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Fulltext Effect of single-dose dexmedetomidine on postoperative recovery after ambulatory ureteroscopy and ureteric stenting: a double blind randomized controlled study

Shariffuddin II, Teoh WH, Wahab S, Wang CY

BMC Anesthesiol, 2018 01 05;18(1):3.
PMID: 29304735 DOI: 10.1186/s12871-017-0464-6

BACKGROUND: Ambulatory surgery has recently gain popularity, as it is a good method of optimizinghospital resources utilization. To support ambulatory surgery, anaesthetic goals nowrevolve around patients' early recovery with minimal pain and nausea, expedientdischarge home and prompt resumption of activities of daily living. In this study, weevaluated the effect of a single pre-induction dose of dexmedetomidine on anaestheticrequirements, postoperative pain and clinical recovery after ambulatory ureteroscopy andureteric stenting under general anaesthesia.
METHODS: Sixty patients were randomised to receive IV dexmedetomidine 0.5 μg.kg-1 (Group DEX, n = 30) or IV saline (Group P, n = 30). General anaesthesia was maintained with Sevoflurane: oxygen: air, titrated to BIS 40-60. Pain intensity, sedation, rescue analgesics, nausea/vomiting and resumption of daily activities were recorded at 1 h, and postoperative day (POD) 1-5.
RESULTS: Group DEX patients had significant reduction in sevoflurane minimum alveolar concentration (MAC), mean (SD) DEX vs. Placebo 0.6 (0.2) vs. 0.9 (0.1), p = 0.037; reduced postoperative resting pain at 1 h (VAS 0-10) (mean (SD) 1.00 (1.84) vs. 2.63 (2.78), p = 0.004), POD 1 (mean (SD) 1.50 (1.48) vs. 2.87 (2.72), p = 0.002), POD 2 (0.53 (0.97) vs. 1.73 (1.96), p = 0.001) and POD 3 (0.30 (0.75) vs. 0.89 (1.49), p = 0.001). DEX patients also had less pain on movement POD 1 (3.00 (2.12) vs. 4.30 (3.10), p = 0.043) and POD 2 (2.10 (1.98) vs. 3.10 (2.46), p = 0.040), with higher resumption of daily activities by 48 h compared to placebo, 87% vs. 63%, p = 0.04.
CONCLUSIONS: We conclude that a single dose of dexmedetomidine was a useful adjuvant in reducing MAC and postoperative pain (at 1 h and POD 1-3), facilitating faster return to daily activities by 48 h.
TRIAL REGISTRATION: The Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617001120369 , 31st July 2017, retrospectively registered.

Matched MeSH terms: Postoperative Nausea and Vomiting/prevention & control*
Fulltext A comparative study of post operative analgesia, side effects profile and patient satisfaction using intrathecal fentanyl with and without morphine 0.1 mg in caesarean section

Sawi W, Choy YC

Middle East J Anaesthesiol, 2013 Feb;22(1):21-6.
PMID: 23833846

BACKGROUND: This was a double-blinded, prospective randomized controlled trial to compare the postoperative analgesia, side effects profile and overall satisfaction in patients who received intrathecal fentanyl with or without morphine for elective Caesarean.
METHODS: Sixty ASA I and II parturients were randomized into two groups. Group I received intrathecal fentanyl with 0.1 mg morphine and Group II received intrathecal fentanyl only. Postoperatively, all patients were provided with oral analgesics. The degree of post-operative pain score was assessed by verbal pain score. The incidence of side effects was assessed every 4 hours for 24 hours, which included incidence of nausea, vomiting, pruritus, sedation and evidence of respiratory depression. Patient's overall satisfaction was also recorded.
RESULTS: The verbal pain score was significantly lower in morphine group up to 20 hours postoperative period. The incidence of pruritus, nausea and vomiting were statistically significant up to 12 hours postoperative. There was no incidence of severe side effects in all the patients. There was significant difference between the morphine and no morphine group in terms of overall patient satisfaction.
CONCLUSION: There was significant difference in terms of lower pain score, higher incidence of side effects with better patients' overall satisfaction in morphine group.

