Postoperative pain, nausea and vomiting among pre- and postmenopausal women undergoing cystocele and rectocele repair surgery / 대한마취과학회지

BACKGROUND: Postoperative nausea and vomiting (PONV) and postoperative pain are among the most common side-effects of surgery. Many factors, such as a change in the level of sex hormones, are reported to affect these complications. This study aimed to evaluate the probable effects of the menopause on PONV and postoperative pain. METHODS: Prospective study, in which a total number of 144 female patients undergoing cystocele or rectocele repair surgery under standardized spinal anesthesia were included. Patients were divided into two equally sized sample groups of pre- and postmenopausal women (n = 72). The occurrence of PONV, the severity of pain as assessed by visual analog scale (VAS) pain score, and the quantity of morphine and metoclopramide required were recorded at 2, 4, 6, 12, 18 and 24 h after surgery. RESULTS: The mean VAS pain score and the mean quantity of morphine required was higher among premenopausal women (P = 0.006). Moreover, these patients required more morphine for their pain management during the first 24 h after surgery compared to postmenopausal women (P < 0.0001). No difference was observed between the two groups regarding the incidence of PONV (P = 0.09 and P = 1.00 for nausea and vomiting, respectively) and the mean amount of metoclopramide required (P = 0.38). CONCLUSIONS: Premenopausal women are more likely to suffer from postoperative pain after cystocele and rectocele repair surgery. Further studies regarding the measurement of hormonal changes among surgical patients in both pre- and postmenopausal women are recommended to evaluate the effects on PONV and postoperative pain.

effects of gabapentin on severity of post spinal anesthesia Headache

Spinal anesthesia is a common anesthesia method and post dural puncture headache [PDPH] is one of its most ommon adverse effects. Gabapentin is a popular anticonvulsant drug that has been used as an oral nonopioid analgesic n recent years. In this placebo-controlled double-blind study, 120 patients were randomized in two equal groups 'Placebo or gabapentin]

The patients in the gabapentin group received gabapentin 300 mg orally one hour before the -urgery and then every 12 hours for the first 24 hours after the surgery while the placebo group received placebos in the ame way. Severity of headache and postoperative pain assessed by verbal rating score for pain [VRSP], morphine assumption, nausea, vomiting, somnolence, pruritus, dizziness in the first 48 hours, hypertension, hypotension, nradycardia and tachycardia in the first 24 hours after the surgery were recorded. In first 48 hour after surgery the mean >f severity of headache in the gabapentin group was 0.20 +/- 0.05, and in the placebo group it was 0.93+/-0.01. The mean of postoperative pain in the gabapentin group was2.25 +/- 0.793, and in the placebo group it was3.77+/-0.813. In the first 24 ours post operative the mean of morphine consumptions were 0.20+/-0.030 and 0.32+/-0.0 30 mg in gabapentin and placebo groups

No significant differences were found between the two groups regarding incidence rate of the adverse Tects. in this study, administration of gabapentin decreased the incidence and severity of post spinal anesthesia cadache, postoperative pain and morphine consumption, without any significant differences in serious adverse effects

Effects of clonidine as premedication on plasma renin activity, serum and urine electrolytes and body fluids in general anesthesia. A randomized double blind placebo controlled clinical trial. [Journal Article, Research Support, Non-U.S. Gov't]

Clonidine is a relative alpha2 agonist that's used as a premedicative drug in anesthesia in recent years. The aim was to asses the effect of oral clonidine as premedicative drug on 24 hours urine output, urine specific gravity, serum and urine electrolyte level and renin plasma activityA randomized double blind controlled clinical trial was performed in Asali hospital Khoramabad-Iran during 2004. Sixty patients in ASA class 1 and 2, were randomly selected and divided into two groups. One group received clonidine tablet and control group received placebo tablet, orally, ninety minutes before induction of general anesthesia for cystocel-rectocel perineorraphy surgery. In this study we took blood and urine samples for laboratory measurements before as well as 6 hours after taking the tablets. Differences between two groups were analyzed by students T-test. Significant increase in 24 hours urine output [P=0.001] was seen in clonidine group, compared to control group. Clonidine group had higher urine electrolyte levels [P<0.05] however, no differences were seen in blood electrolyte level [P>0.05]. Urine specific gravity was lower in clonidine group [P<0.05]. Significant decrease in plasma renin activity was seen in clonidine group [P=0.001]. This study suggested that clonidine is a safe premedication drug in anesthesia and does not change the serum electrolytes level