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[PMID]:28464238
[Au] Autor:Wang W; Zhou L; Sun L
[Ad] Endereço:Department of Anesthesiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
[Ti] Título:Ondansetron for neuraxial morphine-induced pruritus: A meta-analysis of randomized controlled trials.
[So] Source:J Clin Pharm Ther;42(4):383-393, 2017 Aug.
[Is] ISSN:1365-2710
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:WHAT IS KNOWN AND OBJECTIVE: Pruritus is one of the most common adverse effects associated with neuraxial morphine. Ondansetron has been used to deal with the problem of neuraxial morphine-induced pruritus (NMIP). The aim of this meta-analysis was to evaluate the preventive efficacy of ondansetron on NMIP. METHODS: Online databases such as PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for eligible randomized controlled trials (RCTs). The primary outcome was the incidence of NMIP. We calculated risk ratios (RR) with 95% confidence intervals (CI) for dichotomous data. Trial sequential analysis (TSA) was performed to avoid the risk of making a spurious claim of significant effect and to calculate the sample size necessary to make a robust claim of effect. RESULTS AND DISCUSSION: Our traditional meta-analysis showed that prophylactic ondansetron could significantly reduce the incidence of NMIP in non-obstetric patients (three trials, RR=0.63, 95% CI 0.45-0.89, P=.008) with modest heterogeneity (I =47%) while it did not show the preventive efficacy of NMIP in obstetric patients (seven trials, RR=0.84, 95% CI 0.69-1.03, P=.10) with obvious heterogeneity (I  =82% ). However, TSA demonstrates that more high-quality RCTs are still needed to confirm the preventive efficacy of ondansetron on NMIP in non-obstetric populations and to study whether ondansetron prevents NMIP in obstetric patients. WHAT IS NEW AND CONCLUSION: Prophylactic ondansetron can significantly reduce the incidence of NMIP in non-obstetric patients but not in obstetric patients. However, more well-designed trials are still required to test the reliability of the results in our traditional meta-analysis.
[Mh] Termos MeSH primário: Morfina/efeitos adversos
Ondansetron/uso terapêutico
Prurido/prevenção & controle
[Mh] Termos MeSH secundário: Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/efeitos adversos
Antipruriginosos/uso terapêutico
Seres Humanos
Incidência
Morfina/administração & dosagem
Prurido/induzido quimicamente
Prurido/epidemiologia
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Antipruritics); 4AF302ESOS (Ondansetron); 76I7G6D29C (Morphine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/jcpt.12539


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[PMID]:28977021
[Au] Autor:Yokoi A; Mihara T; Ka K; Goto T
[Ad] Endereço:Department of Anesthesiology, Kanagawa Children's Medical Center, Minami-ku, Yokohama, Japan.
[Ti] Título:Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis.
[So] Source:PLoS One;12(10):e0186006, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Postoperative nausea and vomiting is a distressing complication of surgery, and 5-HT3 receptor antagonists are often prescribed to prevent it. Ondansetron is the agent typically administered to prevent postoperative nausea and vomiting. Although ramosetron has a longer duration of action than ondansetron, it remains unclear whether ramosetron is the more effective medication. We performed an updated meta-analysis on the comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting. METHODS: We searched six databases for all trials that randomly assigned patients to ramosetron or ondansetron groups. The primary outcome was postoperative nausea or vomiting in the early, late, and next-day periods. The secondary outcomes were side effects of the medications. We used the random-effects model to combine the results. Trial sequential analyses were performed to correct for repetitive testing in the updated meta-analysis. RESULTS: Twenty-seven randomized controlled trials with 3,811 patients were included in the meta-analysis. The combined results of ramosetron vs. ondansetron efficacy in preventing postoperative nausea and vomiting were as follows: Risk ratio [95% confidence interval] = 0.82 [0.69-0.98] for early postoperative nausea, 0.76 [0.65-0.89] for late postoperative nausea, 0.69 [0.57-0.84] for next-day postoperative nausea, 0.78 [0.63-0.98] for early postoperative vomiting, 0.57 [0.45-0.72] for late postoperative vomiting, and 0.61 [0.43-0.86] for next-day postoperative vomiting. Dizziness was significantly lower in ramosetron groups than in ondansetron groups (risk ratio [95% confidence interval] = 0.81 [0.66-0.98]). Trial sequential analysis revealed that the results for late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea were conclusive. CONCLUSIONS: Ramosetron is more effective in preventing late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea than ondansetron. The incidence of dizziness may be lower in patients receiving ramosetron than in patients receiving ondansetron. TRIAL REGISTRATION: University hospital Medical Information Network Clinical Trials Registry: UMIN000022980.
