasing nausea or vomiting caused by continuous epidural infusion of buprenorphine. In conclusion, continuous epidural administration of droperidol is useful to prevent nausea or vomiting.

Adolescent↗
PubMed1997

Physiologic mechanisms of nausea and vomiting in patients with cancer.

PURPOSE/OBJECTIVES: To review the current literature describing the multiple etiologies of nausea and vomiting in patients with cancer. DATA SOURCES: Reports of pertinent research, clinical articles, and book chapters. DATA SYNTHESIS: As a result of knowledge gained about the important role of serotonin in mediating the initial emetic response to antineoplastic drug administration, nurses have made tremendous strides in controlling acute chemotherapy-induced nausea and vomiting. The role of neurotransmitters other than serotonin in mediating the response of delayed or persistent nausea and vomiting remains unclear. Efforts continue to further describe the mechanisms and management of nausea and vomiting that occur as a result of other cancer-related conditions or treatments. CONCLUSIONS: A rational, often combinational approach to antiemetic therapy is derived from a working knowledge of the physiologic mechanisms associated with nausea and vomiting in patients with cancer. Assessment of the individual's precancer history and current physiologic and psychosocial status is the corner-stone of designing and providing effective therapies. IMPLICATIONS FOR NURSING PRACTICE: Understanding the physiologic mechanisms responsible for the cause and control of nausea and vomiting in patients with cancer facilitates creative use of drugs and nonpharmacologic strategies that are more likely to result in control of these distressing symptoms.

Antineoplastic Agents↗
PubMed1997

Nonpharmacologic management of chemotherapy-induced nausea and vomiting.

PURPOSE/OBJECTIVES: To review the nonpharmacologic interventions indicated to prevent or control chemotherapy-induced nausea and vomiting. DATA SOURCES: Journal articles. DATA SYNTHESIS: Despite improvements in antiemetic drug therapy, as many as 60% of patients with cancer who are treated with antineoplastic agents experience nausea and vomiting. Anticipatory nausea and vomiting are thought to be caused by the behavioral process of classical conditioning. Most nonpharmacologic interventions that are used to prevent or control nausea and vomiting in patients with cancer are classified as behavioral interventions. Behavioral interventions involve the acquisition of adaptive behavioral skills to interrupt the conditioning cycle. CONCLUSIONS: Nonpharmacologic interventions appear to be effective in reducing anticipatory and post-treatment nausea and vomiting. IMPLICATIONS FOR NURSING PRACTICE: These behavioral interventions can be effective in reducing anticipatory and post-treatment nausea and vomiting. Oncology nurses must learn these nonpharmacologic techniques and teach their patients to use them in combination with their prescribed antiemetic therapy.

Acupressure↗
PubMed1998

Initial control of chemotherapy-induced nausea and vomiting in patient quality of life.

The side effects commonly experienced by patients receiving chemotherapy for the treatment of cancer can challenge many aspects of daily life. Nausea and vomiting, the most common side effects reported by patients, affect the ability to continue with usual life activities and, thus have a pronounced impact on quality of life. This paper reviews studies of the impact of nausea and emesis on quality of life, and highlights the importance of prevention of these side effects by presenting new data on how persistent uncontrolled nausea and vomiting can be. The Morrow Assessment of Nausea and Emesis (MANE) was used to collect information on symptoms experienced by consecutive patients starting chemotherapy between September 1987 and December 1995 at any of 18 geographically diverse member sites of the University of Rochester Cancer Center Community Clinical Oncology Program. Data from 1,413 patients were collected after each of four successive chemotherapy treatments. Reported incidences of posttreatment nausea and posttreatment vomiting after the first treatment were 59.4% and 28.6%, respectively. Occurrence of nausea/vomiting at the first treatment was a strong predictor of nausea/vomiting at later treatments. Of the 839 patients reporting initial nausea, 763 (90.9%) reported nausea at at least one subsequent treatment, and approximately 59% reported nausea after all three subsequent treatments. Fewer than half (45.6%) of the patients who had no nausea at the first treatment developed it later. The majority (72.0%) of patients reporting vomiting at the first treatment also reported subsequent vomiting, 30.7% of whom experienced emesis at all remaining treatments. Conversely, 76.2% of patients who were emesis-free at the first treatment remained so for all later treatments. These findings show a continuing need for further progress in controlling nausea and vomiting, and demonstrate the importance of aggressive nausea/vomiting control at the first treatment. In addition, more emphasis on controlling chemotherapy-induced nausea after its initial occurrence is necessary.

