RESUMEN
BACKGROUND: PONV is a complication that reduces a patient's quality of life (QOL). Recently, it was reported that PONV is reduced by preoperative administration of histamine receptor (H1 and H2) inhibitor. In the present study, based on the hypothesis that PONV might be reduced by preoperative administration of H2 blocker, we examined the effect of preoperative administration of H2 blocker only on the incidence of PONV. METHODS: Eighty seven patients having regular operations were randomly assigned into two groups; the control (C), and the H2 blocker (F) groups. In the operating room, 20 min after intravenous injection of famotidine 20 mg as H2 blocker, anesthesia was maintened by sevofluorane, oxygen, nitrous oxide, and fentanyl following the induction by fentanyl, propofol, and vecuronium. The frequency and extent of vomiting were observed and the patients were interviewed at postoperative hours 0-6 and 6-12. The incidences between the two groups were examined using the chi-squared test. RESULTS: No significant difference in the appearance of PONV was found between the F group and the C group. In women in the F group, the incidence of vomiting was lower. CONCLUSIONS: Preoperative administration of H2 blocker tends to reduce PONV in women.
Asunto(s)
Famotidina/administración & dosificación , Antagonistas de los Receptores H2 de la Histamina/administración & dosificación , Náusea y Vómito Posoperatorios/prevención & control , Premedicación , Cuidados Preoperatorios , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Incidence and intensity of pain on intravenous injection of propofol were assessed with emulsion of long-chain/medium-chain triglycerides (LCT/MCT, 50: 50) and only long-chain triglycerides (LCT, 100) in patients undergoing different elective surgical interventions in this prospective, randomized, cross over and double-blinded study. METHODS: 1) Forty six patients were assigned to two groups. One group received 0.2 mg x kg(-1) LCT/ MCT propofol prior to LCT propofol administration. The other group received 0.2 mg x kg(-1) LCT propofol prior to LCT/MCT propofol administration. Pain elicited upon questioning was assessed with each injection in the two groups. Patients were asked to grade the pain as VAS of 0 to 100 mm. 2) Fifty one patients were randomly assigned to two groups. One group received 0.4 mg x kg(-1) LCT propofol. The other group received 0.4 mg x kg(-1) LCT/MCT propofol. Patients were asked to grade the pain as VAS of 0 to 100 mm. RESULTS: Pain of LCT propofol injection was stronger than LCT/MCT propofol. As incidence of 0.4 mg x kg(-1) propofol injection, VAS on LCT/MCT propofol and LCT propofol gave score as 0 and 23.5 (P=0.0019). CONCLUSIONS: Propofol with emulsion of long- and medium-chain triglycerides appears to reduce the injection pain than with emulsion of only long-chain triglycerides.
Asunto(s)
Anestesia Intravenosa , Anestésicos Intravenosos/administración & dosificación , Dolor/etiología , Propofol/administración & dosificación , Anestésicos Intravenosos/efectos adversos , Estudios Cruzados , Método Doble Ciego , Emulsiones , Femenino , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Propofol/efectos adversos , Estudios Prospectivos , Triglicéridos/químicaRESUMEN
Corticosteroids were successfully used to treat a 66-year-old man with retroperitoneal fibrosis (RPF) and previously diagnosed membranous nephropathy. Proteinuria was noted at the age of 51 years, and membranous nephropathy was diagnosed by renal biopsy. Ten years later, he presented with right hydronephrosis and renal dysfunction, and was diagnosed as having RPF based on the typical diagnostic imaging findings. Steroid therapy was successful, resulting in improvement of the hydronephrosis and renal function. The hydronephrosis recurred three years later, but corticosteroids were again effective in improving ureteral obstruction. This was a rare case of recurrent RPF with membranous nephropathy in which steroid therapy was effective in treating pleural effusion and hypergammaglobulinemia during the clinical course. This case suggests that an immunological disorder is involved in the pathogenesis of RPF.