[Mh] Termos MeSH primário: Antieméticos/uso terapêutico
Benzimidazóis/uso terapêutico
Ondansetron/uso terapêutico
Náusea e Vômito Pós-Operatório/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Antiemetics); 0 (Benzimidazoles); 4AF302ESOS (Ondansetron); 7ZRO0SC54Y (ramosetron)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186006


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[PMID]:28882877
[Au] Autor:Rutman L; Klein EJ; Brown JC
[Ad] Endereço:Department of Pediatrics, University of Washington, Seattle, Washington; and lori.rutman@seattlechildrens.org.
[Ti] Título:Clinical Pathway Produces Sustained Improvement in Acute Gastroenteritis Care.
[So] Source:Pediatrics;140(4), 2017 Oct.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Despite widespread use of the rotavirus vaccine in the last decade, dehydrating illnesses impact almost 2 billion children worldwide annually. Evidence supports oral rehydration therapy as a first-line treatment of mild to moderate dehydration. Ondansetron has proven to be a safe and effective adjunct in children with vomiting. We implemented a clinical pathway in our pediatric emergency department (ED) in January 2005 to improve care for this common condition. Our objective in this study was to determine the long-term impact of the pathway for acute gastroenteritis (AGE) on the proportion of patients receiving intravenous (IV) fluids and ED length of stay (LOS) for discharged patients. METHODS: Cases were identified by using diagnosis codes. We used statistical process control to analyze process and outcome measures for 2 years before and 10 years after pathway implementation. RESULTS: We included 30 519 patients. We found special cause variation with a downward shift in patients receiving IV fluids after initiation of the pathway and later with addition of ondansetron to the pathway from 48% to 26%. Mean ED LOS for discharged patients with AGE decreased from 247 to 172 minutes. These improvements were sustained over time. CONCLUSIONS: Implementation of a clinical pathway emphasizing oral rehydration therapy and ondansetron for children with AGE led to decreased IV fluid use and LOS in a pediatric ED. Improvements were sustained over a 10-year period. Our results suggest that quality-improvement interventions for AGE can have long-term impacts on care delivery.
[Mh] Termos MeSH primário: Antieméticos/uso terapêutico
Procedimentos Clínicos
Serviço Hospitalar de Emergência/normas
Hidratação/métodos
Gastroenterite/terapia
Ondansetron/uso terapêutico
Melhoria de Qualidade/estatística & dados numéricos
[Mh] Termos MeSH secundário: Doença Aguda
Adolescente
Criança
Pré-Escolar
Terapia Combinada
Serviço Hospitalar de Emergência/estatística & dados numéricos
Feminino
Hidratação/normas
Hidratação/estatística & dados numéricos
Hidratação/utilização
Seres Humanos
Lactente
Tempo de Internação/estatística & dados numéricos
Masculino
Avaliação de Processos e Resultados (Cuidados de Saúde)
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiemetics); 4AF302ESOS (Ondansetron)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE


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[PMID]:28866307
[Au] Autor:Iammatteo M; Keskin T; Jerschow E
[Ad] Endereço:Division of Allergy and Immunology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
[Ti] Título:Evaluation of periprocedural hypersensitivity reactions.
[So] Source:Ann Allergy Asthma Immunol;119(4):349-355.e2, 2017 Oct.
