Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Vomiting”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed2006

Zonisamide or levetiracetam for adults with cyclic vomiting syndrome: a case series.

BACKGROUND & AIMS: Management of cyclic vomiting syndrome in adults is limited by the small number of effective medications for maintenance therapy. The clinical response to treatment with 2 newer antiepileptic drugs was evaluated retrospectively to see whether they might have a prophylactic role in this syndrome. METHODS: Outpatient records from 20 adult patients with cyclic vomiting syndrome attending a university-based practice were reviewed. Each had received zonisamide (median dose, 400 mg/d) or levetiracetam (median dose, 1000 mg/d) because tricyclic antidepressants alone were unsatisfactory as maintenance medications. Outcome was graded from chart review and directed interview; characteristics of the vomiting episodes were compared before and after initiation of antiepileptic drug therapy. RESULTS: At least moderate clinical response was described by 15 (75.0%) subjects, and 4 of these (20.0% of the total) reported symptomatic remission during 9.5 +/- 1.8 months of follow-up. Rate of vomiting episodes decreased from 1.3 +/- 0.3 to 0.5 +/- 0.2 per month (P = .01). Tricyclic antidepressants were discontinued in 11 (61.1%) of the 18 subjects who were still taking the medications when antiepileptic drug therapy was initiated. Moderate or severe side effects were reported by 45.0%, but by switching drugs, intolerance to antiepileptic drug therapy occurred in only 1 subject. CONCLUSIONS: Newer antiepileptic drugs, specifically zonisamide and levetiracetam, appeared beneficial as maintenance medications for nearly three fourths of adults with cyclic vomiting syndrome in this uncontrolled clinical experience. Although side effects occur in a large proportion of subjects, newer antiepileptic drugs might offer an alternative for patients who fail conventional treatment.

Adult↗
PubMed2005

The effect of preoperative dexamethasone on early oral intake, vomiting and pain after tonsillectomy.

OBJECTIVE: Postoperative morbidity in patients undergoing tonsillectomy with or without adenoidectomy includes inadequate oral intake, pain, nausea, vomiting and bleeding. The purpose of this study is to evaluate the effect of preoperative 0.5 mg/kg i.v. dexamethasone on postoperative early oral intake, pain, vomiting in patients undergoing adenotonsillectomy while performing standard anesthesia technique and sharp dissection tonsillectomy. METHODS: In this prospective, double-blinded, placebo-controlled study 62 children, aged 4-12 years, who underwent tonsillectomy with or without adenoidectomy were randomly assigned to receive single dose of 0.5 mg/kg i.v. dexamethasone preoperatively. Patients started to receive 100 ml of clear fluids 2 h postoperatively, then were offered every hour. When pain score was 3 or above, paracetamol was given for pain control. Tolerating 400 ml of clear fluids, no bleeding and no vomiting were accepted as discharge criteria. The discharge time was also recorded. The incidence of early vomiting, pain scores, amount of oral intake were recorded until the discharge time. RESULTS: Compared with placebo, the patients who received preoperative dexamethasone had significantly less pain score during the first 6 h postoperatively (p<0.05), adequate amount of oral intake time was shorter (p<0.05) and the discharge time was earlier (p<0.05). No difference was found in vomiting incidence in both groups. CONCLUSION: Preoperative dexamethasone use significantly reduces early posttonsillectomy pain, improves oral intake and facilitates meeting the discharge criteria while using standard anesthesia technique and sharp dissection tonsillectomy without any significant side effects.

Anti-Inflammatory Agents↗
PubMedDate not supplied

A comparison of different severities of nausea and vomiting during pregnancy relative to stress, social support, and maternal adaptation.

