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Background. Postoperative nausea is a common occurrence that is very uncomfortable for patients and may result in complications including pain, strain at the surgical site, aspiration, and possible dehiscence. Antiemetics used to manage the nausea cause many adverse reactions, such as dysrhythmias and/or drowsiness resulting in an unwillingness to ambulate or perform deep-breathing exercises. Literature review. Previous studies have reported a decrease in nausea following the use of peppermint oil. Study methodology. Researchers obtained informed consent from 123 patients for this study; 34 (28%) of them experienced nausea and were offered a nasal inhaler that contained peppermint oil. Results. The average nausea rating before the use of peppermint oil was 3.29 (SD, 1.0) on a scale of 0 to 5, with 5 being the greatest nausea. Two minutes later, the average nausea rating was 1.44 (SD, 1.3). Using paired t-tests, these differences were found to be statistically significant (P = 0.000). Discussion. The researchers concluded that pepper- mint oil inhalation is a viable first-line treatment for nausea in postoperative cardiac surgery patients. [ABSTRACT FROM AUTHOR]

Rooted in traditional Chinese medicine, the use of acupressure to alleviate symptoms, support the healing process, promote relaxation, and improve overall health has grown considerably in the West. The effects of acupressure--like those of acupuncture, with which it shares a theoretical framework--cannot always be explained in terms of Western anatomical and physiologic concepts, but this noninvasive practice involves minimal risk, can be easily integrated into nursing practice, and has been shown to be effective in treating nausea as well as low back, neck, labor, and menstrual pain. The author discusses potential clinical indications for the use of acupressure, describes the technique, explains how to evaluate patient outcomes, and suggests how future research into this integrative intervention might be improved. [ABSTRACT FROM AUTHOR]

The article presents a study which offers a comparison on the three types of postoperative pain management after posterior lumbar spinal surgery. The study examines the effectiveness of low-dose morphine-soaked microfibrillar collagen hemostatic sponge (MMCHS), patient-controlled analgesia (PCA), and injection of meperidine. The study concluded that the administration of single low-dose MMCHS is effective for pain control and lowers the occurrence of postoperative nausea and vomiting (PONV).

Chemotherapy-induced nausea and vomiting is the commonest side-effect for patients undergoing cancer treatment with chemotherapy. These symptoms can lead to nutritional deficiencies, dehydration and electrolyte imbalance, and negative impacts on quality of life. However, wide gaps exist between clinician and patient perceptions of nausea and vomiting. Effective communication about these symptoms is essential for proper treatment. We conducted a recent chart review to identify gaps in practice regarding chemotherapy-induced nausea and vomiting assessment and documentation. The goal of this project was to improve local practice in the management of chemotherapy-induced nausea and vomiting in patients with cancer. This study used one pre- and two post-implementation audit strategies utilising the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI-PACES) and Getting Research into Practice (GRiP) module. The study was conducted in the 33-bed oncology ward of a large acute care hospital in Korea from February 2010 to June 2010. To facilitate evidence-based nursing practice, audit-feedback-re-audit cycles strategies were used. The audits included four criteria recommended by the Joanna Briggs Institute. There were statistically significant improvements in all four criteria. The first post-implementation audit showed that all four audit criteria rated >50% in compliance. At the second follow-up audit, all four audit criteria rated 100% compliance, indicating excellent compliance with best practice. The differences between the pre- and post-data were statistically significant ( P < 0.001) for all four audit criteria. The results indicate that the pre- and post-implementation audits are an effective method in improvement of assessment, documentation and evidence-based nursing implementation for cancer symptom management. [ABSTRACT FROM AUTHOR]

Background and objective: Despite advantages of induction and maintenance of anaesthesia with sevoflurane, postoperative nausea and vomiting occurs frequently. Fentanyl is a commonly used supplement that may contribute to this, although it may also improve analgesia. Methods: This double-blind study examined the incidence and severity of postoperative nausea and vomiting and pain in the first 24 h after sevoflurane anaesthesia in 216 adult day surgery patients. Patients were randomly allocated to either receive or not receive 1μg kg-1 fentanyl, while a third group received dexamethasone in addition to fentanyl. Results: Omission of fentanyl did not reduce the overall incidence of postoperative nausea and vomiting, but did reduce the incidence of vomiting and/or moderate to severe nausea prior to discharge from 20% and 17% with fentanyl and fentanyl-dexamethasone, respectively, to 5% (P = 0.013). Antiemetic requirements were reduced from 24% and 31% to 7% (P 0.0012). Dexamethasone had no significant effect on the incidence or severity of postoperative nausea and vomiting. Combining the two fentanyl groups revealed further significant benefits from the avoidance of opioids, reducing postoperative nausea and vomiting and nausea prior to discharge from 35% and 33% to 22% and 19% (P 0.049 and P = 0.035), respectively, while nausea in the first 24h was decreased from 42% to 27% (P = 0.034). Pain severity and analgesic requirements were unaffected by the omission of fentanyl. Fentanyl did reduce minor intraoperative movement but had no sevoflurane-sparing effect and increased respiratory depression, hypotension and bradycardia. Conclusion: As fentanyl exacerbated postoperative nausea and vomiting without an improvement in postoperative pain and also had adverse cardiorespiratory effects, it appears to be an unnecessary and possibly detrimental supplement to sevoflurane in day surgery. [ABSTRACT FROM AUTHOR]

