ABSTRACT
Objective: To evaluate postoperative nausea and vomiting [PONV] with and without metoclopramide with opioid use for control of pain
Study Design: Interventional comparative study
Place and Duration of Study: This study was carried out at KAH, Bisha, Saudi Arabia for period of 3 months 18th July 2014 to 17th October 2014
Patients and Methods: Fifty patients were included and divided into Group A and B. Group A was given inj. Fentanyl 1.5mg/kg intra-operatively and Inj. Pethidine 1.5mg/kg post-operatively to control pain. Group B was given inj. Metoclopramide 0.15 mg/kg intra-operatively and same dose postoperatively in addition to Inj. Fentanyl andPethidine
Results: In Group A, 10 [40%] female patients and 02 [8%] male patients developed PONV while in Group B only one [4%] female patient developed PONV
Conclusion: PONV is reduced when anti-emetics are used along with opioids for pain control. Inj. Metoclopramide, an anti-dopaminergic prokinetic, was found to give better results as its antiemetic action is considered
ABSTRACT
A 34 years old woman was brought with complaints of severe difficulty in breathing, sweating, inability to lie in bed for last 02 hours. She had amenorrhoea for last 09 months and was a known case of Bronchial asthma for the last 15 years, for which she was taking regular treatment. General and physical examination revealed sweating, eye brow lifting, nasal flaring, pursing of mouth, licking of lips, ineffective cough, active expiration, irritability, tracheal tug; Patient was restless all the time and was continuously requesting for help in breathing assistance. She rested in a forward sitting posture at one time but then changed posture sooner. She weighed 50 kg Her Last Menstrual Period [LMP] was 20th Nov 2002 and Expected Date of Delivery [EDD] was 27th Aug 2003. Ultrasound abdomen revealed single alive fetus with cephalic presentation. Weight of fetus was 2649 +/- 397 grams. Fetal heart rate was 90/min. No fetal movements detected in 20 minutes. Patient was shifted to operation theatre in sitting position. Her 02 saturation was 88% with 02 being given by mask at 10 litres per minutes. Her peak expiratory flow rate was 60 L/minute. Patient was given injection metochloperamide 10 mg I/V, lignocaine Hcl 100mg and Oxygenated at 10L/minute for 03 minutes. General anaesthesia was induced in modified supine position. Ventilation was controlled with Intermittent Positive Pressure Ventilation [IPPV]. Intraoperatively Inj Hydrocortisone Sodium succinate 200 mg I/V, and Lignocaine 100 mg I/V were given in addition to already started Inj Aminophylline 250 mg I/V infusion in ITC. As her wheeze and bronchospasm was not relieved. She was given salbutamol [100 ugm] 03 puffs intra operatively during ventilation with anaesthesia circuit although adequate delivery of salbutamol was doubtful Inj Adrenaline 1:1000 ,0.5 ml subcutaneously was given and repeated which relieved bronchospasm and improved wheeze. A full term male baby was delivered through a vertical incision