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At least 541 records · Page 30Linked to original sources
PubMed1999

Tropisetron or droperidol in the prevention of postoperative nausea and vomiting. A comparative, randomised, double-blind study in women undergoing laparoscopic cholecystectomy.

BACKGROUND: Women undergoing laparoscopic cholecystectomy are susceptible to postoperative nausea and vomiting (PONV). This study was undertaken to evaluate the efficacy of tropisetron or droperidol for preventing PONV after laparoscopic cholecystectomy. METHODS: In a prospective, randomised, double-blind trial, 120 female patients received either tropisetron 5 mg or droperidol 1.25 mg intravenously at the beginning of surgery. A standard general anaesthetic technique and postoperative analgesia were used. Nausea, emetic episodes and the need for rescue medication were recorded for 24 h postoperatively. RESULTS: Nausea was experienced by 55% of the patients in the tropisetron group and by 62% in the droperidol group (ns). The incidence of emetic episodes was 20% and 52% (P=0.001) in the two groups, respectively. Rescue antiemetic medication was needed in 42% and 50% (ns) of the patients, respectively. Patients in the droperidol group were more drowsy in comparison with patients in the tropisetron group, mean sedation score being 6.7 vs 5.7, respectively (P=0.023). No difference in other side-effects was observed. CONCLUSION: Tropisetron, when compared with droperidol, had no better efficacy on the prevention of postoperative nausea but resulted in a significantly lower incidence of vomiting after laparoscopic cholecystectomy.

Adult↗
PubMed2000

Electrical stimulation of the vestibular system prevents postoperative nausea and vomiting.

BACKGROUND: Electrical stimulation of the vestibular system may prevent nausea and vomiting. We studied the influence of transcutaneous impulse stimulation in prevention of postoperative nausea and vomiting (PONV) following gynaecological surgery. METHODS: In this randomised study 70 women undergoing elective gynaecological surgery under general anaesthesia were assigned to receive either the activated (stimulation group) or the inactivated (non-stimulation group) impulse stimulator. The stimulator comprises the stimulator itself, two negative electrodes on a headset applied over both mastoid processes and a nuchal positive electrode. The device yielded a pulse frequency of 5 Hz direct current, individually adjustable between 0.5 and 4 mA. A trapezoid stimulation of 50 ms was applied. Nausea, vomiting, dizziness and the amount of antiemetic drugs used were assessed during the first 4 h postoperatively. RESULTS: Lower postoperative nausea scores with a lower incidence of vomiting and postoperative dizziness were found in the stimulation group. A lower amount of antiemetic drugs was needed in the stimulation group when compared to the non-stimulation group (P<0.01 between groups). CONCLUSION: This study suggests that electrical stimulation of the vestibular system may be useful in prevention of PONV.

Adult↗
PubMed2001

Neostigmine 50 microg kg(-1) with glycopyrrolate increases postoperative nausea in women after laparoscopic gynaecological surgery.

BACKGROUND: Neostigmine, used for reversal of neuromuscular block, has been implicated in the development of postoperative nausea and vomiting (PONV). The use of mivacurium, which does not require neostigmine reversal due to its metabolism by plasma cholinesterase, has made it possible to study the effect of neostigmine on PONV in a randomised, double-blind, placebo-controlled manner. METHODS: Ninety healthy women scheduled for laparoscopic gynaecological surgery were randomly allocated to two groups in a double-blind manner. One group was given neostigmine (50 microg kg(-1)) and glycopyrrolate (10 microg kg(-1)) (group NG), the other NaCl i.v. as placebo (group P) at the end of surgery when all the patients were spontaneously reversed to at least 75% of full muscle power. The risk of PONV was reduced by using low doses of opioids and ondansetron prophylaxis. All the patients were monitored and assessed for 24 h with regard to pain, nausea, vomiting and overall satisfaction. RESULTS: There was a statistically significant difference (P=0.03) in the occurrence of nausea during the first 6 h postoperatively between NG group (30%) and P group (11%), resulting in the more extensive use of antiemetic drugs in the NG group (28%) than in P group (7%) (P=0.01) in this period. There was no difference between the groups in the frequency of vomiting; seven nauseated patients had vomiting, four in group NG, three in group P. Total number of patients with PONV during the observation period of 24 h, usage of antiemetic rescue medication and overall patient satisfaction did not differ significantly between the groups. CONCLUSION: The results suggest that antagonism of neuromuscular block with a high dose of neostigmine increases postoperative nausea and the use of antiemetic drugs during the first 6 h after administration.