Matched MeSH terms: Postoperative Nausea and Vomiting/epidemiology
Fulltext Application of occupational health surveillance program among responder’s during chemical incident at Pasir Gudang, Johor

Salvaraji L., Haidar R.T., Mohd Aris N., Ayob Q. A., Nordin N., Abdul Latif N., et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):29-29.
MyJurnal

Introduction: Responder’s action during mass environmental chemical incident involves collaboration of multiple agency. They clean the exposure site, control public safety and safe lives. The health of the responder is also as valuable as the public and always been neglected. Hence, this study is to highlights the method used and challenges during the incidents. Methods: A modified Occupational Health Surveillance Programme designed by Baker and Matte (Thirteen Steps in designing and implementing an Occupational Health Surveillance Programme) was imple-mented. These method full fill the criteria of impossible further reduce exposure to known hazards and uncertain health effect of the offending chemicals. Two core workplace namely the source of chemical contamination locale and victims’ evacuation centre were identified. The exposed responder is identified and categorised according to their expected exposure. Offending chemicals identified were known hazardous to health. An electronic survey form was developed and the surveillance were conducted during the event and post-exposures of one, third and sixth months. Laboratory tests were performed as a grab sample randomly and strategically to represent responder exposure. Results: During the event, 1338 responders were surveyed and twenty percent had symptoms of cough, headache, sore throat, nausea and skin irritation. After one-month post-exposure, three percent of responder noted to have continue symptoms. Laboratory tests were performed randomly due to the sheer numbers of responders in action. Only sixty-one samples were collected and sixteen percent had positive metabolites for urine cyanide. Re-sponders with abnormal laboratory result (FBC/LFT/RP/Urine) were interviewed and a repeat sample were performed. Conclusion: The health surveillance of the responder in mass environmental chemical incident is a great challenge when the exposure level is unsure and involve more than one chemicals. Likewise, reliability and validity adopting statistical test for health surveillance instruments is unattainable due to urgency. However, a proper method of occu-pational surveillance need to be devised and implemented to ensure the protection of worker’s health is guaranteed.

Matched MeSH terms: Nausea
Fulltext Extraction, Analytical and Advanced Methods for Detection of Allura Red AC (E129) in Food and Beverages Products

Rovina K, Siddiquee S, Shaarani SM

Front Microbiol, 2016;7:798.
PMID: 27303385 DOI: 10.3389/fmicb.2016.00798

Allura Red AC (E129) is an azo dye that widely used in drinks, juices, bakery, meat, and sweets products. High consumption of Allura Red has claimed an adverse effects of human health including allergies, food intolerance, cancer, multiple sclerosis, attention deficit hyperactivity disorder, brain damage, nausea, cardiac disease and asthma due to the reaction of aromatic azo compounds (R = R' = aromatic). Several countries have banned and strictly controlled the uses of Allura Red in food and beverage products. This review paper is critically summarized on the available analytical and advanced methods for determination of Allura Red and also concisely discussed on the acceptable daily intake, toxicology and extraction methods.

Matched MeSH terms: Nausea
Simulator sickness: a threat to simulator training

Rabihah Ilyas

Journal of Occupational Safety and Health, 2012;9(1):45-52.
MyJurnal

Rapid development of technology has made simulator as a promising training tool. Advantages offered such as interactive and realistic training environments, mistake tolerance and training in hazardous scenario without causing harm to trainee, cost effectiveness, opportunity of training review and training time flexibility makes simulator widely used in aviation training, driver training, medical training and rehabilitation. Despite of these advantages, a major drawback of simulator is simulator sickness. Simulator sickness is a condition caused by inconsistency perceived by our vestibular system. Effected individual reported that they are experiencing nausea, fatigue, postural instability, headaches and difficulty in focusing which linger for hours or days in some cases. This paper will discuss the simulator usage and simulator sickness condition in Malaysia as experienced by researchers and a few organizations that use simulator as their training tool.

Matched MeSH terms: Nausea
Infantile Hypertrophic Pyloric Stenosis in Postoperative Esophageal Atresia with Tracheoesophageal Fistula

R A A H, Y U C, R N, I R

J Neonatal Surg, 2015 07 01;4(3):32.
PMID: 26290814

Development of infantile hypertrophic pyloric stenosis during postoperative period in EA with TEF is rare. Postoperative vomiting or feeding intolerance in EA is more common which is due to esophageal stricture, gastroesophageal reflux and esophageal dysmotility. A typical case of IHPS also presents with non-bilious projectile vomiting at around 3-4 weeks of life. The diagnosis of infantile hypertrophic pyloric stenosis in this subset is usually delayed because of its rarity. We report a case of IHPS in postoperative EA and emphasize on high index of suspicion to avoid any delay in diagnosis with its metabolic consequences.