[Is] ISSN:1534-4436
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Identifying the cause of periprocedural hypersensitivity reactions (HSRs) remains challenging because of the multitude of medications involved. Antibiotics are the most common cause in the United States, whereas neuromuscular blocking agents are most common in Europe. OBJECTIVE: To identify causative agents for periprocedural HSRs. METHODS: This study was a 7-year retrospective medical record review of patients evaluated between December 2009 and January 2017 at a drug allergy center in Bronx, New York for periprocedural HSRs, defined as occurring soon before, during, or soon after a medical procedure or operation with or without general anesthesia. Demographics, description of historical HSRs, results of testing to potential causative medications, and tolerance of subsequent anesthesia were reviewed. RESULTS: Thirty-four patients completed a comprehensive evaluation. Skin testing identified an IgE-mediated cause in 22 patients (64.7%). The most common causative class of medications was induction agents (n = 9 [36%]), with midazolam being the most frequently implicated (n = 6 [3 positive skin test results, 3 equivocal skin test results]). Cefazolin was the most common agent identified (n = 8 [32%]) followed by ondansetron (n = 3 [12%]). Sixteen of 22 contacted patients were exposed to subsequent anesthesia, including 3 patients with negative evaluations. One patient experienced a mild urticarial HSR. CONCLUSION: Induction agents were the most common causative agents in our patients, which differs from other studies. Given the variability in evaluations of periprocedural HSRs across the United States with data published on small sample sizes, there is a need to establish national guidelines to standardize evaluations and to create a national registry to allow for data sharing.
[Mh] Termos MeSH primário: Anestésicos Gerais/efeitos adversos
Antibacterianos/efeitos adversos
Hipersensibilidade a Drogas/diagnóstico
Tolerância a Medicamentos/imunologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Anestésicos Intravenosos/efeitos adversos
Cefazolina/efeitos adversos
Hipersensibilidade a Drogas/sangue
Hipersensibilidade a Drogas/imunologia
Hipersensibilidade a Drogas/fisiopatologia
Feminino
Seres Humanos
Imunoglobulina E/sangue
Masculino
Midazolam/efeitos adversos
Meia-Idade
Ondansetron/efeitos adversos
Guias de Prática Clínica como Assunto
Estudos Retrospectivos
Testes Cutâneos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, General); 0 (Anesthetics, Intravenous); 0 (Anti-Bacterial Agents); 37341-29-0 (Immunoglobulin E); 4AF302ESOS (Ondansetron); IHS69L0Y4T (Cefazolin); R60L0SM5BC (Midazolam)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170904
[St] Status:MEDLINE


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[PMID]:28709705
[Au] Autor:de Azevedo CRAS; Thuler LCS; de Mello MJG; de Oliveira Lima JT; da Fonte ALF; Fontão DFS; Carneiro VCG; Chang TMC; Ferreira CG
[Ad] Endereço:Instituto de Medicina Integral Prof. Fernando Figueira - IMIP, Recife, Brazil; Clínica Multihemo/Oncoclínicas do Brasil, Recife, Brazil. Electronic address: carla.rameri.de.azevedo@gmail.com.
[Ti] Título:Phase II trial of neoadjuvant chemotherapy followed by chemoradiation in locally advanced cervical cancer.
[So] Source:Gynecol Oncol;146(3):560-565, 2017 Sep.