Adjuvants, Anesthesia↗
PubMed1992

Ondansetron is effective in decreasing postoperative nausea and vomiting.

The efficacy of ondansetron, a selective 5-HT3 receptor antagonist, in preventing postoperative nausea and vomiting in surgical patients was studied. Fifty women were randomized in a double-blind manner to receive either two 8 mg doses of intravenous ondansetron or two doses of placebo vehicle: the first given just before general anesthesia induction and the second 8 hours later. During the first 24 postoperative hours, the number of emetic episodes was recorded and the subjects rated their nausea on a scale from 0 to 10. Ondansetron-treated subjects had fewer emetic episodes (p less than 0.001) and lower subjective nausea scores (p less than 0.001). The number of complete responders (no emetic episodes and no rescue therapy) was 1 of 24 (4%) and 15 of 26 (58%) in the placebo and ondansetron groups, respectively (p less than 0.001). Ondansetron is clearly more effective than placebo in the prophylaxis of postoperative nausea and vomiting. The adverse event profile for ondansetron was similar to that of placebo.

Abdomen↗
PubMed2000

Menstrual cycle irregularity and the incidence of nausea and vomiting after laparoscopy.

Gender is an important risk factor for postoperative nausea and vomiting. Menstrual cycle phase has also been implicated as a further variable in female patients. It is not clear whether a history of an irregular menstrual cycle is a significant variable and studies to date have not examined this. The influence of an irregular menstrual cycle on nausea and vomiting after laparoscopy was evaluated in a blinded, prospective, observational study. One hundred and fifty-nine patients scheduled for laparoscopy and dye investigation were included. Anaesthetic technique and postoperative analgesia were standardised. In comparison with patients who had a regular cycle, an irregular menstrual cycle increased the incidence of nausea or vomiting from 20.5% to 40.5% (absolute difference 20%; 95% CI 0.03-0.37, p = 0.01). Other variables were similar between the groups. An irregular menstrual cycle appears to increase the risk of postoperative nausea and vomiting.

Adult↗
PubMed2003

The effect of caffeine consumption and nausea on the risk of miscarriage.

Evidence for a harmful effect of caffeine intake on risk of miscarriage (spontaneous abortion) is inconsistent and nausea during pregnancy has been claimed to explain any association seen. The objective of this analysis was to determine whether caffeine consumption both before and during pregnancy influenced the risk of miscarriage in a group of pregnant women in the UK. We examined the association with maternal caffeine intake in a case-control study of 474 nulliparous women. Participants were recruited during the years 1987-89 from the Royal Berkshire Hospital in Reading and from a large group practice situated within the hospital's catchment area. Cases were 160 women with a clinically diagnosed miscarriage and controls were 314 pregnant women attending for antenatal care. Information on coffee/tea/cola consumption and potential confounders was collected by interview and caffeine content was assigned to individual drinks according to published data on caffeine content of beverages. Compared with a maternal caffeine intake of < 151 mg/day, we found evidence that caffeine consumption > 300 mg/day doubled the risk of miscarriage. Adjusted odds ratios were 1.94 [95% CI 1.04, 3.63] for 301-500 mg/day and 2.18 [95% CI 1.08, 4.40] for > 500 mg/day. This effect could not be explained by nausea in pregnancy. Nausea appeared to be strongly independently associated with a reduced risk of miscarriage (test for trend P < 0.0001). There was no evidence that prepregnancy caffeine consumption affected the risk. Our results indicate that high caffeine consumption during pregnancy (>300 mg/day), in particular coffee consumption, is an independent risk factor for increased risk and nausea is an independent protective factor for a lower risk of miscarriage.

Abortion, Spontaneous↗
PubMed1999

Parents associated with children in measuring acute and delayed nausea and vomiting.

The purpose of this study was to identify the relationship between parents and children in measuring children's acute and delayed nausea and vomiting induced by cancer chemotherapy. Twenty parent-child dyads participated in the study. Both instruments: Adapted Rhodes Index of Nausea and Vomiting by parent and by child (8-18 years old) were used every 12 h. The reliability and validity of these instruments have been established. There were significantly moderate to strong associations between parents and children in measuring these symptoms from Day 1 to Day 3 (total scores: r = 0.85-0.93; nausea scores: r = 0.67-0.93; and vomiting scores: r = 0.91-0.99, all P < 0.01). Therefore, parents' observation of their children's symptoms was strongly associated with their child's self-report of symptoms. Parents were able to assess their children's acute and delayed nausea and vomiting because in this sample almost all parents accompanied their children all day long.