Matched MeSH terms: Postoperative Nausea and Vomiting
Fulltext Anxiety disorders and quality of life among patients with hematological cancer in a Malaysian hospital

Priscilla, D., Hamidin, A., Azhar, M. Z., Noorjan, K. O. N., Salmiah, M. S., Bahariah, K.

Malaysian Journal of Medicine and Health Sciences, 2011;7(2):9-16.
MyJurnal

Objective: The purpose of this study is to access the prevalence of anxiety disorders and quality of life factors among hematological cancer patients in a Malaysian hospital. Methods: This study used a cross-sectional research design. It was conducted at the Ampang Hospital in Kuala Lumpur, a tertiary referral center for hematological cancer. Anxiety disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI); quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQC30) questionnaire. Results: A total of 105 hematological cancer patients participated in the study, which constituted a response rate of 83.3%. The prevalence of anxiety disorders in our sample ranged from 1% to 24.8%. Overall, compared to patients without anxiety disorders, hematological cancer patients with anxiety disorders reported impaired quality of life in regards to emotional functioning, cognitive functioning, insomnia, dyspnoea, nausea and vomiting, appetite loss and constipation (p

Matched MeSH terms: Nausea
Fulltext Health-related quality of life profile in relation to chemotherapy-induced nausea and vomiting among breast cancer patients

Pei, Lin Lua, Noor Salihah Zakaria, Nik Mazlan Mamat

ASEAN Journal of Psychiatry, 2012;13(1):0-0.
MyJurnal

Objective: Despite the availability of modern anti-emetics, chemotherapy-induced nausea and vomiting (CINV) symptoms remain distressing to a high number of cancer patients. This study intended to (1) describe the incidence of CINV and antiemetic usage; (2) assess the health-related quality of life (HRQoL) and correlate its components with Global Health Status; (3) evaluate HRQoL status in relation to CINV among breast cancer patients receiving chemotherapy. Methods: A cross sectional study was conducted in two government hospitals located in the East Coast of Peninsular Malaysia (Terengganu, Kelantan). The Morrow Assessment of Nausea and Emesis Follow-up (MANE-FU) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were administered. Descriptive statistics and non-parametric tests were employed (SPSS 16). Results: Respondents included 41 female patients (age = 49 ± 9.6 years; Malay = 92.7%; no family history of breast cancer = 68.3% and on moderately emetogenic chemotherapy = 97.6%). Majority of patients experienced nausea during or after chemotherapy (90.2%) and rated it as ‘severe’. Most patients had taken anti-emetic
(87.8%) and considered it ‘somewhat useful’. The median score for Global Health Status was 50 (IqR= 16.7). Emotional Functioning, Fatigue and Pain correlated fairly with HRQoL (rs= +0.435; -0.417; -0.387 respectively). Patients with ‘a lot’ and ‘moderate’ nausea displayed significantly more fatigue compared to those with little nausea (p=0.029). Those who experienced vomiting reported worse HRQoL profile compared to those who did not (p=0.011). Conclusion: These findings generally ascertained that CINV remains poorly controlled and significantly interferes with HRQoL, providing rooms for improvements in therapeutic intervention.

Matched MeSH terms: Nausea
Fulltext Functional status and health-related quality of life in patients with primary intracranial tumour

Ooi AL, Mazlina M

Med J Malaysia, 2013 Dec;68(6):448-52.
PMID: 24632911 MyJurnal

This study aimed to evaluate the functional status and HRQoL in patients with primary intracranial tumours in Malaysia. Karnofsky Performance Scale (KPS) and Modified Barthel Index (MBI) were used to assess the functional status whereas EORTC core Quality of Life Questionnaire (QLQ-C30) and Brain Cancer Module (BN-20) questionnaires were used to assess the HRQoL. Thirty-eight patients with primary intracranial tumours admitted for surgery in University Malaya Medical Center were recruited. These assessments were administered before surgery (baseline) and six months after surgery (follow-up). All patients received some form of rehabilitation interventions after surgery. The global HRQoL and functional status of these patients showed improvement at six months after surgery. Emotional Functioning score showed the greatest improvement among the functional domains (63 vs 86, p=0.003). Reduction in symptom burden such as fatigue, nausea, vomiting, pain and headache were also noted at follow-up together with less future uncertainty (p<0.05). Pearson correlation revealed statistically significant positive correlation between functional status and HRQoL at baseline and follow-up, in particular, global health status (r=0.50 and r=0.67), physical functioning (r=0.53 and r=0.90) and role functioning (r=0.34 and r=0.77). Thus, from the correlation found, improving a patient's function and independence level throughout all stages of care, even before any surgical intervention is offered would improve the HRQoL concurrently.