[Is] ISSN:1095-6859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Cervical cancer is a global public health challenge. Since 1999, platin based chemoradiation (CRT) is the standard treatment for those patients with locally advanced disease. However, this population still has a dismal prognosis and, alternatives approaches such as adjuvant chemotherapy are controversial, especially because of increased toxicity. Neoadjuvant chemotherapy (NACT) could be an option for more intensive treatment with manageable toxicity. METHODS: A phase II, prospective, non-randomized trial was conducted at a reference center in Recife, Brazil. Locally advanced cervical cancer patients (Ib2-IVa) were treated with neoadjuvant cisplatin 35mg/m and gemcitabine 1000mg/m D1 and D8, for 2cycles. Then, they received CRT (50.4Gy) with weekly cisplatin 40mg/m followed by brachytherapy. Response rate (RR) and toxicity were the primary endpoints. Progression-free survival (PFS) and overall survival (OS) were secondary endpoints. RESULTS: Between Sep/2013 and Oct/2015, 50 patients were initiated on NACT and CRT. RR was 81% at the end of treatment. Hematological and gastrointestinal toxicity were most common. Grade 3/4 toxicity was 20% during NACT and 44% during CRT. Late adverse events were present in 20% of patients. PFS at 1 and 3-years were 73.4% (IC 58.7-83.6) and 53.9% (IC 36.9-68.3), respectively; and, OS at 1 and 3-years were 93.9% (IC 82.4-98.0) and 71.3% (IC 53.3-83.3), respectively. CONCLUSION: In our hands NACT in locally advanced cervical cancer patients did not show a meaningful improvement in ORR. Nevertheless, we believe it should be further explored in prospective trials.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Carcinoma de Células Escamosas/terapia
Quimiorradioterapia
Terapia Neoadjuvante
Neoplasias do Colo do Útero/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Braquiterapia
Quimiorradioterapia/efeitos adversos
Quimioterapia Adjuvante/efeitos adversos
Cisplatino/administração & dosagem
Desoxicitidina/administração & dosagem
Desoxicitidina/análogos & derivados
Dexametasona/administração & dosagem
Intervalo Livre de Doença
Fracionamento de Dose
Feminino
Seres Humanos
Meia-Idade
Terapia Neoadjuvante/efeitos adversos
Ondansetron/administração & dosagem
Estudos Prospectivos
Critérios de Avaliação de Resposta em Tumores Sólidos
Taxa de Sobrevida
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE
[Nm] Nome de substância:
0W860991D6 (Deoxycytidine); 4AF302ESOS (Ondansetron); 7S5I7G3JQL (Dexamethasone); B76N6SBZ8R (gemcitabine); Q20Q21Q62J (Cisplatin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170716
[St] Status:MEDLINE


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[PMID]:28625425
[Au] Autor:Klinger RY; Habib AS
[Ad] Endereço:Department of Anesthesiology, Duke University, Durham, NC 27710, United States.
[Ti] Título:Acetaminophen and ondansetron: The central serotonergic connection.
[So] Source:J Clin Anesth;40:101-102, 2017 08.
[Is] ISSN:1873-4529
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Acetaminofen
Ondansetron
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
362O9ITL9D (Acetaminophen); 4AF302ESOS (Ondansetron)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE


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Brandão, Marcos Antonio Fernandes
[PMID]:28557789
[Au] Autor:Ferreira AO; Polonini HC; Loures da Silva S; Cerqueira de Melo VA; de Andrade L; Brandão MAF
[Ad] Endereço:Ortofarma-Quality Control Laboratories, Matias Barbosa, MG, Brazil. anderson@ortofarma.
[Ti] Título:Stability of Alprazolam, Atropine Sulfate, Glutamine, Levofloxacin, Metoprolol Tartrate, Nitrofurantoin, Ondansetron Hydrochloride, Oxandrolone, Pregabaline, and Riboflavin in SyrSpend SF pH4 Oral Suspensions.
[So] Source:Int J Pharm Compd;21(3):255-263, 2017 May-Jun.
[Is] ISSN:1092-4221
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of this study was to evaluate the stability of 10 commonly used active pharmaceutical ingredients compounded in oral suspensions using an internationally used suspending vehicle (SyrSpend SF PH4): alprazolam 1.0 mg/mL, atropine sulfate 0.1 mg/mL, glutamine 250.0 mg/mL, levofloxacin 50.0 mg/mL, metoprolol tartrate 10.0 mg/mL, nitrofurantoin 2.0 mg/mL, ondansetron hydrochloride 0.8 mg/mL, oxandrolone 3.0 mg/mL, pregabaline 20.0 mg/mL, riboflavin 10.0 mg/mL. All suspensions were stored at both controlled refrigeration (2°C to 8°C) and controlled room temperature (20°C to 25°C). Stability was assessed by measuring the percent recovery at varying time points throughout a 90-day period. Active pharmaceutical ingredients quantification was performed by high-performance liquid chromatography via a stability-indicating method. Given the percentage of recovery of the active pharmaceutical ingredients within the suspensions, the beyond-use date of the final products (active pharmaceutical ingredients + vehicle) was at least 90 days for all suspensions with regard to both temperatures. This suggests that the vehicle is stable for compounding active pharmaceutical ingredients from different pharmacological classes.