A cross-sectional and comparative research design with convenience sampling was used to recruit pregnant women from prenatal clinics in southern Taiwan between 2002 and 2003 to examine the differences in perceived stress, social support, and maternal psychosocial adaptation among women with different severities (mild or less than mild, moderate, and severe) of nausea and vomiting during pregnancy. A total of 150 pregnant women participated in this study. One-way analysis of variance indicated that perceived stress was significantly different among the 3 groups. The least significant difference post-hoc test revealed that pregnant women with mild nausea and vomiting had significantly lower stress than did pregnant women with severe nausea and vomiting. The severity of nausea and vomiting was significantly associated with the Prenatal Self Evaluation Questionnaire subscales for "acceptance of pregnancy" and "fear of helplessness and loss of control in labor." Social support and maternal psychosocial adaptation were not significantly different among these three groups. The degree of perceived stress and maternal psychosocial adaptation may be related to the severity of nausea and vomiting during pregnancy.

Adult↗
PubMed2006

Cyclic vomiting with generalized epileptiform discharges responsive to topiramate therapy.

Cyclic vomiting syndrome is a disorder characterized by recurrent attacks of vomiting and intervals of normal health between vomiting episodes averaging 2-4 weeks. It has been described by a variety of names such as abdominal migraine, abdominal epilepsy, and periodic syndrome but now has been classified in the subgroup of childhood periodic syndromes that are commonly precursors of migraine. Topiramate is an antiepileptic drug used both in the treatment of epilepsy and in migraine prophylaxis. This report presents a child with cyclic vomiting syndrome with generalized epileptiform discharges who responded to topiramate therapy. The common features of epilepsy, migraine, and cyclic vomiting syndrome are discussed.

Anticonvulsants↗
PubMed1998

Upper airway motor outputs during vomiting versus swallowing in the decerebrate cat.

Swallowing and vomiting are antagonistic motor acts; nevertheless, vomiting can be immediately followed by swallowing. The purpose of this study was to clarify the interrelationship between these two behaviors, particularly in regard to comparing the upper airway motor patterns at the end of the expulsion phase with those during subsequent swallowing. Experiments were conducted using both paralyzed and non-paralyzed decerebrate cats, in which recordings were obtained either from upper airway muscles, the diaphragm and abdominal muscles or from the nerves that innervate those muscles. The activity patterns of most nerves recorded in paralyzed animals were consistent with the behavior recorded in non-paralyzed animals from the muscles innervated by those nerves, with the exception of the cricothyroid and stylopharyngeus muscles. Vomiting can be divided into a series of retches followed by expulsion, which itself can be further subdivided into three phases. The final stage of expulsion, characterized by burst-like exaggerated activity of the laryngeal elevator thyrohyoid and the pharyngeal constrictors, proved to be different from pharyngeal swallowing, as judged from differences in the spatio-temporal patterns of the upper airway motor outputs. However, post-vomiting swallowing activity was still observed even after total deafferentation of the laryngeal and pharyngeal areas in paralyzed animals. It is therefore likely that the central processes for vomiting and swallowing closely relate in generating these two behaviors.

Afferent Pathways↗
PubMed1987

Vomiting associated with whole body irradiation.

A study has been made of the patterns of vomiting in 305 patients undergoing total body irradiation before bone marrow transplantation. Vomiting usually begins after a dose of 2 to 3 Gy has been given to the whole body and may persist for up to 12 hours from the start of treatment. There is a recurrence of vomiting after 2 to 5 days. It is infrequent in patients receiving fractionated radiation with fraction sizes of less than 2 Gy, and appears unrelated to cumulative dose after the threshold has been reached. The incidence of vomiting is reduced by limitation of patient movement during radiation and by sedation adequate to keep the patient asleep. It is increased by anxiety and there is a higher incidence in patients aged 10 to 40 than in those aged less than 10 years. Other drugs administered before total body irradiation may affect the incidence. Vomiting can be prevented completely in 50% of patients.

Age Factors↗
PubMed2001

Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial.