Matched MeSH terms: Nausea
Fulltext Isolation and characterization of a 2,4-dinitrophenol-degrading bacterium

Noor Suffiah Md. Zin, Siti Nadzirah Padrilah, Mohd Fadhil Abd. Rahman, Koh, Sim Han, Ariff Khalid, Mohd. Yunus Shukor

Bioremediation Science and Technology Research, 2016;4(2):28-33.
MyJurnal

2,4-dinitrophenol (2,4-DNP) is utilized in the production of wood preservatives, dyes, and also
as a pesticide. Human acute (short-term) exposure to 2,4-DNP in humans by means of oral
exposure are nausea or vomiting, sweating, headaches, dizziness, and weight reduction. Thus, the
removal of this compound is highly sought. A 2,4-DNP-degrading bacterium (isolate 1) was
isolated from a sample soil from Terengganu. This bacterium (isolate 1) was characterized as a
rod Gram positive, non-sporulated, and non-motile bacterium. The bacterium is oxidase negative
and had catalase positive activity and was able to grow aerobically on 2,4-dinitrophenol as the
sole carbon source. This bacterium showed maximal growth on 2,4-DNP at the temperature
optimum of 30 oC, pH 5.0 and was tolerant to 2,4-DNP concentration of up to 0.5 mM (0.092
g/L). This bacterium prefers to use urea as the nitrogen source in addition to yeast extract for
mineral source and vitamin precursors.

Matched MeSH terms: Nausea
Fulltext Post-colonoscopy diverticulitis: A systematic review

Ng ZQ, Tan JH, Tan HCL, Theophilus M

World J Gastrointest Endosc, 2021 Mar 16;13(3):82-89.
PMID: 33763188 DOI: 10.4253/wjge.v13.i3.82

BACKGROUND: Post-colonoscopy diverticulitis is increasingly recognized as a potential complication. However, the evidence is sparse in the literature.
AIM: To systematically review all available evidence to describe the incidence, clinical course with management and propose a definition.
METHODS: The databases PubMed, EMBASE and Cochrane databases were searched using with the keywords up to June 2020. Additional manual search was performed and cross-checked for additional references. Data collected included demographics, reason for colonoscopy, time to diagnosis, method of diagnosis (clinical vs imaging) and management outcomes.
RESULTS: A total of nine studies were included in the final systematic review with a total of 339 cases. The time to diagnosis post-colonoscopy ranged from 2 h to 30 d. Clinical presentation for these patients were non-specific including abdominal pain, nausea/vomiting, per rectal bleeding and chills/fever. Majority of the cases were diagnosed based on computed tomography scan. The management for these patients were similar to the usual patients presenting with diverticulitis where most resolve with non-operative intervention (i.e., antibiotics and bowel rest).
CONCLUSION: The entity of post-colonoscopy diverticulitis remains contentious where there is a wide duration post-procedure included. Regardless of whether this is a true complication post-colonoscopy or a de novo event, early diagnosis is vital to guide appropriate treatment. Further prospective studies especially registries should include this as a complication to try to capture the true incidence.

Matched MeSH terms: Nausea
Fulltext The effect of ketamine on emergence agitation in children: A systematic review and meta-analysis

Ng KT, Sarode D, Lai YS, Teoh WY, Wang CY

Paediatr Anaesth, 2019 12;29(12):1163-1172.
PMID: 31587414 DOI: 10.1111/pan.13752