Background: The National Institutes of Health recently recommended acupuncture as an effective tool for the treatment of various health problems. Acupuncture is an old technique but has been popular in the United States only since 1972. Its history, theories, and indications are not well known to the medical community.Methods: We reviewed the literature to gather information on the history, techniques, physiology, indications, adverse effects, and opposing views to acupuncture.Results: The mechanism by which acupuncture works involves neurotransmitters and adrenocorticotropic hormones. It appears to be effective in the treatment of pain, nausea, and drug detoxification and in stroke victims. Studies suggest acupuncture is no more effective than placebo. Acupuncture side effects have rarely been reported.Conclusions: Acupuncture appears to be a safe and effective alternative medical therapy for certain health problems. More controlled research is necessary to better understand the range of its clinical application. [ABSTRACT FROM AUTHOR]

Examines the effectiveness of palliative care in nausea. Definition of nausea; Mechanisms and pharmacologic management of nausea; Nonpharmacologic interventions for nausea.

SummaryThe anti-emetic effects of ondansetron and droperidol were evaluated in 134 ASA Grade I and II female patients, scheduled for laparoscopic cholecystectomy and minor gynaecological laparoscopic surgery, who were randomly assigned to receive ondansetron 4 mg or droperidol 75 μg kg-1 intravenously immediately after induction of anaesthesia. The patients were assessed 1, 6, 12 and 24 h after surgery for intensity of nausea and number of vomiting episodes. In the case of the patients undergoing laparoscopy, vomiting episodes occurred in a similar proportion in patients treated with ondansetron or droperidol, with the probability of the Type I error of 0.05 and the Type error II of 0.1. Although there was no difference between the two groups in emetic episodes following all laparoÍscopic procedures and gynaecological laparoscopic surgery, there was a significant difference between these parameters after laparoscopic cholecystectomy. The patients treated with ondansetron experienced a lower intensity of nausea (P=0.04) after laparoscopic cholecystectomy, less frequent severe nausea (P=0.02) and episodes of vomiting (P=0.04) when compared with those in the droperidol group. We conclude, that despite the result the droperidol prophylaxis appears to be an effective alternative to ondansetron in all patients undergoing laparoscopy, the ondansetron prophylaxis is superior to droperidol in patients undergoing laparoscopic cholecystectomy. [ABSTRACT FROM AUTHOR]

Presents question-and-answer advisory related to nursing in the United States. Avoidance on the use of cellular phones within health care facilities; Effectiveness of prochlorperazine in controlling nausea than promethazine; Need for nurses to educate themselves about child abuse.

Discusses nursing care for patients suffering from chemotherapy-induced nausea and vomiting. Assessment of patient's risk for nausea and vomiting; Preventive management as effective intervention; Patient teaching points.

Examines the cause of persistent nausea in a woman patient admitted for back pain and increased stress incontinence after a car accident. Adverse reaction to morphine; Frequency of bowel movements; Laboratory values.

Corrections to the articles "Dexamethasone for the Prevention of Nausea and Vomiting After Dilatation and Curettage: A Randomized Controlled Trial" and "Dose-Range Effects of Propofol for Reducing Emetic Symptoms During Cesarean Delivery," both published in previous issues, are presented.

The article reports on the approval of ProStrakan Group's granisetron transdermal system by the U.S. Food and Drug Administration (FDA). Marketed under the name Sancuso, it is the first patch to provide up to 5 consecutive days of nausea and vomiting control for patients receiving a moderately or highly nausea-inducing chemotherapy regimen. The drug was approved for the prevention of chemotherapy-induced nausea and vomiting (CINV).

Reports on the effectiveness of the combination of granisetron and dexamethasone against nausea and vomiting, according to members of the Italian Group for Antiemetic Research. Difference between the combination therapy's efficacy against vomiting and nausea.

Presents tips on how to relieve nausea and vomiting. Includes small, frequent feeding; Drinking liquids one hour before and after eating; Avoiding strong smelling foods.

Presents a test for nurses on how to determine the cause of medical problems in an elderly patient who developed anorexia and nausea and began vomitting. Initial assessment; Medical diagnosis; Symptoms; Cause of the patient's signs and symptoms.

Ondansetron 4 mg was compared with metoclopramide 10 mg for prevention of post-operative nausea and emesis in in-patients undergoing major gynaecological surgery in this double-blind, randomized, placebo-controlled, multicentre study. A total of 1044 patients received a single intravenous (i.v.) injection of study medication immediately before induction of anaesthesia. Nausea and emesis were assessed over the 24 h post-operative period. Significantly more patients who received ondansetron experienced no emetic episodes (44%) compared with those who received metoclopramide (37%, P=0.049) or placebo (25%, P<0.001). No nausea was experienced by significantly more patients who received ondanse- tron (32%) than with patients who received metoIclopramide (24%, P=0.009) or placebo (16%, P<0.001). In addition, fewer emetic episodes, less severe nausea and a reduced need for rescue antiemetics were also observed with ondansetron (P<0.05 vs. metoclopramide and placebo). Metoclopramide and placebo-treated patients were also 1.5 times (95% CI 1.5–4.2) and 2.5 times (95% CI 1.1–2.0) more likely, respectively, to experience nausea post-operatively. Overall, ondansetron was the most effective antiemetic in this patient population. [ABSTRACT FROM AUTHOR]