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 883 records · Page 49Linked to original sources
PubMed2002

Dexamethasone for the prevention of nausea and vomiting after dilatation and curettage: a randomized controlled trial.

OBJECTIVE: To evaluate the efficacy and safety of dexamethasone administered intravenously at three different doses (4 mg, 8 mg, 16 mg) for the prevention of nausea and vomiting after dilatation and curettage. METHODS: In a prospective, randomized, double-masked, placebo-controlled trial, 120 women received placebo or dexamethasone intravenously at doses of 4 mg, 8 mg, or 16 mg immediately before induction of anesthesia (n = 30 in each group). Propofol-based general anesthetic was used. Emetic episodes and safety assessments were performed. To estimate a sufficient sample size, it was calculated that 30 patients per group would be required with alpha =.05 and beta =.2. RESULTS: The rate of patients who were emesis-free (no nausea, retching, or vomiting) 0-24 hours after anesthesia was 57% with dexamethasone 4 mg (P =.796), 87% with dexamethasone 8 mg (P =.005), and 87% with dexamethasone 16 mg (P =.005), compared with placebo (50%). Patients who had received dexamethasone 8 mg or 16 mg were more satisfied than those who had received placebo (P <.05). No clinically important adverse events were observed in any of the groups. CONCLUSION: Dexamethasone 8 mg is an effective antiemetic for preventing postoperative nausea and vomiting 0-24 hours after anesthesia in women undergoing propofol-based general anesthesia for termination of pregnancy. Increasing the dose to 16 mg provided no additional benefit.

Adult↗
PubMed1999

Preoperative oral granisetron for the prevention of vomiting after strabismus surgery in children.

OBJECTIVE: To evaluate the efficacy of oral granisetron for the prevention of postoperative vomiting in children undergoing strabismus surgery. DESIGN: Prospective, randomized, double-masked, placebo-controlled study. PARTICIPANTS: A total of 120 children, 4-10 years of age, scheduled for elective strabismus surgery. INTERVENTION: Patients received oral placebo or granisetron at three different doses (20 microg/kg, 40 microg/kg, 80 microg/kg) 1 hour before surgery. MAIN OUTCOME MEASURES: A complete response, defined as no vomiting, no retching, and no need for rescue antiemetic medication, during the first 24 hours after anesthesia was recorded. RESULTS: A complete response during 0-24 hours after anesthesia occurred in 33% of those who received placebo, 40% who received granisetron 20 microg/kg, 83% who received granisetron 40 microg/kg, and 87% who received granisetron 80 microg/kg (P < 0.05, overall Fisher's exact probability test). CONCLUSION: Preoperative oral granisetron, in doses more than 40 microg/kg, is effective for preventing vomiting after strabismus surgery in children.

Administration, Oral↗
PubMed1999

Behaviors of bulbar respiratory interneurons during fictive swallowing and vomiting.

Behaviors of the same individual medullary respiratory interneurons were examined during both swallowing and vomiting. In 8 decerebrated and paralyzed cats, 18 neurons having either augmenting expiratory (E-AUG), decrementing expiratory (E-DEC), decrementing inspiratory (I-DEC), or constant inspiratory (I-CON) firing patterns were recorded near the most rostral part of the nucleus ambiguus. All neurons exhibited elementary reflexes to single-shock stimulation of the superior laryngeal nerve. During fictive swallowing elicited by superior laryngeal nerve stimulation, all neurons were basically inactive. During fictive vomiting induced by vagal stimulation and/or emetic drugs, all E-AUG and E-DEC neurons tested either were silent or fired weakly between successive retches, whereas I-DEC and I-CON neurons tested exhibited burst activity during the retching and early-expulsion phases. These results indicate that these bulbar respiratory neurons, which may be involved in respiratory rhythmogenesis, are multifunctional neurons that could also be involved in vomiting but not likely in swallowing.

Animals↗
PubMed1994

Acute vomiting.