BACKGROUND: Ketamine is believed to reduce the incidence of emergence agitation in children undergoing surgery or procedure. However, recent randomized controlled trials reported conflicting findings.
AIMS: To investigate the effect of ketamine on emergence agitation in children.
METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were systematically searched from their start date until February 2019. Randomized controlled trials comparing intravenous ketamine and placebo in children were sought. The primary outcome was the incidence of emergence agitation. Secondary outcomes included postoperative pain score, duration of discharge time, and the adverse effects associated with the use of ketamine, namely postoperative nausea and vomiting, desaturation, and laryngospasm.
RESULTS: Thirteen studies (1125 patients) were included in the quantitative meta-analysis. The incidence of emergence agitation was 14.7% in the ketamine group and 33.3% in the placebo group. Children receiving ketamine had a lower incidence of emergence agitation, with an odds ratio being 0.23 (95% confidence interval: 0.11 to 0.46), certainty of evidence: low. In comparison with the placebo, ketamine group achieved a lower postoperative pain score (odds ratio: -2.42, 95% confidence interval: -4.23 to -0.62, certainty of evidence: very low) and lower pediatric anesthesia emergence delirium scale at 5 minutes after operation (odds ratio: -3.99, 95% confidence interval: -5.03 to -2.95; certainty of evidence: moderate). However, no evidence was observed in terms of incidence of postoperative nausea and vomiting, desaturation, and laryngospasm.
CONCLUSION: In this meta-analysis of 13 randomized controlled trials, high degree of heterogeneity and low certainty of evidence limit the recommendations of ketamine for the prevention of emergence agitation in children undergoing surgery or imaging procedures. However, the use of ketamine is well-tolerated without any notable adverse effects across all the included trials.
PROSPERO REGISTRATION: CRD42019131865.

Matched MeSH terms: Postoperative Nausea and Vomiting/drug therapy
The effect of melatonin on delirium in hospitalised patients: A systematic review and meta-analyses with trial sequential analysis

Ng KT, Teoh WY, Khor AJ

J Clin Anesth, 2020 Feb;59:74-81.
PMID: 31279283 DOI: 10.1016/j.jclinane.2019.06.027

OBJECTIVES: Melatonin is an endogenous hormone, which regulates circadian rhythms and promotes sleep. In recent years, several randomised controlled trials examining the prophylactic use of melatonin to prevent delirium were published with conflicting findings. The primary aim of this review was to determine the effect of melatonin on the incidence of delirium in hospitalised patients.
DATA SOURCES: MEDLINE, EMBASE and CENTRAL were systematically searched from their inception until December 2018.
REVIEW METHODS: All randomised clinical trials were included.
RESULTS: Sixteen trials (1634 patients) were included in this meta-analysis. Incidence of delirium was not significantly lower in patients who received melatonin, with an odd ratio, OR (95%Cl) of 0.55 (0.24-1.26); ρ = 0.16, certainty of evidence = low, trial sequential analysis = inconclusive. However, patients who randomised to melatonin had a significantly shorter length of stay in intensive care units, with a mean difference, MD (95%CI) of -1.84 days (-2.46, -1.21); ρ 

Matched MeSH terms: Nausea/chemically induced; Nausea/epidemiology
Fulltext Ultrasound Subcostal Approach Transversus Abdominis Plane Block in Morbidly Obese Patient

Nelbon Giloi, Liew, Constance Sat Lin, Payus, Alvin Oliver, Mac Guad, Rhanye, Murugaiah, Chandrika, Soe, May Zaw, et al.

Borneo Journal of Medical Sciences, 2019;13(3):43-47.
MyJurnal

As general population of obese patients in Malaysia rapidly increases, more obese patients are requiring anaesthesia for various operative procedures. Obesity is associated with anatomical and physiological differences and co-morbidities that influence on the choices of anaesthesia care. A surgical case with general anaesthesia is used as a basis of discussion. A 37-year-old female, history of untreated hypertension and gastrooesophageal reflux disease (GORD), BMI of 41 admitted for laparoscopic cholecystectomy for symptomatic cholelithiasis under general anaesthesia. She presented with pain at the upper right abdomen and associated with bloated abdomen, nausea and vomiting after intake of meals. General anaesthesia and right ultrasound-guided transversus abdominis plane (TAP) block for abdominal wall blocks via subcostal approach was performed. Operation was removal gallstones in the common bile duct via laparoscopic approach. Post-operation patient was extubated successfully. She was prescribed paracetamol 1g 4 hourly and started on fentanyl patient-controlled analgesia (PCA) for next 2 days. In this case report, there is the description of the application of TAP block which when used in obese abdominal surgical procedure, can provide excellent postoperative pain relief, early mobilization and recovery.

