Does Sugammadex Administration Affect Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy: A Prospective, Double-Blind, Randomized Study.

BACKGROUND: The aim of this study is to assess the effect of sugammadex on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy. METHODS: Eighty patients who were scheduled for elective laparoscopic cholecystectomy surgery were enrolled in this prospective study. Patients were randomly assigned to neostigmine (group N) or sugammadex (group S) for neuromuscular antagonism at the end of anesthesia. The incidence of PONV and antiemetic consumption were recorded. RESULTS: Nausea and vomiting were observed in 60% of the patients given sugammadex and 77.5% given neostigmine during the initial 24 hours postoperatively. The incidence of nausea and the need for rescue antiemetic were lower in group S than group N during all time intervals but there were no significant differences between the groups. CONCLUSIONS: Sugammadex seems to be effective in decreasing the incidence of PONV, severity of nausea, number of patients who suffered from nausea and vomiting, and need for rescue antiemetic, although there were no significant differences.

Seizures associated with low-dose tramadol for chronic pain treatment.

The management of cancer pain still poses a major challenge for clinicians. Tramadol is a centrally acting synthetic opioid analgesic. Its well-known side effects include nausea, vomiting, and dizziness; seizures are a rare side effect. Some reports have found that tramadol triggers seizure activity at high doses, whereas a few preclinical studies have found that this seizure activity is not dose-related. We herein present a case involving a patient with laryngeal cancer who developed seizures while on low-dose oral tramadol.

Prilocaine irrigation for pain relief after transurethral resection of the prostate.

PURPOSE: This study aimed to examine the effect of postoperative addition of a local anesthetic agent to irrigation fluid on the alleviation or prevention of pain after transurethral resection of the prostate (TURP). PATIENTS AND METHODS: This prospective, double blind, placebo-controlled study included 50 patients aged 50 to 87 years. The patients were randomized into two groups. As each patient began to experience postoperative pain after spinal anesthesia wore off, 30 mL of 2% prilocaine was injected into the irrigation solution bags, and the bladder was irrigated (prilocaine group). The irrigation solution used in the control group was prilocaine-free. Visual analog scale (VAS) scoring was used to assess the severity of pain. Bladder irrigation in all patients was discontinued 1 day postsurgery. RESULTS: There was not a statistical difference in surgical parameters between the two groups. All patients in the prilocaine group were satisfied with the analgesic efficacy of prilocaine, except for two (8%). The mean number of irrigation solution bags (3000 mL) used for each patient in the prilocaine group was 7.04 ± 1.2. Prilocaine-related side effects were not observed. Conversely, pain developed in all but two patients in the control group. The mean number of irrigation solution bags used for each patient in the control group was 7.6 ± 1.8. Mean VAS pain score was 0.35 ± 0.12 and 5.10 ± 3.26 in the prilocaine and control groups, respectively (P<0.001). CONCLUSION: Prilocaine solution safely alleviated postoperative pain in the patients who underwent TURP. The use of continuous bladder irrigation with a diluted prilocaine solution consistently decreased the need for parenteral analgesics.