Patients commonly present to the emergency clinician for evaluation of acute vomiting. The causes of vomiting range from trivial to life-threatening. The clinician must use the history, physical examination, emergency data-base, and abdominal radiographs to determine the severity of the underlying problem and the extent of the systemic side-effects of vomition. Based on this information, a plan can be devised for optimal emergency management of these patients.

Acute Disease↗
PubMed1984

Behavioral intervention for reducing chemotherapy-related nausea and vomiting in adolescents with cancer.

Eight adolescents (10-17 years, mean 12.1) with cancer received behavioral intervention for chemotherapy-related nausea and vomiting. Within 3-5 days after the administration of each course of chemotherapy, patients rated (1-10 scale; 1 = none, 10 = maximum) their nausea and vomiting and the extent to which chemotherapy bothered them and disrupted their daily routine. After a baseline (preintervention) assessment of 2-3 courses of chemotherapy, patients received intervention during another 2-3 courses. While no significant reduction of symptoms were found prior to intervention, with intervention there were reductions in nausea (Z = 2.37, p less than 0.02), vomiting (Z = 2.52, p less than 0.01), bother (Z = 2.24, p less than 0.02), and disruption of activities (Z = 2.38, p less than 0.02). This preliminary study suggests that chemotherapy side effects in adolescents can be reduced with behavioral intervention.

Adolescent↗
PubMed1986

Vomiting reduction by slower food intake.

Psychogenic vomiting of retarded persons might be partly the result of stomach overloading. A retarded male subject was treated by spacing the food intake and teaching him to eat more slowly. Vomiting decreased during the spaced food intake, resumed during normal intake, and decreased again during the reinstated spaced intake. These results indicate the importance of food-intake factors in psychogenic vomiting.

Adult↗
PubMed2001

A novel method for the evaluation of the severity of nausea and vomiting of pregnancy.

UNLABELLED: The symptomatology of nausea and vomiting of pregnancy (NVP) ranges from mild to very severe. The most advanced method to measure the burden of NVP, the Rhode's scores, incorporates physical signs (length and number of episodes of nausea, number and volume of vomits, and number of retching) with measures of distress caused by these symptoms. However, this system has been validated only for symptoms that occurred in the past 12 h, thus obviating its wide clinical use, and particularly its retrospective use. OBJECTIVE: To examine whether the severity of the physical symptoms of NVP correlate with the degree of stress caused by them, and to develop simple scores that can be used clinically. METHODS AND RESULTS: We prospectively scored 283 women with NVP using the Rhode's system. There was excellent and highly significant correlation between the physical symptoms and their degrees of distress. Subsequently, we examined two simple scoring systems, one with three and one with five physical symptoms. Both yielded distribution of severity of NVP not different from the one found with the use of the full Rhode's score. CONCLUSION: A scoring system based on all five physical symptoms, or only on three (length of nausea, number of episodes of nausea and number of vomits) yielded accurate estimates of severity and changes in severity of NVP. Unlike the Rhode's score, this simple method can be used clinically to evaluate the severity and changes in NVP.

Adolescent↗
PubMed1987

[Epileptic vomiting].

A 17 year-old girl was suffering complex partial seizures, secondary generalized epilepsy and seizures manifested only by vomiting. The neurological, laboratory, radiological studies and the brain CT were normal. The EEG recording of an ictal vomiting showed bisynchronous spike-and-wave and sharp slow-wave discharges. An interictal paroxysmal focus of the right temporo-occipital region appeared at the EEG and a marked photoconvulsant effect was induced by light stimulation. The patient remained seizure-free for the last 4 years on carbamazepine therapy. The authors suggest the vomiting fits originate from the epileptic discharges on the Ammon's horn. The depths of the temporal lobe appear clearly involved in this type of seizures and the rolandic and pre-rolandic neighboring areas are attended too.

Adolescent↗
PubMed1996

Vomiting, ataxia, and altered mental status in an adolescent: late-onset ornithine transcarbamylase deficiency.

