Prevention of post-operative nausea and vomiting following laparoscopic surgery--ephedrine vs propofol.

Postoperative nausea and vomiting (PONV) are relatively common troublesome distressing symptoms. The incidence is reported to be as high as 20-51%. Ninety adult ASA I and II patients scheduled for laparoscopic gynecological or surgical interventions, were randomly and equally assigned to one of the three groups in the immediate postoperative period: Group 1 received 0.1 ml.kg(-1) normal saline intravenously, while Group 2 received 0.5 mg.kg(-1) ephedrine intramuscularly and Group 3 received 0.25 mg.kg(-1) propofol intravenously as preventive antiemetic therapy. Sixty-six, 33 and 50 percent of patients experienced nausea and vomiting syndrome in Group 1, 2 and 3 respectively. Both ephedrine and propofol proved to have antiemetic properties. Ephedrine treated group of patient had significant less emetic score than propofol. No significant hemodynamic changes were recorded in both groups.

The safety and efficacy of desflurane.

Desflurane is a new halogenated ether inhalational general anesthetic with low solubility in blood and body tissues. The aim of this study was to assess its anesthetic efficacy in elective surgical procedures, to evaluate its effect on patients' vital signs during maintenance and recovery and to detect the possible side effects (if any) on patients' liver and kidney functions. The study was carried out on thirty adult (ASA I and II) patients scheduled for different surgical procedures. All patients were premedicated with 0.1 mcg kg-1 oral midazolam and induced with 1 mcg kg-1 fentanyl followed by thiopentone sodium 4 mg kg-1 and atracurium 0.5 mg kg-1. The inspired concentration of desflurane was gradually increased until the required depth of anesthesia was reached. The results showed hemodynamic stability under desflurane. It has dose-dependent hypotensive effects with no arrhythmia. It potentiated atracurium, as the total dose needed to produce complete relaxation was 0.36 +/- 1.18 mg kg-1. There was no observable effect on both liver and kidney function given the small number of patients that were included in this study. In the post anesthetic period desflurane showed rapid recovery (3.81 +/- 4.076) and patients' recovery room stay was (17.22 +/- 1.079 min). No postoperative complications were detected.