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At least 703 records · Page 39Linked to original sources
PubMed1994

Preoperative transdermal scopolamine does not reduce the level of nausea and frequency of vomiting after laparoscopic cholecystectomy.

OBJECTIVE: To determine the efficacy of scopolamine administered transdermally before laparoscopic cholecystectomy as a means of reducing postoperative nausea and vomiting. DESIGN: A randomized, double-blind, placebo-controlled study. SETTING: A tertiary-care, university-affiliated hospital. PATIENTS: A volunteer sample of 125 men and women between 20 and 60 years of age scheduled to undergo elective laparoscopic cholecystectomy. Expectant or nursing mothers were excluded, and 35 patients were excluded from the final analysis because of protocol violations. Forty-three patients received scopolamine and 47 patients received a placebo. INTERVENTION: A skin patch (scopolamine or placebo) was applied behind the right ear on the evening before operation and maintained for at least 24 hours postoperatively. MAIN OUTCOME MEASURES: The postoperative level of nausea assessed by the patient on a visual analogue scale, the frequency of vomiting and the frequency of antiemetic use. RESULTS: There was no significant difference in the level of nausea or in the frequency of emesis or use of antiemetics in the first 24 hours postoperatively between the control and study groups. Furthermore, there was no difference in the overall frequency of side effects. However, visual blurring was experienced by six patients in the study group compared with one in the control group (p = 0.082). CONCLUSION: Scopolamine administered transdermally before laparoscopic cholecystectomy does not reduce the frequency or level of nausea and vomiting postoperatively.

Administration, Cutaneous↗
PubMed1993

[Clinical effects of granisetron and methylprednisolone against nausea, vomiting and anorexia induced by cisplatin].

We investigated the usefulness of concurrent therapy of granisetron with methylprednisolone sodium for on nausea, vomiting and anorexia induced by chemotherapy, including cisplatin, in patients with oral cancer. Group A: 10 patients who were on concurrent therapy of granisetron (3.0 mg/body) with methylprednisolone sodium (750 mg/body) (19 courses). Group B: 13 patients who were given coktail therapy of methylprednisolone sodium (750 mg/body) as the base drug plus metoclopramide (46.7 mg/body on average) and domperidone (82.9 mg/body on average) (21 courses). Efficacy rates for nausea, vomiting and anorexia were 89.4%, 100% and 100% in group A, and 33.3%, 47.6% and 42.9% in group B, respectively. Statistical significance was found with nausea, vomiting and anorexia (p < 0.01). The results suggest usefulness of concurrent therapy of granisetron with methylpredonisolone sodium for cisplatin-induced nausea, vomiting and anorexia.

Adult↗
PubMed1995

Evaluation of methylnaltrexone for the reduction of postoperative vomiting and nausea incidences.

We examined the effect of methylnaltrexone on the incidence of postoperative nausea and vomiting in a prospective double-blind placebo controlled study. One hundred and twenty female patients undergoing laparoscopic major gynecological surgery were allocated randomly to receive either 20 mg methylnaltrexone or placebo IV at the end of surgery. Postoperative nausea and vomiting was evaluated for 6 h after admission to the PACU and assessed by number of episodes and degree of severity. The incidences of nausea and vomiting for the placebo group were 27 and 18 percent, respectively. The corresponding values for the methylnaltrexone group were 20 and 10 percent. We conclude that methylnaltrexone did not prevent nor significantly reduced the incidence and severity of postoperative nausea and vomiting following a balanced anesthetic technique in gynecological procedures.

Adult↗
PubMed1996

[Study on clinical effect of a continuous intravenous infusion of azasetron against nausea and vomiting induced by anticancer drugs including CDDP].

Azasetron, a selective 5-HT3 receptor antagonist, has been previously shown to be highly effective in the prophylaxis of nausea and vomiting induced by anticancer drugs and is widely used in the clinical setting in Japan. In order to improve the antiemetic effect of azasetron, we designed a continuous intravenous infusion method of this drug and compared the antiemetic effect of this method with that of standard bolus intravenous injection on nausea and vomiting associated with anticancer drugs including 75 mg/m2 cisplatin (CDDP). A continuous group is intravenous bolus injection of 2.5 mg azasetron followed by 7.5 mg continuous intravenous infusion for 24 hrs, and a bolus group is intravenous bolus injection of 10 mg azasetron. The inhibitory effect on nausea of the continuous group was significantly superior to those of the bolus group on day 3 and 4 (p < 0.05) and inhibitory effect on vomiting of the continuous group was significantly superior to those of bolus group on day 2 (p < 0.05). No adverse effects were observed in either group of this study. From these data, continuous intravenous infusion of azasetron was considered to be highly effective in prophylaxis of nausea and vomiting induced by anticancer drugs.