Acute Disease↗
PubMed2002

Control of nausea and vomiting after chemotherapy: what is the evidence?

The control of nausea and vomiting is an important problem for patients undergoing chemotherapy. With the introduction of newer agents, including 5-HT3 antagonists, nausea and vomiting control after chemotherapy has much improved but is not always optimal. While there is an intrinsic limitation to the efficacy of anti-emetic drugs, their efficacy can be further reduced if the drugs are not used appropriately. In some circumstances newer anti-emetics may be unnecessary and better nausea and vomiting control may be established by use of older agents. This paper summarizes current evidence regarding the optimal approach to management of nausea and vomiting in patients undergoing chemotherapy.

Antiemetics↗
PubMedDate not supplied

Low-dose dexamethasone reduces nausea and vomiting after tympanomastoid surgery: a comparison of tropisetron with saline.

PURPOSE: The aim of the study was to evaluate the efficacy of low-dose dexamethasone sodium phosphate (5 mg) on the prophylaxis of nausea and vomiting after tympanomastoid surgery. Tropisetron hydrochloride (2 mg) and saline were used as controls. MATERIALS AND METHODS: One hundred twenty patients (n = 40 in each of 3 groups) undergoing general anesthesia for tympanomastoid surgery were enrolled in this randomized, double-blind, placebo-controlled study. Following endotracheal intubation, group 1 received intravenous dexamethasone 5 mg, whereas groups 2 and 3 received intravenous 2 mg tropisetron and saline, respectively. Several parameters connected with the occurrence of postoperative nausea and vomiting were evaluated. RESULTS: Dexamethasone 5 mg significantly reduced the total incidence of nausea and vomiting by 40% (P =.002). Dexamethasone also reduced the incidence of vomiting episodes by more than 4-fold (P =.03) and the incidence of patients requiring rescue antiemetics (P =.02). Tropisetron at a 2-mg dose did not exhibit any significant antiemetic effect. CONCLUSIONS: Dexamethasone sodium phosphate 5 mg was more effective than 2 mg tropisetron hydrochloride and saline in the prevention of nausea and vomiting after tympanomastoid surgery.

Adult↗
PubMed2004

Acupressure wristbands for the prevention of postoperative nausea and vomiting in adults undergoing cardiac surgery.

OBJECTIVE: To determine whether the application of acupressure bands would lead to a reduction in postoperative nausea and vomiting after cardiac surgery. DESIGN: Prospective, randomized, double-blind clinical trial. SETTING: University-affiliated tertiary care teaching hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: One hundred fifty-two patients were enrolled to receive either acupressure treatment (n = 75) or placebo (n = 77). All patients had acupressure bands placed on both wrists before induction of anesthesia; those in the treatment group had a bead placed in contact with the P6 point on the forearm. MEASUREMENTS AND MAIN RESULTS: Patients were assessed for nausea, vomiting, and pain scores during the first 24 hours of the postoperative period. The incidences of nausea, vomiting, pain scores, and analgesic and antiemetic requirements were similar between the 2 groups. A subgroup analysis by gender implied that acupressure treatment may be effective only in female patients. CONCLUSION: Acupressure treatment did not lead to a reduction in nausea, vomiting, or antiemetic requirements in patients after cardiac surgery.

Acupressure↗
PubMed2001

The effects of acupressure on the incidence of postoperative nausea and vomiting in postsurgical patients.

Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a potentially holistic and safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the postoperative patient. Acupressure involves constant pressure (without puncture of the skin) on the Nei Guan acupuncture points through the use of a British product called Sea-Bands (Sea Band UK Ltd, Leics, England). These bands are made of elasticated fabric, with a small round plastic button inside. A quasi-experimental research design was used to examine the effects of unilateral and bilateral application of acupressure on 157 patients who are prone to PONV: postgynecological, postplastic, and posturological surgery patients. The incidence of PONV was determined through retrospective chart reviews. The hypothesis was that there would be a difference in the incidence of PONV between 5 groups: group 1 (Sea-Bands with acupressure on both wrists), group 2 (Sea-Bands with acupressure on one wrist), group 3 (wristband without acupressure on both wrists), group 4 (wristband without acupressure on one wrist), and group 5 (no wristband). This hypothesis was examined by using a one-way analysis of variance (ANOVA); it was not supported. Neither unilateral nor bilateral application of acupressure significantly affected the incidence of nausea and vomiting. These findings must be viewed with caution, however, because power analysis showed low effect sizes and an inadequate sample size. Further research is recommended with a larger sample size. This study has made perianesthesia nurses more aware of other complementary modalities to assist patients with nausea and vomiting.