[Mh] Termos MeSH primário: Preparações Farmacêuticas/química
Suspensões/química
[Mh] Termos MeSH secundário: Alprazolam/química
Atropina/química
Composição de Medicamentos/métodos
Estabilidade de Medicamentos
Armazenamento de Medicamentos/métodos
Glutamina/química
Levofloxacino/química
Metoprolol/química
Nitrofurantoína/química
Ondansetron/química
Oxandrolona/química
Pregabalina/química
Refrigeração/métodos
Riboflavina/química
Temperatura Ambiente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pharmaceutical Preparations); 0 (Suspensions); 0RH81L854J (Glutamine); 4AF302ESOS (Ondansetron); 55JG375S6M (Pregabalin); 6GNT3Y5LMF (Levofloxacin); 7C0697DR9I (Atropine); 7H6TM3CT4L (Oxandrolone); 927AH8112L (Nitrofurantoin); GEB06NHM23 (Metoprolol); TLM2976OFR (Riboflavin); YU55MQ3IZY (Alprazolam)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE


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[PMID]:28407815
[Au] Autor:Schoen NB; Jermakowicz WJ; Luca CC; Jagid JR
[Ad] Endereço:Department of Neurological Surgery, University of Miami Miller School of Medicine, 1150 NW 14th St., Miami, Florida, 33136, USA. nschoen@med.miami.edu.
[Ti] Título:Acute symptomatic peri-lead edema 33 hours after deep brain stimulation surgery: a case report.
[So] Source:J Med Case Rep;11(1):103, 2017 Apr 14.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Symptomatic peri-lead edema is a rare complication of deep brain stimulation that has been reported to develop 4 to 120 days postoperatively. CASE PRESENTATION: Here we report the case of a 63-year-old Hispanic man with an 8-year history of Parkinson's disease who underwent bilateral placement of subthalamic nucleus deep brain stimulation leads and presented with acute, symptomatic, unilateral, peri-lead edema just 33 hours after surgery. CONCLUSIONS: We document a thorough radiographic time course showing the evolution of these peri-lead changes and their regression with steroid therapy, and discuss the therapeutic implications of these findings. We propose that the unilateral peri-lead edema after bilateral deep brain stimulation is the result of severe microtrauma with blood-brain barrier disruption. Knowledge of such early manifestation of peri-lead edema after deep brain stimulation is critical for ruling out stroke and infection and preventing unnecessary diagnostic testing or hardware removal in this rare patient population.
[Mh] Termos MeSH primário: Edema Encefálico/diagnóstico por imagem
Estimulação Encefálica Profunda/efeitos adversos
Cefaleia/etiologia
Doença de Parkinson/terapia
Complicações Pós-Operatórias/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Anti-Inflamatórios/uso terapêutico
Edema Encefálico/terapia
Dexametasona/uso terapêutico
Cefaleia/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Ondansetron/uso terapêutico
Doença de Parkinson/fisiopatologia
Complicações Pós-Operatórias/terapia
Náusea e Vômito Pós-Operatório
Núcleo Subtalâmico
Resultado do Tratamento
Conduta Expectante
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 4AF302ESOS (Ondansetron); 7S5I7G3JQL (Dexamethasone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1275-6


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[PMID]:28372658
[Au] Autor:Bordlee JW; Beakley BD; Mody R; McConville AP; Weed JT; McClure BP; Foldes PJ; Ma JG; Kaye AD; Eskander JP
[Ad] Endereço:Department of Anesthesiology, Tulane School of Medicine, New Orleans, LA. Electronic address: jbordlee@tulane.edu.
[Ti] Título:A case of paradoxical presentation of a postural postdural puncture headache after combined spinal-epidural anesthesia.
[So] Source:J Clin Anesth;38:156-157, 2017 May.