Matched MeSH terms: Nausea
Fulltext Issues in management of acute appendicitis in pregnancy

Nalliah, Sivalingam, Wijesuriya, Lionel, Venugopal, Subramani

International e-Journal of Science, Medicine & Education, 2011;5(1):2-9.
MyJurnal

Acute appendicitis is an infrequent yet the commonest surgical emergency in pregnancy occurring in about 1:1500 pregnancies. The classical abdominal pain in the right lower quadrant of the abdomen is the only reliable clinical sign. Delay in diagnosis is attributed to presence of symptoms commonly seen in pregnancy like nausea and vomiting and difficulty in localizing abdominal pain due to displacement of the appendix with advancing gestation. Perforated appendix and generalized peritonitis impacts adversely on pregnancy contributing to increases in miscarriage, pre-term delivery, fetal loss and even maternal mortality. Imaging studies like abdominal ultrasonogram, helical computerized tomography and magnetic imaging have been utilized to complement clinical suspicion and decrease ‘negative appendectomies’ but robust data on their routine use is awaited. Although the laparoscopic approach is a useful diagnostic and therapeutic tool in early pregnancy, its use as the primary approach for appendicectomy in pregnancy requires further evaluation as increases in the incidence of fetal loss of 5.6% has been reported compared to 3.1% in open access surgery

Matched MeSH terms: Nausea
Alfentanil for intubation under halothane anaesthesia in children

NG KP, Wang CY

Paediatr Anaesth, 1999;9(6):491-4.
PMID: 10597551

Intubating conditions under halothane anaesthesia aided with alfentanil 20 micrograms.kg-1 were compared with suxamethonium 2 mg.kg-1 in 40 children presenting for day dental procedures. The condition of vocal cords, jaw relaxation and presence of movement and coughing were scored to give the overall intubating conditions. Successful intubation was achieved in 100% of the suxamethonium group and 94.7% of the alfentanil group. The cardiovascular response to intubation was attenuated in the alfentanil group. Some 43.7% of those receiving suxamethonium developed myalgia the day after surgery compared with 0% in the alfentanil group (P < 0.01).

Matched MeSH terms: Postoperative Nausea and Vomiting/chemically induced
Fulltext Effect of Acupressure at P6 on Nausea and Vomiting in Women with Hyperemesis Gravidarum: A Randomized Controlled Trial

Mohd Nafiah NA, Chieng WK, Zainuddin AA, Chew KT, Kalok A, Abu MA, et al.

Int J Environ Res Public Health, 2022 Sep 01;19(17).
PMID: 36078602 DOI: 10.3390/ijerph191710886

Hyperemesis gravidarum is characterized by severe nausea and vomiting. This study aims to illustrate the efficacy of acupressure at P6 in treating nausea and vomiting in hyperemesis gravidarum. This parallel randomized controlled trial was conducted from 2016-2017 in a tertiary hospital. Hospitalized women with ≤16 weeks of gestation and moderate to severe nausea and vomiting classified using a modified PUQE score were randomly assigned in a 1:1 ratio to either apply an acupressure wristband at the P6 point three times daily or to receive regular doses of intravenous antiemetics. The primary outcome was differences in modified PUQE scores among the groups. The secondary outcomes were differences in the rate of urine ketone clearance and the frequency of requiring rescue antiemetics. Ninety women were equally randomized into two groups, with no dropout. There was a statistically significant difference in the degrees of nausea and vomiting between the groups at 8, 16, and 24 hours post-admission (p8hours= 0.001, p16hours = 0.006, and p24hours = 0.001). The requirement of antiemetics and the rate of urine ketone clearance between the two groups were also statistically significant, at p = 0.001 and p = 0.02 respectively. There were no side effects in either group. The P6 acupressure was efficacious in alleviating nausea and vomiting among hyperemesis gravidarum women. The trial was retrospectively registered on ClinicalTrials.gov (NCT05175079).

Matched MeSH terms: Nausea/drug therapy
Fulltext Spinal anaesthesia with bupivacaine and intrathecal morphine versus combined spinal-epidural anaesthesia using Bupivacaine and Epidural infusion of bupivacaine plus fentanyl for postoperative analgesia after hip and knee arthroplasty

Mohd Azizan, G., Karis, M., Noordin, Y.