Acupressure↗
PubMed2003

[Metoclopramide and dexamethasone in prevention of postoperative nausea and vomiting after inhalational anaesthesia].

OBJECTIVE: Because of its complex profile of action (binding to dopamine, serotonin and histamine receptors), low rate of adverse effects and low cost as a medicinal preparation, metoclopramide is an interesting substance for the prophylaxis of post-operative nausea and vomiting (PONV). As a single substance its antiemetic effects are slight at the usual dose, so the aim was to test the efficacy of a combination of metoclopramide and dexamethasone for the prevention of PONV on a group of patients with the same operative trauma. METHOD: All patients (n = 204) were recruited prospectively (January-October 2002) and were to undergo a lumbar disc operation. The anaesthetic was administered according to a standard procedure as a balanced anaesthetic with fentanyl and isoflurane in oxygen/air. 60 min before the end of the operation, all patients were given 10 mg of metoclopramide and 8 mg of dexamethasone intravenously. The Würzburg-Oulu-Score served as an instrument for comparison, because no placebo group has been included. 24 hours after the operation, all patients were asked to report on nausea and vomiting, stating the time and the degree of discomfort (quantification by means of an analogue numerical scale from 0-10). The influence of age, height, weight, duration of the anaesthetic, operating position and increased dexamethasone dose was analyzed in addition to the risk factors according to the score. The cost analysis was based on the purchase prices of the hospital dispensary. RESULTS: The expected PONV incidence was 35.8%; 10% nausea (average intensity 4.3) and 3% emesis (4.8) was reported for the 24-hour period. The rescue medication (dimenhydrinate) was requested 8 times. Nausea was mainly during the early part of the period (0-6 hours). Of 42 patients with a history of PONV, 71% had no symptoms. The Odds Ratios for female sex (2.9), non-smoker status (2.0) and post-operative opioid administration (1.9) correspond to the data given in the literature; it was not possible to determine the significance of a history of PONV as an independent risk factor. None of the other factors investigated had a significant influence on PONV. For the chosen combination of antiemetic drugs the number-needed-to-treat is 3.9 (95% CI: 3.3-4.7). The direct costs of the PONV prophylaxis are 0.65 euro per patient. CONCLUSIONS: The metoclopramide/dexamethasone combination proved to be effective and inexpensive, on the basis of these findings it is used prophylactically at our hospital if only one PONV risk factor exists.

Adjuvants, Anesthesia↗
PubMed2004

[Is ginger a relevant antiemetic for postoperative nausea and vomiting?].

OBJECTIVE: Ginger (Zingiber officinale) has traditionally been used in China for gastrointestinal symptoms, including nausea and vomiting. A recent systematic review on the possible antiemetic effect of ginger for various indications, including PONV, morning sickness, and motion sickness, concluded that ginger was a promising antiemetic herbal remedy, but the clinical data were insufficient to draw firm conclusions. Since that publication, additional data has accumulated and thus an updated meta-analysis was performed. METHODS: A systematic search of the literature was performed using different search strategies in MEDLINE, EMBASE, and the Cochrane Library. Six randomized controlled trials including 538 patients were identified investigating ginger to prevent postoperative nausea and vomiting (PONV). Data on the incidences of PONV, nausea, vomiting, and the need for rescue antiemetics within the first 24 postoperative hours were extracted and the pooled relative risk and the numbers needed to treat (NNT) were calculated using a random effects model. RESULTS: The pooled relative risk to suffer from PONV after pre-treatment with ginger was 0.84 (95 %-confidence interval 0.69 - 1.03). About 11 patients must be treated with ginger for one additional patient remaining free from PONV (NNT: 11; 95 %-CI: 6 - 250). Results for nausea, vomiting, and need for antiemetic rescue treatment are similar. CONCLUSION: Ginger is not a clinically relevant antiemetic in the PONV setting.

