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İbrahimoğlu Ö, Güven B, Durmayüksel E, Güven BB. Does Cold Vapor Prevent Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy? A Randomized Controlled Trial. J Perianesth Nurs 2024:S1089-9472(24)00403-9. [PMID: 39601725 DOI: 10.1016/j.jopan.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 08/14/2024] [Accepted: 08/15/2024] [Indexed: 11/29/2024]
Abstract
PURPOSE The aim of this study was to examine the effect of cold vapor on nausea and vomiting in the early postoperative period after laparoscopic cholecystectomy. DESIGN Randomized controlled study. METHODS This study was carried out with 44 intervention and 44 control group patients who underwent laparoscopic cholecystectomy between May 2022 and December 2022. Cold vapor was applied to the experimental group for 15 minutes in the postanesthesia care unit (PACU). The patients were evaluated in terms of nausea and vomiting at the 0th minute and 30th minute in the PACU, and at the 2nd, 6th, 12th, and 24th hours in service after surgery. FINDINGS There was a significant difference between the groups in terms of nausea at the postoperative 30th minute, 2nd hour, and 6th hour. The postoperative nausea incidence and scores in the experimental group were significantly lower. There was no significant difference between the groups in terms of vomiting at all times after surgery. CONCLUSIONS Postoperative cold vapor helps to reduce the severity of nausea but does not affect vomiting. Thus, it can be used in the control of nausea after cholecystectomy.
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Affiliation(s)
- Özlem İbrahimoğlu
- Nursing Department, Faculty of Health Sciences, İstanbul Medeniyet University, İstanbul, Turkey.
| | - Betül Güven
- Faculty of Nursing, İstanbul University, İstanbul, Turkey
| | - Esra Durmayüksel
- Nursing Department, Faculty of Health Sciences, Bahçeşehir University, İstanbul, Turkey
| | - Bülent Barış Güven
- Department of Anesthesia and Reanimation, Dr Suat Günsel University of Kyrenia Hospital, Kyrenia, Cyprus
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Domínguez-García P, Fernández-Ruano L, Báguena J, Cuadros J, Gómez-Canela C. Assessing the pharmaceutical residues as hotspots of the main rivers of Catalonia, Spain. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:44080-44095. [PMID: 38926308 PMCID: PMC11502600 DOI: 10.1007/s11356-024-33967-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
The global increase in pharmaceutical consumption, driven by factors such as aging populations and chronic diseases, has raised concerns regarding the environmental impact of pharmaceutical contaminants. Europe, and more specifically Catalonia (Spain), exhibits high pharmaceutical consumption rates, potentially exacerbating environmental contamination. Pharmaceuticals enter rivers through various pathways, persisting after wastewater treatment plants and posing risks to aquatic organisms and human health. Llobregat and Besòs Rivers in Catalonia, crucial water sources, demonstrate detectable pharmaceutical levels, necessitating comprehensive analysis. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) proves effective in detecting pharmaceutical residues, facilitating their risk assessment. This paper reviews the occurrence, fate, and risks associated with 78 pharmaceuticals and metabolite in Llobregat and Besòs Rivers, using LC-MS/MS for analysis. Understanding pharmaceutical impacts on Catalonian River ecosystems is essential for developing mitigation strategies.
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Affiliation(s)
- Pol Domínguez-García
- Department of Analytical and Applied Chemistry, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - Laura Fernández-Ruano
- Department of Quantitative Methods, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - Judith Báguena
- Department of Analytical and Applied Chemistry, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - Jordi Cuadros
- Department of Quantitative Methods, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - Cristian Gómez-Canela
- Department of Analytical and Applied Chemistry, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain.
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Gan W, Zheng X, Chen Y, Shu B, Dan L, Duan G, Chen J. Slower intravenous tramadol administration can prevent nausea and vomiting and predict postoperative nausea and vomiting: a randomized controlled trial. Ann Med Surg (Lond) 2024; 86:867-874. [PMID: 38333234 PMCID: PMC10849459 DOI: 10.1097/ms9.0000000000001616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/03/2023] [Indexed: 02/10/2024] Open
Abstract
Objective Nausea and vomiting are the most common complications in patients who use tramadol for analgesia. This study evaluated the risk of nausea and vomiting related to intravenous tramadol administration. Methods In this study, 315 patients who received pre-analgesia before elective surgery were selected, and participants were divided into groups based on the Apfel risk assessment of nausea and vomiting, as follows: high risk (Apfel=4), medium risk (Apfel=2-3), and low-risk (Apfel=1). Tramadol (1.5 mg/kg) was administered intravenously over a duration of 1 min, 2 min, or 3 min before anaesthesia induction to observe preoperative nausea and vomiting reactions within 10 min. Results In the low-risk group, the numeric rating scale for postoperative nausea scores and the incidence of nausea and vomiting were significantly lower in the 3-min group than those in the 1-min group, and the incidence of preoperative nausea and vomiting after intravenous administration of tramadol in the 1-min and 3-min groups were significantly related to the incidence of postoperative nausea and vomiting. The incidence of nausea and vomiting during pre-administration in the 1-min and 3-min groups was identified as an independent risk factor for postoperative nausea and vomiting. Conclusions In the clinical treatment of pain with tramadol, the slow intravenous application of tramadol within 3 min is worthy of being adopted and promoted by clinicians in their daily work.
