AI Article Synopsis
- The study aimed to compare the effects of exteriorized versus in situ uterine repair on intraoperative nausea and vomiting during elective cesarean deliveries under spinal anesthesia.
- A randomized trial including 180 women showed that the in situ repair group experienced significantly less nausea and vomiting (22%) compared to the exteriorization group (39%).
- Additionally, the exteriorization group had higher incidences of hypotension and required more phenylephrine boluses for blood pressure management, suggesting that in situ repair may be a safer option for minimizing these complications.
Article Abstract
Objective: To compare the effect of exteriorized with in situ uterine repair on intraoperative nausea and vomiting during elective cesarean delivery under spinal anesthesia using a phenylephrine infusion.
Methods: This study was a randomized double-blinded controlled trial of 180 women undergoing elective cesarean delivery using a standardized anesthetic protocol. Patients were randomized to exteriorization (n=90) or in situ uterine repair (n=90). The spinal anesthetic, phenylephrine infusion, and blood pressure management were all standardized. The primary outcome was postdelivery intraoperative nausea and vomiting using a 4-point scale (0-3). A sample size of 80 patients per group was needed to demonstrate a 50% reduction in intraoperative nausea and vomiting with in situ repair.
Results: From November 2015 through July 2018, 180 patients were enrolled. Incidence of postdelivery intraoperative nausea and vomiting was 39% in the exteriorization group compared with 22% in the in situ group (P=.01). Incidence of hypotension (80% vs 50%; P<.001) and tachycardia (33% vs 17%; P=.02) was significantly higher in the exteriorization group, and more phenylephrine boluses were administered to this group (median 4 boluses [first and third quartiles 1.25-7] vs 2 [0-4]; P<.001). The duration of surgery, blood loss, and postoperative hemoglobin decline were similar between groups.
Conclusion: In situ uterine repair for elective cesarean delivery under spinal anesthesia with a phenylephrine infusion is associated with less postdelivery intraoperative nausea and vomiting.
Clinical Trial Registration: ClinicalTrials.gov, NCT02587013.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/AOG.0000000000003821 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of hyperthermia combined with opioids on cancer pain control and surgical stress in patients with gastrointestinal cancer.
World J Gastrointest Surg
December 2024
Department of Oncology, Suzhou Ninth People's Hospital, Suzhou 215200, Jiangsu Province, China.
Background: Surgical palliative surgery is a common method for treating patients with middle and late stage gastrointestinal tumors. However, these patients generally experience high levels of cancer pain, which can in turn stimulate the body's stress and undermine the effect of external surgery. Although opioid drugs have a significantly positive effect on controlling cancer pain, they can induce adverse drug reactions and potential damage to the body 's immune function.
View Article and Find Full Text PDFUltrasound-guided Genicular Nerve Block in Patients Undergoing Knee Arthroscopy: A Randomized Controlled Trial.
Sports Med Arthrosc Rev
October 2024
Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
This study was to investigate the efficacy of ultrasound-guided genicular nerve block for patients who underwent knee arthroscopy. Patients were randomized into two groups: 1. nerve block group: ultrasound-guided genicular nerve block (superomedial, superolateral and inferomedial genicular nerve, 2-ml 0.
View Article and Find Full Text PDFProphylactic ondansetron for preventing intraoperative shivering, nausea and vomiting during spinal anesthesia for cesarean section: a randomized controlled trial.
Front Pharmacol
December 2024
Department of Anesthesiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China.
Background: Shivering, nausea and vomiting are common complications in cesarean section during neuraxial anesthesia. The aim of this study was to investigate the effects of prophylactic use of ondansetron on intraoperative shivering, nausea and vomiting in women undergoing cesarean section.
Methods: A total of 80 full-term parturients were randomly divided into the ondansetron group and the control group.
The Effects of Opioid-Free Anesthesia with Dexmedetomidine and Esketamine on Postoperative Anesthetic-Related Complications for Hip Surgery in the Elderly.
Int J Gen Med
December 2024
Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Purpose: The routine perioperative use of opioids has recently been questioned due to opioid-related side effects, which can be potentially harmful in geriatric patients. This study aimed to evaluate the effects of opioid-free anesthesia in geriatric patients undergoing hip surgery.
Patients And Methods: A total of 121 patients, aged 60 years or older, undergoing elective hip surgery were randomized to receive either opioid-free anesthesia with dexmedetomidine and esketamine (OFA group) or balanced anesthesia with opioids (CON group).
Incidence and factors associated with postoperative hemodynamic change in the postanaesthetic care unit among adult surgical patients at a tertiary care hospital in Ethiopia: a prospective observational study.
BMC Anesthesiol
December 2024
Department of Anaesthesia, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia.
Background: Hemodynamic changes are independent risk factors for long-term patient morbidity and duration of hospital stay. According to the statistics, the three most prevalent complications in the postanaesthesia care unit were airway events, haemodynamic instability, and postoperative nausea and vomiting. Hemodynamic instability in the postanaesthesia care unit can result in serious complications, such as long-term patient morbidity and prolonged hospital stays.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!