Antiemetics↗
PubMed1990

Efficacy of ondansetron (GR 38032F) and the role of serotonin in cisplatin-induced nausea and vomiting.

We compared the efficacy and safety of ondansetron (GR 38032F), a selective antagonist of serotonin S3 receptors, with that of placebo in controlling the nausea and vomiting induced by cisplatin treatment in 28 patients with cancer. The patients received either three intravenous doses of ondansetron (0.15 mg per kilogram of body weight) or normal saline (placebo) at four-hour intervals, beginning 30 minutes before the administration of cisplatin. Nausea and vomiting were markedly diminished in the group given ondansetron. The median time to the first episode of emesis was 2.8 hours in the placebo group and 11.6 hours in the ondansetron group (P less than 0.001); the median number of episodes in 24 hours was 5.5 in the placebo group and 1.5 in the ondansetron group (P less than 0.001); the mean (+/- SEM) number of regurgitations or dry heaves per episode was 3.2 +/- 0.5 in the placebo group and 1.17 +/- 0.1 in the ondansetron group (P less than 0.001). None of the 14 patients given ondansetron, but 12 of 14 given placebo, required treatment with antiemetic-rescue agents for the control of nausea and vomiting. There were no adverse effects attributable to ondansetron. The urinary excretion of 5-hydroxyindoleacetic acid, the main metabolite of serotonin, was increased in all patients two to six hours after they received cisplatin chemotherapy, and the increases paralleled the episodes of emesis. We conclude that ondansetron is an effective and safe agent for controlling the nausea and vomiting induced by cisplatin treatment. We suggest that cisplatin treatment increases the release of serotonin from enterochromaffin cells, and that ondansetron acts by blocking S3 receptors for serotonin.

Adult↗
PubMed2000

Dexamethasone alone or in combination with ondansetron for the prevention of delayed nausea and vomiting induced by chemotherapy.

BACKGROUND: The prevention of delayed nausea and vomiting caused by moderately emetogenic chemotherapy for cancer has not been studied systematically. METHODS: We enrolled patients who were scheduled to receive chemotherapy for the first time in a double-blind, randomized, multicenter study. All the patients received ondansetron combined with dexamethasone for prophylaxis against emesis that might occur within 24 hours after the start of chemotherapy (acute emesis). They were then divided into two groups: patients who did not have either vomiting or moderate-to-severe nausea (the low-risk group) and patients who had one or both (the high-risk group). Patients in the low-risk group were then randomly assigned to one of the following regimens, given on days 2 through 5 after the start of chemotherapy: oral placebo, 4 mg of dexamethasone given orally twice daily, or 8 mg of ondansetron in combination with 4 mg of dexamethasone, given orally twice daily. Patients in the high-risk group were randomly assigned to receive oral dexamethasone alone or in combination with ondansetron at the same doses as those used in the low-risk group. RESULTS: Among the 618 patients in the low-risk group, there was a complete absence of both delayed vomiting and moderate-to-severe nausea in 91.8 percent of those who received ondansetron combined with dexamethasone, 87.4 percent of those who received dexamethasone alone, and 76.8 percent of those who received placebo. The proportions of patients who were protected by dexamethasone combined with ondansetron or by dexamethasone alone were significantly greater than the proportion protected by placebo (P<0.001 and P<0.02, respectively). Of the 87 patients in the high-risk group, complete protection was achieved in 40.9 percent of those treated with ondansetron and dexamethasone and in 23.3 percent treated with dexamethasone alone (P not significant). CONCLUSIONS: The best way to prevent delayed nausea and vomiting in patients receiving moderately emetogenic chemotherapy is to control these complications within the first 24 hours after the start of chemotherapy. Dexamethasone alone provides adequate protection against delayed emesis in patients at low risk (those who have not had acute emesis).

Aged↗
PubMed2004

A factorial trial of six interventions for the prevention of postoperative nausea and vomiting.