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Affiliation(s)
- Wanxia Gan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University
| | - Xiaozhu Zheng
- Chongqing Yubei District People’s Hospital, Chongqing, China
| | - Yuanjing Chen
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University
| | - Bin Shu
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University
| | - Ling Dan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University
| | - Guangyou Duan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University
| | - Jie Chen
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University
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Keyhanifard M, Javan R, Disfani RA, Bahrami M, Mirzaie MS, Taghiloo S, Mokhtari H, Nasiry D, Sadrzadeh Aghajani Z, Shooraj M. Coenzyme Q10 attenuates neurodegeneration in the cerebellum induced by chronic exposure to tramadol. J Chem Neuroanat 2024; 135:102367. [PMID: 38043916 DOI: 10.1016/j.jchemneu.2023.102367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Chronic use of tramadol can cause neurotoxic effects and subsequently cause neurodegeneration in the cerebellum. The main damage mechanisms identified are oxidative stress and inflammation. Currently, we investigated the effects of coenzyme Q10 (CoQ10) in attenuates of neurodegeneration in the cerebellum induced by chronic exposure to tramadol. MATERIAL AND METHODS Seventy-two male mature albino rats were allocated into four equal groups, including; non-treated group, CoQ10 group (which received CoQ10 at 200 mg/kg/day orally for three weeks), tramadol group (which received tramadol hydrochloride at 50 mg/kg/day orally for three weeks), and tramadol+CoQ10 group (which received tramadol and CoQ10 at the same doses as the previous groups). Tissue samples were obtained for stereological, immunohistochemical, biochemical, and molecular evaluations. Also, functional tests were performed to evaluate behavioral properties. RESULTS We found a significant increase in stereological parameters, antioxidant factors (catalase, glutathione, and superoxide dismutase), and behavioral function scores in the tramadol+CoQ10 group compared to the tramadol group (p < 0.05). In addition, malondialdehyde levels, the density of apoptotic cells, as well as the expression of pro-inflammatory (tumor necrosis factor-alpha, interleukin 1 beta, and interleukin 6) and autophagy (lysosome-associated membrane protein 2, autophagy-related 5, beclin 1, and autophagy-related 12) genes were considerably reduced in the tramadol+CoQ10 group compared to the tramadol group (p < 0.05). CONCLUSION We conclude that the administration of CoQ10 has neuroprotective effects in the cerebellum of rats that have chronic exposure to tramadol.
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Affiliation(s)
- Majid Keyhanifard
- Iranian Board of Neurology, Tehran University of Medical Sciences, Tehran, Iran; Kurdistan Board of Neurology, Iraq; Fellowship of Interventional Neuroradiology, Zurich University, Switzerland
| | - Roghayeh Javan
- Non-Comunicable Disease Risearch Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Reza Ataee Disfani
- Student Research Committee, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Maryam Bahrami
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Sedigh Mirzaie
- Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeid Taghiloo
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mokhtari
- Department of Paramedicine, Amol School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Davood Nasiry
- Department of Paramedicine, Amol School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
| | | | - Mahdi Shooraj
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Votta-Velis G, Daviglus ML, Borgeat A, Beckmann K, Ta AQ, Parker JL, Kravets S, Garcia OL, Pirzada A, Gastala N, Valle V, Benken JJ, Campara M, Aguiluz G, Memtsoudis SG, Giulianotti PC, Benedetti E. Surgical opioid-avoidance protocol: a postoperative pharmacological multimodal analgesic intervention in diverse patient populations. Reg Anesth Pain Med 2023; 48:594-600. [PMID: 37024267 DOI: 10.1136/rapm-2022-103864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 03/22/2023] [Indexed: 04/08/2023]
Abstract
INTRODUCTION This study evaluated the effect of a surgical opioid-avoidance protocol (SOAP) on postoperative pain scores. The primary goal was to demonstrate that the SOAP was as effective as the pre-existing non-SOAP (without opioid restriction) protocol by measuring postoperative pain in a diverse, opioid-naive patient population undergoing inpatient surgery across multiple surgical services. METHODS This prospective cohort study was divided into SOAP and non-SOAP groups based on surgery date. The non-SOAP group had no opioid restrictions (n=382), while the SOAP group (n=449) used a rigorous, opioid-avoidance order set with patient and staff education regarding multimodal analgesia. A non-inferiority analysis assessed the SOAP impact on postoperative pain scores. RESULTS Postoperative pain scores in the SOAP group compared with the non-SOAP group were non-inferior (95% CI: -0.58, 0.10; non-inferiority margin=-1). The SOAP group consumed fewer postoperative opioids (median=0.67 (IQR=15) vs 8.17 morphine milliequivalents (MMEs) (IQR=40.33); p<0.01) and had fewer discharge prescription opioids (median=0 (IQR=60) vs 86.4 MMEs (IQR=140.4); p<0.01). DISCUSSION The SOAP was as effective as the non-SOAP group in postoperative pain scores across a diverse patient population and associated with lower postoperative opioid consumption and discharge prescription opioids.