OBJECTIVE: To determine the effectiveness of ginger for the treatment of nausea and vomiting of pregnancy. METHODS: Women with nausea and vomiting of pregnancy, who first attended an antenatal clinic at or before 17 weeks' gestation, were invited to participate in the study. During a 5-month period, 70 eligible women gave consent and were randomized in a double-masked design to receive either oral ginger 1 g per day or an identical placebo for 4 days. Subjects graded the severity of their nausea using visual analog scales and recorded the number of vomiting episodes in the previous 24 hours before treatment, and again during 4 consecutive days while taking treatment. At a follow-up visit 7 days later, five-item Likert scales were used to assess the severity of their symptoms. RESULTS: All participants except three in the placebo group remained in the study. The visual analog scores of posttherapy minus baseline nausea decreased significantly in the ginger group (2.1 +/- 1.9) compared with the placebo group (0.9 +/- 2.2, P =.014). The number of vomiting episodes also decreased significantly in the ginger group (1.4 +/- 1.3) compared with the placebo group (0.3 +/- 1.1, P <.001). Likert scales showed that 28 of 32 in the ginger group had improvement in nausea symptoms compared with 10 of 35 in the placebo group (P <.001). No adverse effect of ginger on pregnancy outcome was detected. CONCLUSION: Ginger is effective for relieving the severity of nausea and vomiting of pregnancy.

Administration, Oral↗
PubMed1984

Intravenous prochlorperazine for the rapid control of vomiting in the emergency department.

In this study, 40 patients whose active vomiting stemmed from various causes were given 2.5 mg of prochlorperazine by slow intravenous push. If no response was observed within 20 minutes, the dosage was repeated. Of 35 patients, 32 responded to doses of 2.5 to 5.0 mg. Three patients experienced no relief of vomiting while in the emergency department, after a total of 5 mg each, in divided doses. These three patients had received morphine sulphate for acute myocardial infarctions. The mean time to cessation of vomiting was 8.5 minutes, versus 35 minutes for a similar group receiving intramuscular prochlorperazine. This difference was statistically significant using analysis of variance (P less than .05). None experienced extrapyramidal reactions, or developed hypotension. We concluded that 2.5 mg of intravenous prochlorperazine given over one minute is an effective, safe treatment for the control of vomiting in the emergency department, until the etiology of the nausea and vomiting is determined and treated specifically. Further double-blind, controlled studies are warranted.

Adolescent↗
PubMed1983

Hypnosis for reduction of vomiting associated with chemotherapy and disease in adolescents with cancer.

Vomiting is often a major source of distress for adolescent oncology patients. This study evaluates the effectiveness of hypnosis in reducing the vomiting associated with chemotherapy and disease in 12 adolescents with cancer. Eight patients receiving chemotherapy demonstrated significant reductions in the frequency (p less than 0.01) and intensity (p less than 0.05) of emesis. Six of the eight patients also demonstrated a shortened duration of emesis. The ninth patient, whose vomiting was secondary to her brain tumor, showed a gradual but steady reduction in vomiting with eventual total elimination following hypnosis intervention. Three patients rejected hypnosis. Trait anxiety scores for the group were significantly lower at retest 6 months following hypnosis intervention (p less than 0.05). Significant changes in scores of health locus of control, impact of illness, or self-esteem were not found. These data support the efficacy of hypnosis for reducing vomiting when used in the context of a comprehensive clinical approach to the cancer patient.

Adolescent↗
PubMed1984

An adolescent with vomiting and weight loss.

A 17-year-old female complained of difficulty swallowing and recurrent vomiting of one year duration. She stated that she was trying to gain weight. She felt that a weight at the 5th percentile for age was appropriate for her 70th percentile height. She denied binge eating, self-induced vomiting, concern over abnormal eating, or depressed mood. She had low normal intelligence, long-standing problems with school and peer relationships, and was experiencing significant conflict with her stepfather. The mother noted that her daughter's symptoms had begun at the time her prized horse went lame. Physical examination was unremarkable except for thinness. At a two-week follow-up visit, all vomiting had ceased and the patient had gained 1.6 kg. Plans for a barium esophagogram were cancelled and psychiatric consultation was arranged. A six-week followup revealed no vomiting, although weight gain had not progressed. Six months later, the patient was seen with a two-month history of recurrent vomiting. A barium esophagogram revealed achalasia. Pneumatic dilation of the lower esophageal sphincter was successful. Seventeen months after the initial visit the patient was asymptomatic, happy, and seemingly well adjusted.

