AANA journal
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Randomized Controlled Trial
A comparative analysis of isopropyl alcohol and ondansetron in the treatment of postoperative nausea and vomiting from the hospital setting to the home.
We compared the efficacy of inhaled isopropyl alcohol (IPA) with ondansetron for the control of postoperative nausea and vomiting (PONV) during a 24-hour period in 100 ASA class I-III women undergoing laparoscopic surgery. Nausea was measured postoperatively using a 0 to 10 verbal numeric rating scale (VNRS). The control group received ondansetron, 4 mg intravenously, and the experimental group inhaled IPA vapors. ⋯ The IPA treatment was successful in alleviating PONV symptoms in the home in 91% of the experimental group. We determined that using IPA after discharge from the postanesthesia care unit is a valuable method to control PONV in the hospital and at home. The results of this study suggest that IPA is much faster than ondansetron for 50% relief of nausea.
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Randomized Controlled Trial
Meclizine in combination with ondansetron for prevention of postoperative nausea and vomiting in a high-risk population.
Postoperative nausea and vomiting (PONV) is prevalent in surgical patients with known risk factors: general anesthesia, female, nonsmoker, motion sickness history, and PONV history. Common treatment involves ondansetron; however, the effects are short-lived, and supplemental medication may be required. Meclizine, a long-acting drug with a low side-effect profile, may be ideal in combination with ondansetron for at-risk patients. ⋯ The meclizine group had lower VNRS scores in the PACU at 15 (P = .013) and 45 (P = .006) minutes following rescue treatment. The incidence of nausea was lower in the meclizine vs. placebo group (10% vs. 29%) following discharge (P = .038). Prophylactic meclizine resulted in lower incidence and severity of PONV in a high-risk population, especially after rescue treatment.
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Cyclodextrins are molecules with a hollow, truncated cone shape that possess unique lipophilic and hydrophilic properties. These unique properties enable cyclodextrins to engulf and bind lipophilic molecules while maintaining aqueous solubility. ⋯ Sugammadex is the name of a modified cyclodextrin currently in phase 3 studies by Organon International (Oss, The Netherlands), and it may hold promise for a new concept in muscle relaxant reversal. Encapsulation rather than competitive antagonism of neuromuscular blockade may be a future modality of anesthetic practice.
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As university faculty, Certified Registered Nurse Anesthetists (CRNAs) are expected to meet the same obligations as other members of the academy. The purposes of this investigation were to describe the educational preparation and role expectations of nurse anesthesia faculty. Following institutional human assurance committee approval, an investigator-developed questionnaire was mailed to the directors of 85 nurse anesthesia programs recognized by the Council on Accreditation of Nurse Anesthesia Educational Programs. ⋯ Assistant directors allocated 75% of their time to classroom teaching, clinical teaching, and program administration. Among all program faculty, limited time was reserved for research and scholarly activities. Increasing the percentage of doctorally prepared faculty and the amount of time allocated to research and scholarship are essential for full integration of nurse anesthetists into the university and to continue the development of nurse anesthesia's specialty knowledge.