Adult↗
PubMed1996

[Efficacy of granisetron rescue therapy for nausea and vomiting induced by cancer chemotherapies in urogenital malignant tumor].

In this study, the usefulness of granisetron rescue therapy for nausea and vomiting induced by cancer chemotherapies, including CDDP, was examined. Granisetron was given to twenty patients with urogenital malignant tumor by iv infusion for thirty minutes after the onset of nausea or vomiting. Nausea disappeared in 15 out of 20 patients (75%), 8 of whom (40%) experienced its disappearance while the granisetron was being administered. Vomiting was perfectly controlled in 5 out of 20 patients (25%) for 24 hours after the granisetron administration. No adverse event seemingly due to granisetron was observed. The result of this study confirmed the speedy effect granisetron on nausea induced by cancer chemotherapy including CDDP, but it stopped short of demonstrating sufficient efficacy for vomiting. Prophylactic use, therefore, seems more desirable in view of the patient's QOL, when a highly emetogenic anti-tumor drug, such as CDDP, is used.

Adult↗
PubMed1996

[Postoperative nausea, vomiting and pain in laparoscopic cholecystectomy: a comparison with minilaparotomy-cholecystectomy].

Postoperative nausea, vomiting and pain were compared between laparoscopic cholecystectomy group and minilaparotomy-cholecystectomy group. All patients were women, and ranged in age from 20 to 60 years. The body mass index of the patients was less than 30, and duration of operation was within 120 minutes in both groups. All patients received general anesthesia combined with epidural analgesia. Morphine hydrochloride 4 mg was administered into epidural space before incision. No significant differences were found in the incident of nausea and vomiting among the two groups. Postoperative analgesic requirement of laparoscopic cholecystectomy group was significantly less than that of minilaparotomy-cholecystectomy group. No significant differences were found in the incidence of nausea and vomiting between the group which required postoperative analgesic drugs and the group which required no postoperative analgesic drugs. These results suggest that laparoscopic operation and postoperative pain do not influence the incidence of nausea and vomiting. Postoperative pain after laparoscopic cholecystectomy is less than that after minilaparotomy-cholecystectomy.

Adult↗
PubMed1995

Granisetron (IV) compared with ondansetron (IV plus oral) in the prevention of nausea and vomiting induced by moderately-emetogenic chemotherapy. A cross-over study.

The French Northern Oncology Group carried out a randomised, cross-over study comparing two anti-emetic treatment strategies in 150 chemotherapy-naive patients, receiving their first two courses of moderately-emetogenic drugs. Nausea and vomiting were assessed using a self-administered questionnaire for five days. Anti-emetic treatments consisted of granisetron (G) 3 mg intravenously (iv) before chemotherapy or ondansetron (O) 8 mg intravenously, followed by 8 mg orally every eight hours for the next three days (for a total of 9 tablets). No significant difference was detected between treatment regimens in terms of their ability to control either acute vomiting (no vomiting - G = 72%; O = 77%) or acute nausea (no nausea - G = 54%; O = 47%), nor in terms of the number of total responders, (no emesis and no nausea) on day 1 (G = 52%; O = 45%) or on days 1- 5 ( mean G - 37%; O = 32%). Furthermore, there was also no significant difference between patient preference for the two treatments, either with regard to efficacy (G = 39%; O = 34%) or tolerability (G = 29%; O = 27%). In conclusion, no difference was observed between the two treatments.

Administration, Oral↗
PubMed1995

Guidelines for the optimal management of chemotherapy-induced nausea and vomiting: a consensus.

Nausea and vomiting are the most frequently reported adverse effects of cancer chemotherapy and have a significant impact on patients' daily functioning, quality of life and compliance with chemotherapy. Summarized in this article are the recommendations for the optimal management of nausea and vomiting developed by a multidisciplinary group of health care professionals. Issues relating to chemotherapy-induced nausea and vomiting are discussed; general principles of treatment are reviewed; treatment algorithms based on emetogenicity and types of chemotherapy are presented; and the importance of issues including non-pharmacological approaches, patient education and pharmacoeconomic perspectives are considered. The goal of antiemetic therapy should be no episodes of vomiting or retching and minimal or no nausea. Data from clinical trials support the clear superiority of 5-HT3 receptor antagonists in a variety of clinical situations. Their cost must be considered not only as an isolated item from the institutional perspective, but also from the perspective of the impact of successful therapy on the patient.