Adolescent↗
PubMed1992

[Prevention of postoperative nausea and vomiting by ondansetron].

This study was carried out to assess the efficacy of oral ondansetron, a new 5HT3 receptor antagonist, in patients undergoing thyroid surgery. It included 60 patients, randomly assigned to two groups, and receiving orally, 1 h before induction of anaesthesia, either 8 mg of ondansetron (n = 29) or a placebo (n = 30). One patient was excluded. The same anaesthetic protocol, consisting of 3 to 5 micrograms.kg-1 of fentanyl, 4 to 6 mg.kg-1 of thiopentone, and 0.5 mg.kg-1 of atracurium, was used in all. Anaesthesia was maintained with 50% nitrous oxide in oxygen with 0.8 to 1% endtidal concentration of isoflurane and additional boluses of 0.1 mg of fentanyl as required. The incidence and intensity of nausea, graded mild, moderate or severe, and the incidence of vomiting were recorded postoperatively. During the first twelve hours after surgery, 40% of patients in the placebo group had nausea (16.7% mild, 20% moderate and 6.7% severe), and 50% vomited. In the ondansetron group, nausea and vomiting occurred in 13.8% and 20.4% of patients respectively. The 4 patients in the latter group complained of major nausea. The differences between the groups were statistically significant: p = 0.025 for nausea and p = 0.042 for vomiting. It is concluded that oral ondansetron, 8 mg taken orally 1 h before surgery, significantly reduces the incidence of nausea and vomiting during the first twelve postoperative hours. As it is easy to use and has no side-effects, it might be of interest in day-case surgery patients, despite its high cost.

Administration, Oral↗
PubMed1998

Comparison of tropisetron and chlorpromazine combinations in the control of nausea and vomiting of patients with advanced cancer.

The single-institution, prospective, randomized trial was performed to evaluate the efficacy of tropisetron and chlorpromazine in the management of nausea and vomiting of terminal cancer patients. Patients had no recent chemotherapy or radiotherapy, and emesis was not due to bowel obstruction, electrolytic or metabolic disturbances, drug intake, or intracranial disease. One hundred and sixty patients randomly received either (a) chlorpromazine (CLO) (50 mg/day) plus dexamethasone (DEX) (2 mg/day), (b) chlorpromazine (25 mg/day) plus tropisetron (TRO) (5 mg/day), (c) chlorpromazine (25 mg/day plus tropisetron (5 mg/day) plus dexamethasone (2 mg/day), or (d) tropisetron (TRO) (5 mg/day). Patients were monitored from day 1 to day 15. No nausea or vomiting was defined as "total" control. On day 15, total vomiting control was achieved in 33.3% of the patients receiving CLO + DEX, 84.6% of the patients receiving CLO + TRO, 92.5% of the patients receiving CLO + TRO + DEX, and 78.9% of the patients receiving TRO. Total control of nausea was achieved in 18.0% of the patients receiving CLO + DEX, 74.4% of the patients receiving (CLO + TRO), 85.0% of the patients receiving CLO + TRO + DEX, and 65.8% of the patients receiving TRO. Tropisetron-containing combinations produced significant control of nausea and vomiting from the third day onward. All antiemetic drugs were well tolerated. These data suggest that tropisetron-containing combinations or tropisetron as a single agent are much more effective in the control of emesis in patients with advanced cancer than the conventional antiemetic combination of chlorpromazine plus dexamethasone. Tropisetron is well tolerated and may be the best choice for controlling persistent nausea and vomiting in terminal cancer patients.

Adult↗
PubMed1997

Ondansetron versus droperidol or placebo when given prophylactically for the prevention of postoperative nausea and vomiting in patients undergoing middle ear procedures.