[Is] ISSN:1873-4529
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We report a case of paradoxical presentation of a postural postdural puncture headache secondary to dural puncture with a 25-gauge Whitacre needle for combined spinal-epidural anesthesia. This 27-year-old female patient presented to the emergency department with elevated blood pressure and a global headache 9 days after administration of epidural anesthesia for a spontaneous vaginal delivery after an uncomplicated pregnancy. The patient reported that the headache was more intense when lying down and immediately improved when she sat or stood up from a recumbent position. The patient was discharged from emergency department after an improvement following treatment with labetalol, ondansetron, ketorolac, and fluid resuscitation.
[Mh] Termos MeSH primário: Anestesia Epidural/efeitos adversos
Anestesia Obstétrica/efeitos adversos
Raquianestesia/efeitos adversos
Vazamento de Líquido Cefalorraquidiano/complicações
Cefaleia Pós-Punção Dural/diagnóstico
[Mh] Termos MeSH secundário: Acetaminofen/uso terapêutico
Adulto
Analgésicos Opioides/administração & dosagem
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Parto Obstétrico/efeitos adversos
Combinação de Medicamentos
Feminino
Fentanila/administração & dosagem
Seres Humanos
Hipertensão/tratamento farmacológico
Hipertensão/etiologia
Cetorolaco/uso terapêutico
Labetalol/uso terapêutico
Agulhas
Ondansetron/uso terapêutico
Oxicodona/uso terapêutico
Cefaleia Pós-Punção Dural/tratamento farmacológico
Cefaleia Pós-Punção Dural/etiologia
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 0 (Drug Combinations); 0 (oxycodone-acetaminophen); 362O9ITL9D (Acetaminophen); 4AF302ESOS (Ondansetron); CD35PMG570 (Oxycodone); R5H8897N95 (Labetalol); UF599785JZ (Fentanyl); Y8335394RO (Bupivacaine); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE


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[PMID]:28236862
[Au] Autor:Yagan Ö; Tas N; Mutlu T; Hanci V
[Ad] Endereço:Ordu University, School of Medicine, Department of Anesthesiology, Ordu, Turkey. Electronic address: ozguryagan@hotmail.com.
[Ti] Título:Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting.
[So] Source:Braz J Anesthesiol;67(2):147-152, 2017 Mar - Apr.
[Is] ISSN:0104-0014
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV). METHODS: Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly divided into two groups given 2mgkg sugammadex (Group S) or 50µgkg neostigmine plus 0.2mgkg atropine (Group N). Monitoring and recording times were set as 1 hour postoperative and from 1-6, 6-12, and 12-24hours. The anti-emetic amounts administered were recorded. RESULTS: In the first hour postoperative 13 patients in Group N (27%) and 4 in Group S (8%) were observed to have nausea and/or vomiting and the difference was statistically significant (p=0.0016). During the 24 hours of monitoring there was no significant difference in the incidence and severity of PONV (p>0.05), however the number of patients given ondansetron for PONV treatment in Group N was statistically significantly higher than the number in Group S (16 in Group N, 6 in Group S, p<0.011). CONCLUSIONS: At the end of our study comparing neostigmine with sugammadex for neuromuscular blockage antagonism, we found use of sugammadex had lower incidence of PONV in the postoperative 1st hour and less anti-emetic use in 24 hours of monitoring.
[Mh] Termos MeSH primário: Antieméticos/uso terapêutico
Neostigmina/administração & dosagem
Náusea e Vômito Pós-Operatório/epidemiologia
gama-Ciclodextrinas/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Anestesia Geral/métodos
Antieméticos/administração & dosagem
Atropina/administração & dosagem
Quimioterapia Combinada
Feminino
Seres Humanos
Incidência
Intubação Intratraqueal
Masculino
Meia-Idade
Neostigmina/efeitos adversos
Bloqueio Neuromuscular
Ondansetron/administração & dosagem
Ondansetron/uso terapêutico
Náusea e Vômito Pós-Operatório/induzido quimicamente
Estudos Prospectivos
Índice de Gravidade de Doença
Método Simples-Cego
gama-Ciclodextrinas/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antiemetics); 0 (gamma-Cyclodextrins); 361LPM2T56 (Sugammadex); 3982TWQ96G (Neostigmine); 4AF302ESOS (Ondansetron); 7C0697DR9I (Atropine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170227
[St] Status:MEDLINE



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