Antineoplastic Agents↗
PubMed2000

Unexplained Nausea and Vomiting.

Nausea and vomiting are debilitating symptoms for patients, and can be challenging problems in diagnosis and management for physicians. Initial efforts must be made to establish a specific diagnosis that represents the pathophysiological cause of the nausea and vomiting. If a specific diagnosis is made (for example, antral ulceration), then specific therapy for the lesion will usually eradicate the nausea and vomiting associated with the specific disease. When standard gastrointestinal diseases are eliminated as a cause of nausea and vomiting, then gastric neuromuscular disorders (disorders of motility) should be considered as potential causes of these symptoms. Gastric neuromuscular disorders range from gastric dysrhythmias and abnormalities of gastric accommodation to frank gastroparesis. Treatments for nausea and vomiting due to gastric neuromuscular dysfunction include: 1) patient education and dietary counseling; 2) gastrokinetic drugs; 3) visceral, sensory afferent and CNS drugs; 4) gastrostomy for stomach venting; 5) jejunostomy for enteral feeding access; and 6) acustimulation and gastric pacemaker therapies. Treatment approaches based on the pathophysiology of gastric neuromuscular dysfunction(s) and on patient education aid in the successful management of unexplained nausea and vomiting.

Journal Article↗
PubMedDate not supplied

Experience of Taiwanese women living with nausea and vomiting during pregnancy.

Two common symptoms of pregnancy are nausea and vomiting, which, for some women, cause great discomfort and profoundly impact daily life. A descriptive phenomenological method was used to understand how Taiwanese women deal with nausea and vomiting during pregnancy. A purposive sample of 10 expectant mothers participated in the study. A transcription of each informant's verbal description of her nausea and vomiting experience was made and analyzed using Colaizzi's phenomenological methodology. Four themes emerged from the interview data after inductively analyzing the narrative content concerning nausea and vomiting: 1) understanding nausea and vomiting, 2) finding coping strategies, 3) psychosocial adaptation, and 4) needing support. The results also indicated the importance of social support to pregnant women's health, including instrumental and emotional forms of support. Health professionals, however, were not mentioned in the mothers' narratives as a source of support. The issues of social support, language translation, and western and eastern perspectives on nausea and vomiting and cultural differences in perceptions of their severity are discussed.

Activities of Daily Living↗
PubMed1984

Clinical characteristics associated with the development of anticipatory nausea and vomiting in cancer patients undergoing chemotherapy treatment.

Approximately one in four patients experiences nausea and/or vomiting in anticipation of a chemotherapy treatment by the time of their fourth treatment cycle. Anticipatory nausea and vomiting is a prevalent problem of clinical significance in the total management of chemotherapy side effects. While refractory to standard antiemetic treatment, anticipatory nausea and vomiting has been successfully treated with behavioral approaches such as systemic desensitization. The present study was designed to identify the characteristics of patients at high risk for developing anticipatory side effects. Early identification of cancer patients prone to developing anticipatory side effects could lead to preventive measures. One hundred seventy-six consecutive ambulatory patients with histologically confirmed cancer who were being treated at three geographically separate hospitals of the University of Rochester Cancer Center were studied at the time of their fourth chemotherapy treatment. Patients found to experience anticipatory nausea and vomiting were significantly more likely (P less than .001) to have four or more of the following characteristics than patients who did not report anticipatory side effects: (1) less than 50 years of age; (2) the experience of nausea and/or vomiting after their last chemotherapy treatment; (3) a description of nausea after the last treatment as "moderate, severe, or intolerable"; (4) a description of vomiting after the last treatment as "moderate, severe, or intolerable"; (5) the reporting of the side effect "warm or hot all over" after their last treatment; (6) a susceptibility to motion sickness; (7) the experience of "sweating after their last treatment"; (8) and the experience of "generalized weakness after their last chemotherapy treatment." Results support a view that anticipatory side effects are conditioned and point to practical interventions for their clinical control.

Antineoplastic Agents↗