BACKGROUND: Untreated, one third of patients who undergo surgery will have postoperative nausea and vomiting. Although many trials have been conducted, the relative benefits of prophylactic antiemetic interventions given alone or in combination remain unknown. METHODS: We enrolled 5199 patients at high risk for postoperative nausea and vomiting in a randomized, controlled trial of factorial design that was powered to evaluate interactions among as many as three antiemetic interventions. Of these patients, 4123 were randomly assigned to 1 of 64 possible combinations of six prophylactic interventions: 4 mg of ondansetron or no ondansetron; 4 mg of dexamethasone or no dexamethasone; 1.25 mg of droperidol or no droperidol; propofol or a volatile anesthetic; nitrogen or nitrous oxide; and remifentanil or fentanyl. The remaining patients were randomly assigned with respect to the first four interventions. The primary outcome was nausea and vomiting within 24 hours after surgery, which was evaluated blindly. RESULTS: Ondansetron, dexamethasone, and droperidol each reduced the risk of postoperative nausea and vomiting by about 26 percent. Propofol reduced the risk by 19 percent, and nitrogen by 12 percent; the risk reduction with both of these agents (i.e., total intravenous anesthesia) was thus similar to that observed with each of the antiemetics. All the interventions acted independently of one another and independently of the patients' baseline risk. Consequently, the relative risks associated with the combined interventions could be estimated by multiplying the relative risks associated with each intervention. Absolute risk reduction, though, was a critical function of patients' baseline risk. CONCLUSIONS: Because antiemetic interventions are similarly effective and act independently, the safest or least expensive should be used first. Prophylaxis is rarely warranted in low-risk patients, moderate-risk patients may benefit from a single intervention, and multiple interventions should be reserved for high-risk patients.

Anesthesia, General↗
PubMed2000

Prochlorperazine versus promethazine for uncomplicated nausea and vomiting in the emergency department: a randomized, double-blind clinical trial.

STUDY OBJECTIVE: Nausea and vomiting related to gastritis or gastroenteritis are common complaints in the emergency department. The most effective antiemetic agent is yet undetermined. This study was conducted to compare the efficacy of prochlorperazine versus promethazine for uncomplicated nausea and vomiting in the ED. METHODS: The study was a randomized, double-blind comparison of prochlorperazine (Compazine) and promethazine (Phenergan) for acute ED treatment of gastritis or gastroenteritis. We studied patients 18 years or older with presumed uncomplicated gastritis or gastroenteritis who presented to 2 academic EDs. Patients were randomly assigned to receive either prochlorperazine, 10 mg intravenously, or promethazine, 25 mg intravenously. Visual analog scale readings of patient comfort were obtained at baseline and at 30- and 60-minute intervals. The primary endpoint was degree of relief at 30 and 60 minutes. Secondary endpoints were time to complete relief, need for further antiemetic medication (treatment failures), and side effects. Statistical analysis was performed using the Mann-Whitney U test for nonparametric analysis and repeated-measures analysis of variance (ANOVA). RESULTS: Eighty-four patients were enrolled in the study; 42 received prochlorperazine and 42 received promethazine. There were no differences in demographics in the 2 groups. At baseline (time 0), there was no difference in symptoms (P =.23). At 30 and 60 minutes after receiving medication, prochlorperazine worked significantly better than promethazine (P =.004 and P <.001 using nonparametric analysis). Using repeated-measures ANOVA, there was a significant difference in symptoms over time for both groups (P <.001) and a significant difference in prochlorperazine versus promethazine (P =.002). Time to complete relief was significantly shorter with prochlorperazine (P =.021). There were significantly fewer treatment failures with prochlorperazine (P =.03, 9.5% versus 31%; difference 21%, 95% confidence interval 5 to 38). There was no difference in incidence of extrapyramidal effects. Prochlorperazine caused significantly fewer complaints of sleepiness (P =.002, 38% versus 71%; difference 33%, 95% confidence interval 13 to 53; P =.002). CONCLUSION: Prochlorperazine works significantly better than promethazine for relieving symptoms of nausea and vomiting more quickly and completely in ED patients with uncomplicated nausea and vomiting.

Adolescent↗
PubMed2002

Nausea and vomiting of pregnancy: an obstetric syndrome.

Although the cause of nausea and vomiting of pregnancy is not known, there is strong evidence linking human chorionic gonadoptropin or estrogens. Evidence is presented to show that the incidence and severity of nausea and vomiting of pregnancy is linked to temporal and pathologic alterations in these hormones during pregnancy. The way in which the pregnant woman responds to the primary stimulus to nausea and vomiting of pregnancy appears to depend on her susceptibility mediated by vestibular, gastrointestinal, olfactory, and behavioral pathways. Conceiving of nausea and vomiting of pregnancy as a syndrome suggests new pathways of investigation and possible therapies.

Digestive System Physiological Phenomena↗