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Affiliation(s)
- Gina Votta-Velis
- Anesthesiology, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
- Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, Department of Medicine, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Alain Borgeat
- Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Katharina Beckmann
- Anesthesiology, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Andrew Q Ta
- Anesthesiology, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - John L Parker
- Anesthesiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sasha Kravets
- Division of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Chicago, Illinois, USA
| | - Olga L Garcia
- Institute for Minority Health Research, Department of Medicine, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Amber Pirzada
- Institute for Minority Health Research, Department of Medicine, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Nicole Gastala
- Family Medicine, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Valentina Valle
- Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Jamie J Benken
- Pharmacy Practice & Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Maya Campara
- Pharmacy Practice & Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Gabriela Aguiluz
- Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Stavros G Memtsoudis
- Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA
| | - Pier C Giulianotti
- Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
| | - Enrico Benedetti
- Surgery, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA
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Gan W, Yang X, Chen J, Lyu H, Yan A, Chen G, Li S, Zhang Y, Dan L, Huang H, Duan G. Role of daytime variation in pharmaceutical effects of sufentanil, dezocine, and tramadol: A matched observational study. Front Pharmacol 2022; 13:993506. [PMID: 36188598 PMCID: PMC9523536 DOI: 10.3389/fphar.2022.993506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/30/2022] [Indexed: 11/21/2022] Open
Abstract
The role of daytime variation in the comprehensive pharmaceutical effects of commonly used opioid analgesics in clinical setting remains unclear. This study aimed to explore the differences in daytime variation among elective surgery patients who were scheduled to receive preemptive analgesia with equivalent doses of sufentanil, dezocine, and tramadol in the morning and afternoon. The analgesic effect was assessed by changes in the pressure pain threshold before and after intravenous administration of sufentanil, dezocine, and tramadol. Respiratory effects were evaluated using pulse oximetry, electrical impedance tomography, and arterial blood gas analysis. Other side effects, including nausea, sedation, and dizziness, were also recorded, and blood concentration was measured. The results showed that the analgesic effects of sufentanil, dezocine, and tramadol were significantly better in the morning than in afternoon. In the afternoon, sufentanil had a stronger sedative effect, whereas dezocine had a stronger inhibitory respiratory effect. The incidence of nausea was higher in the morning with tramadol. Additionally, significant differences in different side effects were observed among three opioids. Our results suggest that the clinical use of these three opioids necessitates the formulation of individualized treatment plans, accounting for different administration times, to achieve maximum analgesic effect with minimal side effects.
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Affiliation(s)
- Wanxia Gan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xinqing Yang
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jie Chen
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Hongyao Lyu
- Department of Preventive Medicine, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Ai Yan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Guizhen Chen
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Shiqi Li
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yamei Zhang
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ling Dan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - He Huang
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- *Correspondence: He Huang, ; Guangyou Duan,
| | - Guangyou Duan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- *Correspondence: He Huang, ; Guangyou Duan,
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Tulipan J, Abboudi J, Wang ML, Kwok M, Seigerman D, Gallant GG, Beredjiklian P. Tramadol Versus Codeine in Hand Surgery. Cureus 2022; 14:e26886. [PMID: 35854953 PMCID: PMC9286301 DOI: 10.7759/cureus.26886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Tramadol and codeine are both commonly prescribed in the setting of surgery or injury to the upper extremity. Despite their comparable strength in terms of opioid receptor affinity, the drugs differ pharmacologically and thus are not completely interchangeable. Methods This study analyzes all prescriptions for codeine and tramadol by a group of hand surgeons over a one-year period and tests the central hypothesis that the prescribing and refill patterns of these two drugs would be similar. Results Despite similar prescription amounts in terms of morphine equivalents, patients receiving tramadol required prescription refills at a significantly higher amount than those receiving codeine, and these individuals tended to be older. Additionally, patients treated nonoperatively were prescribed significantly more tramadol than those treated surgically. Conclusion Our findings suggest that codeine and tramadol are not equivalent in managing upper extremity pain. Further study is needed to articulate the situations in which physicians and patients are better served by tramadol versus codeine.
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