Document Detail


Prevention of nausea and vomiting following breast surgery.
MedLine Citation:
PMID:  16720146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to determine the rate of nausea and vomiting in women following breast surgery (PONV) under general anesthesia (GA), before and after the introduction of a standardized prophylactic anti-emetic (AE) regimen. METHODS: We performed a retrospective review of eligible patients, between July 2001 and March 2003. Patients operated on before September 2002 had standard preoperative care (old cohort [OC]); patients operated on after September 2002 were treated prophylactically with oral dronabinol 5 mg and rectal prochlorperazine 25 mg (new cohort [NC]). Data were collected from hospital records regarding age, diagnosis, comorbid conditions, previous anesthesia history, anesthesia and operative details, episodes PONV, and use of AE. The rate and severity of PONV was calculated for both cohorts. RESULTS: Two hundred forty-two patients were studied: 127 patients in the OC and 115 patients in the NC. The median age was 56 years (range 32 to 65). The rate of nausea and vomiting were significantly better in the patients treated prophylactically with dronabinol and prochlorperazine (59% vs. 15%, P < .0001 and 29% vs. 3%, P < .0001). Twenty patients in the OC were given some prophylactic AE treatment and 12 (60%) of them required further treatment; only 12 of 109 patients (11%) in the NC required further AE treatment (P < .0001). CONCLUSION: PONV is a significant problem in breast surgical patients. Preoperative treatment with dronabinol and prochlorperazine significantly reduced the number and severity of episodes of PONV.
Authors:
Rakhshanda Layeeque; Eric Siegel; Rena Kass; Ronda S Henry-Tillman; Maureen Colvert; Anne Mancino; V Suzanne Klimberg
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of surgery     Volume:  191     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-24     Completed Date:  2006-06-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  767-72     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Division of Breast Surgical Oncology, University of Arkansas for Medical Sciences and The Central Arkansas Veterans Hospital System, 4301 W. Markham, Slot 725, Little Rock, AR 72205, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Administration, Rectal
Adult
Antiemetics / therapeutic use*
Breast Neoplasms / pathology*,  surgery*
Cohort Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Humans
Logistic Models
Mastectomy / adverse effects,  methods*
Middle Aged
Multivariate Analysis
Patient Satisfaction
Postoperative Nausea and Vomiting / prevention & control*
Preoperative Care / methods
Primary Prevention
Probability
Prochlorperazine / therapeutic use*
Prognosis
Retrospective Studies
Tetrahydrocannabinol / therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antiemetics; 1972-08-3/Tetrahydrocannabinol; 58-38-8/Prochlorperazine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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