Algorithms↗
PubMed1996

Managing the multiple causes of nausea and vomiting in the patient with cancer.

PURPOSE/OBJECTIVES: To review the multiple causes of nausea and vomiting in the patient with cancer. Pharmacologic and nonpharmacologic management strategies are provided to deal with each type, and selected clinical nursing research is discussed. DATA SOURCES: Scholarly and professional published articles. DATA SYNTHESIS: Nausea and vomiting may result from chemical, visceral, central nervous system, and vestibular causes at any time during the disease process of the patient with cancer. Investigation of possible causes beyond adverse chemotherapeutic effects is necessary prior to initiating antiemetic therapy. Anticipation of potential related problems and proactive pharmacologic and nursing management are advisable. Further nursing research is needed related to nonpharmacologic management methods such as aerobic exercise, guided imagery, progressive relaxation, and acupressure. CONCLUSIONS: Proper diagnosis and targeted intervention are essential to effectively manage cancer-related nausea and vomiting. IMPLICATIONS FOR NURSING PRACTICE: Healthcare providers must thoroughly assess and reassess the patient's disease status and current treatment interventions to effectively manage nausea and vomiting. Nurses can participate in this assessment and provide the appropriate drug therapies as well as continue to develop non-pharmacologic intervention methods that the patient can implement independently.

Antiemetics↗
PubMed1996

[Treatment of postoperative nausea and vomiting with ondansetron in patients administered anti-neoplastic agents].

The antiemetic effect of ondansetron (a 5-HT3 antagonist) was evaluated in patients treated with intraperitoneally administered anti-neoplastic agents (cisplatin and mitomycin-C) during surgery for ovarian cancer. Anesthesia was induced with intravenous thiopental 5 mg x kg-1 and maintained with nitrous oxide 66% in oxygen and isoflurane. After surgery, 6 patients received a single intravenous dose of ondansetron 4 mg (group O), 6 others did not receive ondansetron (group C). Both groups received an intravenous dose of methyl-prednisolone 500 mg. An intravenous dose of metoclopramide 10 mg was provided in case of continued vomiting or at the patient's request as a rescue antiemetic. The incidence of vomiting was 13% in group O and 87% in group C (P < 0.05). Nausea scores (range 1-4) were significantly lower in group O as compared with group C at 4 h and 8 h after surgery. Total dose of metoclopramide was 20 +/- 13 mg (mean +/- SD) in group C and 2 +/- 4 mg in group O. Administration of anti-neoplastic agents during surgery caused severe nausea and vomiting after surgery and ondansetron prevented the occurrence of nausea and vomiting almost completely. We conclude that ondansetron is an effective antiemetic for preventing postoperative nausea and vomiting in patients administered anti-neoplastic agents.

Adult↗
PubMedDate not supplied

Relieving nausea and vomiting in patients with cancer: a treatment algorithm.

PURPOSE/OBJECTIVES: To describe a treatment algorithm for the choice of antiemetic therapy for the patient receiving chemotherapy. DATA SOURCES: Published literature, data collected on an inpatient oncology unit. DATA SYNTHESIS: Because little information is available to systematically guide clinicians in choosing the best antiemetic for an individual patient who is receiving a particular chemotherapy protocol, a treatment algorithm was developed. The four main variables include emetogenicity of the protocol, patient's age, previous adverse reaction to antiemetics, and failure of previous antiemetics. Other factors to consider include alcohol use, anticipatory nausea, patient health status, nausea history not related to chemotherapy, and type and availability of IV access. CONCLUSION: The use of this algorithm resulted in appropriate choice of antiemetics and improved patient outcomes associated with reduced incidence of nausea and vomiting. IMPLICATIONS FOR NURSING PRACTICE: Nurses can have a significant impact on a patient's experience with chemotherapy treatment by improving symptom management of nausea and vomiting.

Adult↗
PubMed1997

[Clinical effect of two azasetron treatment methods against nausea and vomiting induced by anticancer drugs including CDDP].