A case of a 13-year-old boy with protracted vomiting, ataxia, and altered mental status, ultimately diagnosed with late-onset ornithine transcarbamylase (OTC) deficiency, is presented. OTC deficiency is the most common urea cycle defect and typically is diagnosed in male infants with irritability, poor feeding, vomiting, lethargy, and often death caused by the effects of hyperammonemia. Late-onset OTC deficiency has been described in patients of all ages. The presenting symptoms in these patients vary but the most common are vomiting and lethargy. The pathophysiology, clinical features, differential diagnosis, and treatment of this disorder are discussed. Because of the risks of serious consequences, early detection and treatment of OTC deficiency and hyperammonemic episodes are mandatory. Emergency physicians caring for children and adults need to be aware of the spectrum of clinical presentations of OTC deficiency, including late-onset disease.

Adolescent↗
PubMed1996

Leukocytosis, hyperglycemia, vomiting, and positive X-rays are not indicators of severity of iron overdose in adults.

To determine whether leukocytosis, hyperglycemia, vomiting, and opacities in abdominal radiographs are indicators of a serum iron concentration of > 300 micrograms/dL in adult iron overdose patients, a retrospective medical record review was undertaken at a university medical center of all patients older than 12 years of age for whom clinical data were collected before deferoxamine therapy and within 6 hours of iron ingestion. Forty-three patients met the inclusion criteria; 37 were female. The mean and range serum iron concentrations were 382 micrograms/dL and 58 to 710 micrograms/dL, with 34 patients having values of > 300 micrograms/dL. There were no statistically significant relationships between iron concentration of > 300 microgram/dL and leukocytosis, hyperglycemia, vomiting, and opacities in abdominal radiographs (P > .05). Sensitivities, specificities, and positive and negative predictive values indicate poor performance of these parameters as clinical predictors of serum iron concentration of > 300 micrograms/dL. Leukocytosis, hyperglycemia, vomiting, or the presence of opacities in abdominal X-rays are not indicators of a serum iron concentration of > 300 micrograms/dL in adults. These parameters should not be used to assess the severity of iron overdose or to guide its management.

Adolescent↗
PubMed1996

[Does oral ondansetron reduce the incidence of nausea and vomiting after surgery for strabismus in children?].

OBJECTIVE: To compare the efficacy of oral ondansetron with oral metoclopramide for the prevention of postoperative vomiting and nausea in children undergoing strabismus surgery. STUDY DESIGN: Prospective, randomized, double-blind trial. PATIENTS: Thirty children of physical class 1, age 9 +/- 4 years, scheduled for strabismus surgery, were randomized into two groups (ondansetron and metoclopramide). METHODS: In the ondansetron group, the children received the first oral dose of ondansetron (4 mg) 1 hour before induction of anaesthesia and the other doses 8 and 16 hours later. In the metoclopramide group, children received metoclopramide (5 mg) in the same conditions. Anaesthesia was induced with thiopentone, vecuronium and fentanyl and maintained with halothane and N2O/O2. Patients were evaluated by an independent observer for nausea and emesis in recovery room (0-2 h) and on the ward. The adverse effects of oral ondansetron and metoclopramide were assessed. RESULTS: There were non-significant differences between the two groups for incidence of nausea and vomiting (40% and 53% in ondansetron group versus 33 and 60% in metoclopramide group, respectively. CONCLUSION: Unlike intravenous ondansetron, oral ondansetron is not superior to metoclopramide for the prevention of nausea and vomiting caused by strabismus surgery in children.

Administration, Oral↗
PubMed1997

Intractable nausea and vomiting due to gastrointestinal mucosal metastases relieved by tetrahydrocannabinol (dronabinol).

Four years following resection of a Clark's level IV malignant melanoma, a 50-year-old man developed widespred metastatic disease involving the liver, bones, brain, gastrointestinal mucosa, and lungs. One week after whole brain radiation therapy, he was admitted to the hospital for nausea, vomiting, and pain. He was treated with several antiemetic drugs, but it was not until dronabinol was added that the nausea and vomiting stopped. Dronabinol was an effective antiemetic used in combination with prochlorperazine in nausea and vomiting unresponsive to conventional antiemetics.

Antiemetics↗
PubMed1998

Ondansetron in nausea and vomiting induced by spinal morphine.

