Paper Information

Journal:   TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)   2004 , Volume 62 , Number 5; Page(s) 351 To 356.
 
Paper: 

THE COMPARISON OF EFFECTIVENESS OF LIDOCAINE, PROPOFOL AND LOW DOSE DEXAMETHASONE IN REDUCING POST OPERATIVE NAUSEA AND VOMITING

 
 
Author(s):  MOVAFEGH A., AKRAMI M., MEHRAEIN A.
 
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Abstract: 

Background: Post operative nausea and vomiting (PONV) occurs in 25 to 35 percent of patients but its incidence is higher after some procedures like orthopedic surgery. PONY is a significant problem and may lead to severe complications; therefore the use of prophylactic drugs which have low cost and few complications is favorable. In this study we evaluated the efficacy of lidocaine, propofol and low dose dexamethasone in prevention of PONY in orthopedic surgery.
Materials and Methods: Two hundred eighty ASA class I -
P male patients (n=70 in each of 4 groups) undergoing general anesthesia for orthopedic surgery in upper extremities, were enrolled in this randomized double - blinded, placebo - controlled study in Dr. Ali Shariati hospital. All patients hydrated with ringer lactate (5cc/kg) before Induction of anesthesia and then premeditated with fentanyl (2μglkg). Induction of anesthesia in placebo group done by thiopental sodium 5mg/kg + normal saline 5cc.In lidocaine group done by thiopental sodium 5mglkg + lidocaine 1.5mg/kg (5cc) and in dexamethasone group done by thiopental sodium 5mglkg + dexamethasone 0.1 mg/kg (5cc) and in propofol group done by propofol 1.5mg/kg + normal saline (5cc). Tracheal intubation was facilitated with cisatracurium 0.2mg/kg. Anesthesia was maintained with N2O 50%, O2 50%, halothane (0.7%) and fentanyl (1μg/kg every 30 minutes).
Results: The incidence of PONY, in control, lidocaine, dexamethasone and propofol groups were 48.57%, 27.14%, 25.71% and 24.29% respectively (P=0.005).Lidocaine and low dose Dexamethasone were compared with propofol and their efficacies were not found different.
Conclusion: Prophylactic intravenous lidocaine or low dose dexamethasone significantly reduce the incidence of PONV in men after orthopedic surgeries.

 
Keyword(s): POSTOPERATIVE NAUSEA AND VOMITING, PROPOFOL, LIDOCAINE, LOW DOSE DEXAMETHSONE, THIOPENTAL SODIUM
 
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