Amisulpride Prevents Postoperative Nausea and Vomiting in Patients at High Risk A Randomized, Double-blind, Placebo-controlled Trial

Background Postoperative nausea and vomiting causes distress for patients and can prolong care requirements. Consensus guidelines recommend use of multiple antiemetics from different mechanistic classes as prophylaxis in patients at high risk of postoperative nausea and vomiting. The prophylactic efficacy of the dopamine D2/D3 antagonist amisulpride in combination with other antiemetics was investigated.Methods This double-blind, randomized, placebo-controlled, international, multicenter trial was conducted in 1,147 adult surgical patients having three or four postoperative nausea and vomiting risk factors. Patients were randomized to receive either intravenous amisulpride (5  mg) or matching placebo at induction of general anesthesia, in addition to one standard, nondopaminergic antiemetic, most commonly ondansetron or dexamethasone. Vomiting/retching, nausea, and use of rescue medication were recorded for 24 h after wound closure. The primary endpoint was complete response, defined as no emesis or rescue medication use in the 24-h postoperative period.Results Complete response occurred in 330 of 572 (57.7%) of the amisulpride group and 268 of 575 (46.6%) of the control group (difference 11.1 percentage points; 95% CI, 5.3 to 16.8;P
Source: Anesthesiology - Category: Anesthesiology Source Type: research

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Conditions:   Blood Pressure;   Pediatrics;   Electrocardiography;   Accelerometer Intervention:   Device: Biosignal measurements Sponsor:   Seoul National University Hospital Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Catherine J. A. Williams, Eva M. Greunz, Steffen Ringgaard, Kasper Hansen, Mads F. Bertelsen, and Tobias Wang The ejection fraction of the trabeculated cardiac ventricle of reptiles has not previously been measured. Here we use the gold standard clinical methodology – electrocardiogram (ECG) gated flow magnetic resonance imaging (MRI) – to validate stroke volume measurements and end diastolic ventricular blood volumes. This produces an estimate of ejection fraction in the red footed tortoise Chelonoidis carbonaria (n=5) under isoflurane anaesthesia of 88±11%. After elimination of the prevailing right-to-...
Source: Journal of Experimental Biology - Category: Biology Authors: Tags: SHORT COMMUNICATION Source Type: research
ConclusionsThe reperfusion VT/VFs were independently predicted by increased Tp ‐Te dispersion, which suggests the importance of multi‐lead evaluation of Tp‐Te intervals.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ EXPERIMENTAL Source Type: research
In this study we aimed to investigate the effectiveness of analgesia nociception index as a tool for acute postoperative pain assessment. Our hypothesis was that analgesia nociception index may have good correlation with Numerical Rating Scale values. METHODS: A total of 120 patients of ASA physical status I and II undergoing any surgical procedure under halogenated-based anesthesia with fentanyl or remifentanil were enrolled for the study. At the 15th minute of arrival to the Postoperative Care Unit the patients' pain was rated on a 0?10 point Numerical Rating Scale. The patients' heart rate, ...
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
ConclusionsThe reperfusion VT/VFs were independently predicted by increased Tp ‐Te dispersion, which suggests importance of multi‐lead evaluation of Tp‐Te intervals.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ EXPERIMENTAL Source Type: research
Conclusions and significance: DI-SCT is a safe and non-invasive modality for diagnosing the obstructive sites in OSAS patients. PMID: 31373241 [PubMed - as supplied by publisher]
Source: Acta Oto-Laryngologica - Category: ENT & OMF Authors: Tags: Acta Otolaryngol Source Type: research
A 44-YEAR-OLD woman (height 158 cm, weight 62 kg) presented with shortness of breath on mild exertion of several months duration. An electrocardiogram indicated the presence of atrial fibrillation with a ventricular rate of 80 to 100/min. Transthoracic echocardiography revealed severe mitral stenosis with an enlarged left atrium. The patient was scheduled for mitral valve replacement surgery. After induction of anesthesia, transesophageal echocardiography (TEE) confirmed the previous findings and demonstrated layered thrombus in the left atrium along the atrial septum.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research
This article is protected by copyright. All rights reserved. PMID: 31330058 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Pharmacology and Physiology - Category: Drugs & Pharmacology Authors: Tags: Clin Exp Pharmacol Physiol Source Type: research
Authors: Nakayama S, Koie H, Kato-Tateishi M, Pai C, Ito-Fujishiro Y, Kanayama K, Sankai T, Yasutomi Y, Ageyama N Abstract The demand for monkeys for medical research is increasing, because their ionic mechanism of repolarization is similar to that of humans. The QT interval is the distance between the Q wave and T wave, but this interval is affected by heart rate. Therefore, QT correction methods are commonly used in clinical settings. However, an accurate correction formula for the QT interval in cynomolgus monkeys has not been reported. We assessed snapshot ECGs of 353 ketamine-anesthetized monkeys, including ag...
Source: Experimental Animals - Category: Research Tags: Exp Anim Source Type: research
Abstract: Adrenaline (epinephrine) is one of the prime messengers of the fight-or-flight response, favoring the activation of β-adrenergic receptors. Although general vasoconstriction to nonessential tissues is imperative, the vasodilatory effect of β-adrenergic receptor activation contends with this. We aimed to determine the dose-dependent effects of adrenaline on hemodynamics and to test whether adrenaline could lower blood pressure (BP) through a β2-adrenergic pathway. Nineteen Danish landrace pigs were used to pharmacologically probe the hemodynamic effect of adrenaline. Pigs were anesthetized, intuba...
Source: Journal of Cardiovascular Pharmacology - Category: Cardiology Tags: Original Article Source Type: research
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