Azasetron, a selective 5-HT3 receptor antagonist, has been previously shown to be highly effective in the prophylaxis of nausea and vomiting induced by anticancer drugs, and is widely used in the clinical setting in Japan. In order to improve the antiemetic effect of azasetron, we designed two treatment methods using this drug and compared the antiemetic effect of this method with that of standard bolus intravenous injection on nausea and vomiting associated with anticancer drug including 75 mg/m cisplatin (CDDP). The two-treatment group received an intravenous bolus injection of 5 mg azasetron before and 8 hours after the start of chemotherapy, and a standard group was given an intravenous bolus injection of 10 mg azasetron only once a day. The inhibitory effect on vomiting in the two-treatment group was significantly greater than those of the standard group on day 1 and 2 (p = 0.0458, p = 0.0273), and the inhibitory effect on nausea of the two-treatment group tended to be superior those of the bolus group on day 2 (p = 0.0533). No adverse effects were observed in either group of this study. From these data, the two-treatment approach was considered to be highly effective in prophylaxis of nausea and vomiting induced by anticancer drug.

Adult↗
PubMedDate not supplied

Use of dexamethasone with 5-HT3-receptor antagonists for chemotherapy-induced nausea and vomiting.

The use of 5-hydroxytryptamine (HT)3-receptor antagonists represents a major improvement in the management of chemotherapy-induced nausea and vomiting. Despite treatment with a 5-HT3-receptor antagonist, nausea and vomiting persist in approximately 40% to 60% of patients receiving highly emetogenic chemotherapy. To improve control of acute emetic episodes, dexamethasone is frequently added to enhance the antiemetic efficacy of a 5-HT3-receptor antagonist. Combination therapy with dexamethasone is rational given the different mechanisms of action, low incidence of adverse effects, and potential synergistic effect with 5-HT3-receptor antagonists. In > 1,600 cisplatin-treated patients evaluated in randomized clinical trials, complete response (no nausea and vomiting) was achieved in 58% to 92% of patients receiving a corticosteroid plus a 5-HT3-receptor antagonist, compared with 39% to 79% of patients receiving a 5-HT3-receptor antagonist alone. Combination antiemetic therapy also has demonstrated effectiveness in patients receiving repeat-cycle chemotherapy and in patients refractory to other antiemetics, including combinations of traditional antiemetics plus corticosteroids or 5-HT3-receptor antagonists alone. Intermittent use of high-dose corticosteroids is rarely associated with significant adverse effects. A corticosteroid plus a 5-HT3-receptor antagonist is a safe and effective combination to control chemotherapy-induced nausea and vomiting and should be considered in patients receiving moderately and highly emetogenic chemotherapy and in patients refractory to other antiemetics.

Antineoplastic Agents↗
PubMed1998

Tropisetron in the prevention of acute nausea and vomiting in patients treated with high dose epirubicin.

Tropisetron is a novel selective antagonist of the type-3 serotonin (5-HT3) receptor, with proven efficacy in the control of emesis related to cancer treatment. Epirubicin in doses of > 100 mg/m2 has a high emetogenic potential. This study was designed to determine whether a single intravenous administration of tropisetron could prevent acute nausea and vomiting in patients treated with high dose epirubicin. Forty chemotherapy naive breast cancer patients treated with epirubicin at a dose of 110 mg/m2 on an outpatient basis were enrolled in the study. Tropisetron 5 mg i.v. was used as antiemetic prophylaxis. "On demand" treatment with tropisetron 5 mg p.os was used for the rescue of patients who failed on the initial i.v. dose. Complete control of acute nausea and vomiting had 62.5% (95% C.I. 47.2-77.8), partial control 15% (95% C.I. 3.8-26.2) and 22.5% (95% C.I. 9.3-35.7) insufficient control or failure. Headache was the most common adverse event reported in 3 patients (7.5%) and constipation in 2 patients (5%). Interestingly, patients with a negative experience of nausea and vomiting during pregnancy and those treated for metastatic disease, had a better control of chemotherapy-induced nausea and vomiting. In conclusion, a single 5 mg i.v. dose of tropisetron is safe and effective in preventing acute emesis in patients treated with high dose epirubicin.

Acute Disease↗
PubMed1998

Post operative nausea and vomiting in Nigerians.

A retrospective survey of postoperative nausea and vomiting (PONV) in the recovery room over a five year period was conducted, followed by a prospective study of 200 adult patients to estimate the incidence and predisposing factors to nausea and vomiting during the first 24 hours after anaesthesia and surgery in Nigerians. In the retrospective study only records of 61 patients (0.79%) out of the 7714 post anaesthetic recovery room charts reviewed revealed documentation of vomiting. These were 20 males (32.8%) and 41 females (67.2%). In the prospective study, the incidence of post operative nausea and vomiting within twenty four hours of surgery was 41.6% and 19.6%, respectively. But only two out of 39 patients (one per cent) vomited within the first three hours in postoperative period. The frequency of vomiting varied from one to 15 times and women had significantly more emetic symptoms than men (p < 0.05). Preoperative administration of pethidine and morphine was associated with postoperative nausea and vomiting. It is suggested that Nigerian women should be considered for prophylactic anti-emetic therapy, especially when narcotic analgesic are to be employed in their anaesthetic management.