STUDY OBJECTIVE: To compare the prophylactic administration of ondansetron with droperidol or placebo to determine its effectiveness in reducing postoperative nausea and vomiting after middle ear procedures. DESIGN: Prospective, randomized, double-blind study. SETTING: Inpatient otolaryngology service at a university medical center. PATIENTS: 120 ASA physical status I and II patients presenting for elective middle ear surgical procedures. INTERVENTIONS: Patients were randomly assigned to receive either placebo (Group 1), ondansetron 4 mg intravenously (IV) (Group 2), or droperidol 25 mcg/kg i.v. (Group 3) 10 minutes before induction of general anesthesia using thiopental 5 mg/kg i.v. with fentanyl 2 mcg/kg i.v. and maintenance anesthesia with isoflurane 1% to 2% end-tidal in a 50% air/oxygen mixture. MEASUREMENTS AND MAIN RESULTS: Total surgical, anesthesia, extubation, and postanesthesia care unit (PACU) occupancy times were recorded along with anesthesia recovery scores. The incidence and severity of nausea, vomiting, and pain along with rescue antiemetic administration, also were recorded. Similar assessments were made over the next 24 hours. Intergroup demographic data were similar except that the male to female ratio was higher in the ondansetron group. Stewart scores, reflecting emergence from anesthesia, were higher with ondansetron compared with droperidol. The incidence of nausea was similar between the groups but the severity was less after ondansetron therapy. More patients vomited after placebo than when given either droperidol or ondansetron. No intergroup differences were noted in the use of rescue antiemetics. Twenty-four hours later, more patients who received the placebo drug had nausea or vomited compared with either ondansetron or droperidol. CONCLUSIONS: Ondansetron 4 mg i.v. is as effective as droperidol and better than placebo in preventing nausea and vomiting in patients undergoing middle ear surgery. No cost advantage as determined by lower use of rescue antiemetics or shorter PACU times was noted after the prophylactic administration of ondansetron.

Adult↗
PubMed1997

A randomized, double-blind, placebo controlled comparison of droperidol, ondansetron, and metoclopramide for the prevention of vomiting following outpatient strabismus surgery in children.

STUDY OBJECTIVE: To compare the efficacy of ondansetron, droperidol, or metoclopramide with placebo in preventing postoperative vomiting following strabismus surgery. STUDY DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: University outpatient surgery center. PATIENTS: 160 ASA physical status I and II children ages 1 to 12 years who were scheduled for strabismus surgery. INTERVENTIONS: Administration of either ondansetron 100 mcg/kg, metoclopramide 250 mcg/kg, droperidol 75 mcg/kg, or placebo intravenously after induction of anesthesia. MEASUREMENTS AND MAIN RESULTS: Both ondansetron and droperidol were superior to metoclopramide and placebo in preventing predischarge vomiting, with incidences of 5%, 5%, 32%, and 25%, respectively. However, there was no difference in the incidence of postdischarge vomiting among the groups (ondansetron 25%, droperidol 25%, metoclopramide 20%, and placebo 25%). CONCLUSIONS: While both ondansetron and droperidol are more effective than metoclopramide when compared with placebo in decreasing the incidence of predischarge vomiting, none of these drugs was more effective than placebo in decreasing the incidence of postdischarge vomiting. Recovery from anesthesia was not significantly different among the groups as assessed by time to awakening, initial Steward score, and time to discharge.

Ambulatory Surgical Procedures↗
PubMed1999

Prevention or treatment of postoperative vomiting using ondansetron? A mathematical assessment.

STUDY OBJECTIVES: To assess the effectiveness of ondansetron versus placebo when used as prophylaxis of postoperative vomiting compared to its use for the treatment of established postoperative vomiting. DATA SOURCES: All prospectively randomized controlled trials, identified using the MEDLINE database and which had been included in two previously published meta-analyses. MEASUREMENTS AND MAIN RESULTS: The effectiveness of ondansetron (1, 4, and 8 mg) used for prevention (28 studies) or treatment (two studies) of postoperative vomiting was compared using odds ratios and number needed to treat (NNT) scores. NNT values were extrapolated to a similar incidence of vomiting in the placebo groups. The effectiveness equivalence between both meta-analyses was compared by assessing the degree of coincidence between the respective 95% confidence intervals (CI). The 1-mg dose was superior in treatment than in prophylaxis, odds ratios (95% CI): 2.73 (1.81-4.11) versus 1.34 (1.04-1.74), respectively (p < 0.05), although this difference did not reach statistical significance when the NNT values were compared. For the 4-mg dose, a near congruence was observed in the odds ratios; 3.34 (2.22-5.03) versus 2.61 (2.24-3.05) as well as in the NNT values: 3.90 (2.97-5.78) versus 3.40 (2.93-4.07). For the 8-mg dose, there were equivalent NNT values: 4.10 (3.08-6.23) versus 4.08 (3.28-5.43), and with respect to the odds ratios: 3.18 (2.11-4.81) versus 2.42 (1.95-2.99). The differences were not statistically significant. CONCLUSIONS: For the usual doses recommended for postoperative emesis, there was equivalent effectiveness of ondansetron whether administered as prophylaxis or as a treatment of established vomiting.