Journal of Surgical Academia, 2013;3(2):46-53.
MyJurnal

This randomised single-blinded study was conducted to evaluate if there was any difference between spinal anaesthesia with hyperbaric bupivacaine 0.5% and intrathecal morphine 0.2mg and combined-spinal epidural using hyperbaric bupivacaine 0.5% with epidural infusion of bupivacaine 0.1% plus fentanyl 2.0μg/ml for 24 hours, postoperative analgesia following hip and knee arthroplasty, in terms of pain score and side effects (nausea, vomiting, pruritus and respiratory depression). Eighty patients ASA I or ASA II, aged between 18 to 75 years who underwent knee and hip arthroplasty of approximately 3-4 hours, duration were recruited. They were randomly allocated to one of two groups by using computer generated randomised numbers. The pain score during the postoperative period was evaluated using Visual Analogue Score (VAS pain score) and the side effects were documented and treated accordingly. Results showed that patients in Group 1 and Group 2 were comparable in terms of age, gender, height, weight and race. There was no statistical difference in VAS pain score between the two groups at all times intervals. However, patients in Group 1 had a higher incidence of nausea and pruritus than patients in Group 2. None of the patients in either group, experienced respiratory depression. Thus, it was concluded that both intrathecal morphine 0.2mg and epidural infusion of bupivacaine 0.1% plus fentanyl 2.0μg/ml were comparable in providing postoperative analgesia up to 24 hours following hip and knee arthroplasty. Nevertheless, the use of spinal morphine led to a higher incidence of side effects namely nausea and pruritus.

Matched MeSH terms: Nausea
The Effect of an Acupressure Training Program for Pediatric Nurses Caring for Children Undergoing Chemotherapy

Mohammed HG, Al-Sharkawi SS, Mohammed Adly R

Plast Aesthet Nurs (Phila), 2022 12 6;42(4):197-205.
PMID: 36469390 DOI: 10.1097/PSN.0000000000000463

Acupressure is a nonpharmacological technique that can be used to control chemotherapy-induced nausea and vomiting (CINV) in children with cancer. To use acupressure as a strategy for managing CINV, oncology nurses must have adequate knowledge and skills to implement the technique in clinical practice. Our study aimed to evaluate the effect of an acupressure training program for pediatric nurses caring for children undergoing chemotherapy. We used a quasi-experimental design. Our sample populations included a convenience sample of 36 pediatric nurses and a purposive sample of 45 children undergoing chemotherapy. We used four tools for data collection: (1) a structured questionnaire comprising two parts: (a) characteristics of nurses and children and (b) assessment of nurses' knowledge; (2) an observational checklist for application of acupressure technique; (3) the Baxter Animated Retching Faces (BARF) scale; and (4) a vomiting assessment sheet. We found that after the training intervention, 94.4% ( n = 34) of nurses had a good level of knowledge and skill implementing the acupressure technique. There was a statistically significant difference in the knowledge and skill of the nurses before and after the training intervention, χ 2 (35, N = 36) = 19.113, p = .000. We concluded that the training program significantly improved the nurses' level of knowledge and skill when caring for children undergoing chemotherapy. We also found that after implementing the training intervention, the frequency and severity of CINV decreased among the children we studied. We therefore recommend that acupressure (in combination with antiemetic medication) be included as part of a protocol for chemotherapy administration in children.

Matched MeSH terms: Nausea/chemically induced
Fulltext A randomized controlled study comparing subcutaneous pethidine with oral diclofenac for pain relief pain relief after caesarean section

Marzida, M.

JUMMEC, 2009;12(2):63-69.
MyJurnal

It is important to provide effective postoperative analgesia following a Caesarean section because mothers wish to be pain-free, mobile and alert while caring for their babies. The role of regular oral diclofenac as postoperative analgesia was evaluated in a randomized controlled study and it was compared to the established method of parenteral pethidine. Forty healthy women scheduled for elective Caesarean section under spinal anaesthesia with 2-2.5 mg of heavy bupivacaine 0.5% were randomized to receive either 75 mg of oral diclofenac twice daily or 1 mg/kg of subcutaneous pethidine every 8 hourly. Efficacy of pain relief (visual analogue score), patients' satisfaction and side effects such as sedation, nausea and vomiting were recorded for three days. The demographic variables were similar in both groups. Pain relief was adequate and comparable in both groups with similar mean visual analogue score during the second and third day of the study period. However, on the first postoperative day, 60% of the diclofenac group population required rescuemedication consisting of subcutaneous pethidine in order to achieve the same pain scores as those in the pethidine group who did not require any rescue medications. Women who received oral diclofenac reported lower sedation and higher overall satisfaction. The incidence of nausea and vomiting was similar in both groups. This concluded that although oral diclofenac 75mg twice daily may not be superior to the traditional method of subcutaneous pethidine for pain relief following caesarean section, it can still be used alone as an alternative, as it has other benefits of a non-opioid analgesia.

Matched MeSH terms: Nausea

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