Nausea and vomiting induced by opioids are relatively frequent in advanced cancer patients, although other factors may play a role. These effects, which tend to disappear after repeated dosing, can usually be controlled with antiemetic drugs, including metoclopramide, haloperidol, and phenothiazines. Occasionally, nausea and vomiting persist, in spite of the prolonged administration of the antiemetic treatment. We report a patient who had nausea and vomiting that was resistant to common antiemetic treatments, change in opioid drugs, and change in route of administration, and who had a complete and immediate response to parenteral or oral ondansetron.

Analgesics, Opioid↗
PubMed2003

Nausea and vomiting during pregnancy.

The differential diagnosis of nausea and vomiting is extensive and the underlying cause can be difficult to diagnose. Treatment of nausea and vomiting also can be unsatisfactory because the available pharmacotherapy does not correct the fundamental underlying pathophysiologic abnormalities. In contrast, the diagnosis of nausea and vomiting of pregnancy generally is straightforward. Almost 80% of women have some degree of nausea in the first trimester of pregnancy, and the diagnosis of pregnancy is established easily by the patient or physician. The spectrum varies from mild nausea to hyperemesis gravidarum. Various treatment approaches are addressed.

Diagnosis, Differential↗
PubMed1993

The efficacy and safety of ondansetron in the prophylaxis of cancer-chemotherapy induced nausea and vomiting in children.

The management of chemotherapy induced emesis presents a major difficulty in the paediatric population. Ondansetron is a 5-HT3 antagonist and its antiemetic properties have been established in adults receiving chemotherapy. Experience in the treatment of children, however, is limited. There is no standard comparative antiemetic in paediatric practice, so this European, multi-centred study aimed to assess the clinical efficacy and safety of ondansetron in a large cohort of children receiving a range of emetogenic chemotherapy regimens for malignant disease. Two hundred patients were entered into the study, of whom 183 fulfilled entry criteria. Forty per cent (10/25) of patients receiving cisplatin, 68% (27/40) receiving ifosfamide and 70% (83/118) receiving other drugs had less than 3 emetic episodes (vomit or retch) during their worst 24 hours of chemotherapy. The number of days without vomiting or retching during and shortly after receiving chemotherapy was also related to the emetic potential of the agents in the regimen: cisplatin 82/182 (45%), ifosfamide 137/213 (64%) and other agents 430/566 (76%). The control of nausea appeared better than that of emesis in each of the sub-groups analysed. Ondansetron was safe, well tolerated and effective in the prevention of vomiting in children receiving a wide variety of chemotherapy regimens.

Antineoplastic Agents↗
PubMed2002

Postoperative nausea and vomiting: comparison of the effect of postoperative meperidine or morphine in gynecologic surgery patients.

STUDY OBJECTIVE: To evaluate the incidence and severity of postoperative nausea and vomiting in women receiving postoperative intravenous morphine or meperidine following gynecologic surgery. DESIGN: Prospective, double-blind, randomized study. SETTING: Tertiary-care academic medical center. PATIENTS: 200 ASA physical status I, II, and III patients scheduled for elective gynecologic surgery. INTERVENTIONS: Patients received either postoperative IV morphine (n = 100) or meperidine (n = 100) following gynecologic surgery. MEASUREMENTS: We compared pain scores, sedation scores, nausea scores, well-being scores, vomiting rate, and patient satisfaction in both groups 15, 30, 60, and 120 minutes after arrival in the postoperative anesthesia care unit. MAIN RESULTS: The vomiting rate was 8/100 versus 7/100 (at 15 min), 4/100 versus 26/100 (at 30 min) (p < 0.05), 3/100 versus 23/100 (at 60 min) (p < 0.05), and 0/100 versus 0/100 (at 120 min) in the morphine or meperidine groups, respectively. The pain and sedation scores were similar in both groups. No major complications were noted in either group. CONCLUSION: Our study demonstrates an advantage of the use of morphine rather than meperidine for pain control in the immediate postoperative period following gynecologic surgery.

Adult↗
PubMed1997

Nausea and vomiting following thyroid and parathyroid surgery.