Antiemetics↗
PubMed1996

Postoperative nausea and vomiting: the outpatient enigma.

Postoperative nausea and vomiting is an all too common side effect of surgery and anesthesia. The usual occurrence of vomiting within the first 24 hours following surgery involves one quarter to one third of all patients. Although nausea and vomiting is typically self-limiting, lasting less than 24 hours, the consequences must be considered. Patient dissatisfaction, adverse physiological sequelae, delays in discharge from the ambulatory facility, unanticipated hospital admission, and added cost are problems associated with postoperative vomiting. This article will review the multiple factors contributing to postoperative nausea and vomiting and discuss contemporary strategies for the management of these factors.

Ambulatory Surgical Procedures↗
PubMed1981

Binge-eating and vomiting: a survey of a college population.

A survey of 355 college students was carried out to determine the prevalence of the psychiatric disorder bulimia (the binge-eating syndrome). Results of the survey indicate that, within the normal college population, 13% experienced all of the major symptoms of bulimia as outlined in the DSM-III. Within the bulimia population, 87% were females (19% of the female population) and 13% were males (5% of the male population). Although self-induced vomiting may accompany other symptoms of bulimia, the result suggest that self-induced vomiting is not a necessary symptom for diagnosis. A significant relationship between laxative use and self-induced vomiting was detected. These forms of behaviour, termed purging behaviour, occurred in an average of 10% of the students. Individuals who experienced the symptoms of bulimia had a history of being overweight or tended to be in the upper portion of their normal weight range (age, sex, and weight corrected) when compared with those individuals who had not experienced the symptoms of bulimia. No significant weight history differences were detected between vomiters and non-vomiters.

Adolescent↗
PubMed2006

Acupressure for postoperative nausea and vomiting in gynaecological patients receiving patient-controlled analgesia.

BACKGROUND AND OBJECTIVES: To evaluate the effectiveness of acupressure in preventing nausea and vomiting in patients undergoing gynaecological operations and receiving a patient-controlled analgesia device. METHODS: Patients aged between 40 and 65 yr were included. Exclusion criteria were obesity, diabetes mellitus, and history of motion sickness, postoperative nausea and vomiting, or smoking. Patients were randomized into one of two groups, acupressure and control. In the acupressure group, acupressure bands were placed on both wrists with the plastic bead positioned at the P6 point. In controls, beads were placed at a non-acupoint site. All patients received a standard general anaesthetic. Postoperatively, patients were connected to a patient-controlled analgesia device with morphine (loading dose 5 mg, background infusion 1 mg h-1, bolus dose 1 mg and lock-out time 10 min). Pain and sedation scores, respiratory rate, heart rate, arterial pressure and oxygen saturation were recorded for 24 h. Metoclopramide 10 mg was administered intravenously as a rescue antiemetic. RESULTS: Fifty patients received acupressure and 50 were controls. In the acupressure group, 33% of patients had nausea compared with 63% controls. The cumulative incidence of vomiting at 24 h was 25% with acupressure and 61% in controls. The incidence of nausea, vomiting and antiemetic use was significantly lower with acupressure. CONCLUSIONS: Acupressure at the P6 meridian point is an effective alternative for the prevention of nausea and vomiting in patients receiving patient-controlled analgesia with morphine after gynaecological surgery.

Acupressure↗