RESUMEN
Postoperative nausea and vomiting [PONV] are among the most common complications following surgery and anesthesia. Preoperative intravenous fluid therapy is one of the prophylactic methods against PONV. Preoperative administration of hypertonic solutions has already been used for controlling intraoperative hypotension. This study was conducted to assess their efficacy to reduce PONV. Ninety patients were enrolled in the study. The patients were allocated randomly, according to a random number table, to three groups. Group A received intravenous saline [15 cc/kg] thirty minutes before induction of anesthesia. Group B received intravenous ringer [15cc/kg] thirty minutes before induction of anesthesia. Group C received hypertonic saline 5% [2cc/kg] half an hour before the induction of anesthesia. Patients were assessed as to the presence of nausea, vomiting and VAS scores in the recovery room, six, twelve and 24 hours after the surgery. Serum sodium level was checked when leaving the recovery room. Data were recorded through questionnaires in data sheets. The analysis indicates that nausea severity in group C [hypertonic saline 5%] was significantly less than other groups. Vomiting frequency distribution was not significantly different among the three groups in the recovery room. The distribution frequency of vomiting six and twelve hours following the surgery was remarkably less in group C. When leaving the recovery room, serum sodium level in group C was significantly higher than other groups. However this level was still within the normal range and none of the patients manifested the signs or symptoms of hypernatremia. This study suggests that hypertonic saline can reduce PONV more significantly than ringer's solution and normal saline
RESUMEN
Postoperative nausea and vomiting [PONV] are known to be among the most common and undesirable postoperative complications. The aim of this study was to compare the effect of midazolam [IV], metoclopramide [IV] and a combination of both as a treatment for established PONV. One hundred and thirty two males and females who experienced PONV following general anesthesia for cholecystectomy were enrolled in the study. Patients were allocated randomly into three groups of 44 individuals using a random number table. The first group received midazolam [30 micro g/kg, Max 2mg, IV], intravenous metoclopramide [0.15 mg/kg, Max 10 mg] was administered to the second group, and the third group was treated with a combination of midazolam and metoclopramide with mentioned doses. The frequency of vomiting and nausea [with Visual Analog Scale [VAS] >/= 3] were measured and registered at two, six and 24 hours after drug administration. Drug side effects were also recorded and compared. The frequency of nausea [VAS >/= 3] recorded six hours after the administration of injection has been significantly higher in the second group. No other significant differences were detected through the comparison between other values. There were no significant differences among the drug side effects in the three groups. Administration of intravenous midazolam or midazolam-metoclopramide combination is more effective than metoclopramide alone in the treatment of postoperative nausea. The incidence of adverse effects is not significantly in the three groups