STUDY OBJECTIVES: To determine the incidence of postoperative nausea and vomiting (PONV) following thyroid and parathyroid surgery. To determine whether PONV is reduced when propofol is used for maintenance of anesthesia as compared to isoflurane and to evaluate the costs and resource consumption associated with these two anesthetic regimens. DESIGN: Randomized, prospective study. SETTING: University-affiliated hospital--a referral center for endocrinologic surgery. PATIENTS: 118 ASA physical status I and II patients, aged 18 years and older, undergoing elective thyroid or parathyroid surgery. INTERVENTIONS: Patients received either isoflurane (0.5 to 1.3% end-tidal) or propofol (50 to 200 micrograms/kg/min) for maintenance of anesthesia. All patients received propofol for induction of anesthesia, succinylcholine or vecuronium, nitrous oxide, and fentanyl. Prophylactic antiemetics were not administered. Postoperative pain was treated with ketorolac, fentanyl, or acetaminophen. MEASUREMENTS AND MAIN RESULTS: Signs and symptoms of nausea and vomiting were graded on a four point scale as 1 = no nausea; 2 = mild nausea; 3 = severe nausea; 4 = retching and/or vomiting. Grades 3 and 4 were grouped together as PONV. The combined incidence of PONV was 54% over the 24-hour postoperative evaluation period. PONV was significantly more common in patients receiving isoflurane than propofol for maintenance of anesthesia (64% vs. 44%). In women (n = 87), the incidence of PONV was significantly greater in those patients who received isoflurane than those who received propofol for maintenance (71% vs. 42%). However, in men (n = 31), there was no significant difference in PONV between anesthetic regimens (47% with isoflurane vs. 50% with propofol). There were no differences in the duration of stay in the postanesthesia care unit, time to discharge from the hospital, or local wound complications (hematomas) between groups. The use of propofol for maintenance of anesthesia was associated with an additional cost, relative to the isoflurane group, of $54.26 per patient. CONCLUSION: Patients undergoing thyroid or parathyroid surgery are at high risk for the development of PONV. Propofol for maintenance of anesthesia, although more expensive than isoflurane, reduces the rate of PONV in women.

Adult↗
PubMed2000

Pooled analysis of three large clinical trials to determine the optimal dose of dolasetron mesylate needed to prevent postoperative nausea and vomiting. The Dolasetron Prophylaxis Study Group.

STUDY OBJECTIVE: To identify the maximally effective dolasetron dose (i.e., maximum efficacy with minimum adverse events) for prevention of postoperative nausea and vomiting (PONV) using the statistical power generated in a pooled patient sample from three large, nearly identical clinical trials. DESIGN: Three randomized, multicenter, placebo-controlled, double-blinded trials. SETTING: Trials 1, 2, and 3 enrolled patients at 10, 25, and 17 hospitals and/or surgical centers, respectively. PATIENTS: A total of 1,946 ASA physical status, I, II, and III patients. Trials 1 and 2 enrolled only female patients (n = 916) undergoing gynecologic surgery. Trial three enrolled 722 females (approximately 70% gynecologic surgeries) and 308 males (approximately 46% orthopedic surgeries) undergoing a variety of surgical procedures. INTERVENTIONS: All surgical procedures used balanced general anesthesia. Patients received 12.5, 25, 50, or 100 mg of the antiemetic, dolasetron, near the end of anesthesia. MEASUREMENTS AND MAIN RESULTS: Efficacy endpoints were identical and measured for 24 hours: complete response (no vomiting or rescue medication) and maximum nausea, reported using a 100-mm visual analog scale (VAS). Safety was assessed using adverse event reports, laboratory and electrocardiographic data, and vital signs. All four dolasetron doses produced significant increases in complete response and decreases in maximum VAS nausea compared with placebo (p < 0.01). No increased efficacy was observed with dolasetron doses higher than 12.5 mg. Safety was similar between each dolasetron dose and placebo. CONCLUSION: Dolasetron 12.5 mg, given near the end of anesthesia, is the maximally effective dose studied for preventing postoperative nausea and vomiting.

Adult↗