Adult↗
PubMed1998

[Granisetron (per os) compared with ondansetron (per os) in the prevention of nausea and vomiting induced by mildly emetogenic chemotherapies. Groupe de Recherches en Cancerologie du Nord].

It is a randomised cross-over multicenter study comparing the efficacy and the tolerance of granisetron (Gra) 1 mg and ondansetron (Ond) 8 mg, oral, given during two consecutive cycles to 188 naive patients scheduled to receive a moderately emetogenic chemotherapy. The antiemetic treatment is given one day per course, 1 hour before chemotherapy and the second administration from 8 to 12 hours after the beginning, during each of the two cycles; alternatively according to the randomisation. Five criteria are assessed; nausea (ordinal and visual analogic scales), emeric episodes (vomiting orland retching), complete response (minor or no nausea, no emetic episode and no rescue treatment), patient preference and tolerance. The intent to treat analysis showed no significant difference at cycle 1 between Gra and Ond; at cycle 2, there is no significant difference in the number of emetic episodes; for the prevention of nausea, the ordinal scale shows a significant difference (p = 0.028 in favour of Gra at day 1 (D1) but not from D2 to D5. Gra induced more complete response than Ond at D1 (p = 0.028), but not from D2 to D5. The cross-over study did not show any period or order effect, whereas a treatment effect on Ond was significant in favour of Gra (p = 0.01). There is no significant patients preference in favour of Gra or Ond. In conclusion, Gra was more efficient in preventing nausea and obtaining complete response on the first day of treatment, significantly at the second cycle. Both Gra and Ond had a good antiemetic activity for moderately emetogenic chemotherapy with complete response rates always over 50% on day 1; delayed emesis remain less weli controlled.

Adult↗
PubMed1998

[Anticipatory nausea and anticipatory vomiting, food aversion and anticipatory immunomodulation: classical conditioning in cytostatic drug treatment of pediatric chemotherapy patients].

Nausea and/or vomiting are adverse side-effects of cancer chemotherapeutic drugs in adult as well as pediatric cancer patients' complicating treatment and compliance. Nausea and vomiting are not only experienced as posttreatment symptoms after chemotherapy (i.e., posttreatment nausea and/or vomiting). In a subgroup of cancer patients, these symptoms also occur prior to a chemotherapeutic drug infusion, called anticipatory nausea (AN) and anticipatory vomiting (AV). The aim of this paper is to present a model derived from basic psychology to explain anticipatory symptoms as learned responses based on classical conditioning. In addition, food aversions and also immunomodulation are interpreted as conditioned responses. Some data on prevalence of ANV in a pediatric sample and on the correspondence between anticipatory symptoms and predictions from the conditioning model are presented. Finally, therapeutic techniques to prevent AN and/or AV are deduced from the conditioning model.

Adult↗
PubMed1995

Effectiveness of levosulpiride versus metoclopramide for nausea and vomiting in advanced cancer patients: a double-blind, randomized, crossover study.

The antiemetic efficacy of levosulpiride (L) was compared to metoclopramide (M) in a double-blind, randomized, crossover study. Thirty patients with advanced cancer, who were no longer receiving antineoplastic therapy, were randomly assigned to receive either L 75 mg/day or M 30 mg/day. After 7 days, patients were crossed over to the alternate treatment, which was also given for 7 days. The hours with nausea were 1.08 (mean value/day/patient) during treatment with L and 2.01 with M (P = 0.002), independent of the order of administration. The nausea intensity was 0.76 (mean value/day/patient) with L and 1.42 with M (P = 0.0004). Complete control of nausea was obtained in 84.6% of patients receiving L and 42.3% of those treated with M (P = 0.0034). The number of vomiting episodes was 0.38 (mean value/day/patient) during treatment with L and 0.70 with M (P = 0.002), independent of the order of administration. Vomiting disappeared in 81.5% of patients receiving L and 51.8% of those treated with M (P = 0.041). There was a carry-over effect in favor of L. These data indicate that both L and M reduce nausea and vomiting, but L is more effective.

Aged↗