Multimodal antiemetic management prevents early postoperative vomiting after outpatient laparoscopy.

Because no completely effective antiemetic exists for the prevention of postoperative nausea and vomiting (PONV), we hypothesize that a multimodal approach to management of PONV may reduce both vomiting and the need for rescue antiemetics in high-risk patients. After IRB approval, women undergoing outpatient laparoscopy were randomized to one of three groups. Group I (n = 60) was managed by using a predefined multimodal clinical care algorithm.

Antiemetic prophylaxis does not improve outcomes after outpatient surgery when compared to symptomatic treatment.

Background: Although prophylactic administration of antiemetics reduces the incidence of postoperative nausea, vomiting, or both (PONV), there is little evidence to suggest this improves patient outcomes. The authors hypothesized that early symptomatic treatment of PONV will result in outcomes, including time to discharge, unanticipated admission, patient satisfaction, and time to return to normal daily activities, that are similar to those achieved with routine prophylaxis.

Methods: Men and women (n = 575) scheduled for outpatient surgery during general anesthesia were randomized to receive either 4 mg intravenous ondansetron or placebo before operation and either 1 mg intravenous ondansetron or placebo if postoperative symptomatic treatment of PONV was necessary.

A randomized, double-blind, placebo controlled comparison of droperidol, ondansetron, and metoclopramide for the prevention of vomiting following outpatient strabismus surgery in children.

Study Objective: To compare the efficacy of ondansetron, droperidol, or metoclopramide with placebo in preventing postoperative vomiting following strabismus surgery.

Study Design: Randomized, double-blind, placebo-controlled clinical trial.

Setting: University outpatient surgery center.

Small-dose propofol by continuous infusion does not prevent postoperative vomiting in females undergoing outpatient laparoscopy.

This study was designed to test the hypothesis that there is a direct prophylactic antiemetic effect of small-dose propofol given by continuous infusion. Sixty female patients undergoing outpatient laparoscopy under general anesthesia were randomized to receive, in a double-blind fashion, either a bolus of 0.1 mg/kg followed by a constant infusion of 1 mg.

Oxygen administration during transport and recovery after outpatient surgery does not prevent episodic arterial desaturation.

Study Objective: To compare the efficacy of two different oxygen (O2) delivery systems in preventing episodic arterial desaturation in the immediate postoperative period.

Study Design: Randomized, prospective, nonblinded comparison in patients.

Setting: Operating room and postanesthesia care unit (PACU) of a university outpatient surgery center.

NPO after midnight before elective surgery is no longer common practice for the majority of anesthesiologists.

One thousand three hundred thirty-seven anesthesiologists randomly selected from the current American Society of Anesthesiologists' directory were surveyed to discover if their attitudes toward the policy of allowing preoperative patients nothing by mouth (NPO) have changed. One thousand forty surveys were returned. For each response to a survey question, the percentage of respondents giving that response was calculated.

Peripheral nerve blocks.

Infiltration of local anesthetic agents to achieve analgesia for the repair of lacerations or the excision of large lesions requires multiple injections, uses large volumes of local anesthetic solution and frequently produces inadequate pain relief. Peripheral nerve blocks utilize a small number of precisely placed injections to anesthetize relatively large areas of the body. Many of these blocks are safe and easy to perform in an outpatient setting.

Anesthesia considerations during nephrolithotomy with slush.

A retrospective study was made of 113 patients who underwent nephrolithotomy between 1962 and 1973. Multiple parameters from a surgical and anesthesia viewpoint were tabulated. The main findings were a high incidence of pulmonary complications (37 per cent), a general lowering of body temperature during anesthesia and operation and initial decreases in blood pressure, apparently related to the use of d-tubocurarine.