Diss. (sammanfattning) Uppsala : Univ., 2001. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Thesis (Ph. D.)--West Virginia University, 2005. / Title from document title page. Document formatted into pages; contains xi, 292 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 253-268).

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ABSTRACT Purpose: Dexamethasone provides potent analgesic and antiemetic effects. Sevoflurane are associated with an increased incidence of postoperative nausea and vomiting (PONV) and delayed patient discharge compared to propofol. This study was designed to evaluate whether the prophylatic use of dexamethasone with sevoflurane could minimize the incidence of PONV and facilitate early recovery after outpatient anorectal surgery. Methods: Forty outpatients undergoing anorectal surgery were randomly assigned to receive either dexamethasone (5 mg IV; n=20) or an equal volume of saline (n=20) before the induction of anesthesia. Anesthesia was induced with sevoflurane 8% and N2O 67% in oxygen (at 6 L/min) followed by placement of laryngeal mask. Anesthesia was maintained with sevoflurane 2-4% end-tidal in combination with N2O 50% in oxygen 3 L/min. All patients were allowed to breathe spontaneously during the operation. The postoperative nausea and vomiting (PONV), VAS pain score and patient satisfaction were recorded. Results: The incidence of PONV and VAS pain score were significant lower in dexamethasone-treated patients compared with saline-treated ones. The time required for discharge was significantly shorter in dexamethasone-treated patients. Above all, the dexamethasone-treated patients expressed higher satisfaction index. There was no significant difference in recovery time for eye opening, response to commands, orientation, and ambulatory. Conclusions: The prophylactic administration of dexamethasone reduces the incidence of PONV andVAS pain score, promotes recovery to home readiness, and improves the satisfaction after the anesthesia with spontaneously breathing of sevoflurane through laryngeal mask in outpatients undergoing anorectal surgery.

Wan Pui Chu Christina. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 167-191). / Abstracts in English and Chinese. / PUBLICATIONS BASED ON WORK IN THIS THESIS --- p.i / ABSTRACT --- p.ii / ACKNOWLEDGEMENT --- p.vii / TABLE OF CONTENTS --- p.viii / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Introduction to the Vanilloid Receptor --- p.1 / Chapter 1.1.1 --- Properties of the VR1 Channel --- p.2 / Chapter 1.1.2 --- Explaining the Unexplained: De sensitization and Pungency --- p.6 / Chapter 1.2 --- The Quest for the Endogenous Ligand: Activation versus Modulation --- p.2 / Chapter 1.2.1 --- Anandamide and the Cannabinoid System --- p.12 / Chapter 1.2.2 --- Inflammatory Mediators and Lipid Metabolites --- p.15 / Chapter 1.3 --- The Variegated Vanilloid Receptor: Multiple Actions of TRPV1 --- p.18 / Chapter 1.3.1 --- Vanilloid-induced Hypothermia: some like it cold --- p.18 / Chapter 1.3.2 --- "Three's a crowd: Vanilloids, Substance P, and the Emetic Reflex" --- p.22 / Chapter 1.3.3 --- Grooming Behavior and Locomotor Changes: Further Involvement of Neurokinins? --- p.29 / Chapter 1.4 --- Aims and Objectives of the Present Study --- p.33 / Chapter CHAPTER 2 --- METHODS --- p.39 / Chapter 2.1 --- Animals --- p.39 / Chapter 2.2 --- Stereotaxic Surgery and Transmitter Implantation --- p.39 / Chapter 2.3 --- Measurement of Emesis and Genital Grooming --- p.41 / Chapter 2.4 --- Measurement of Locomotor Activity and Body Temperature --- p.41 / Chapter 2.5 --- Experimental Procedures for Central Injection Studies --- p.45 / Chapter 2.6 --- Experimental Procedures for Peripheral Injection Studies --- p.47 / Chapter 2.7 --- Drug Formulation --- p.48 / Chapter 2.8 --- Statistical Analysis --- p.49 / Chapter CHAPTER 3 --- RESULTS --- p.51 / Chapter 3.1 --- Actions of Intracerebroventricularly Administered Vanilloid Agonists --- p.51 / Chapter 3.1.1 --- General Behaviour --- p.51 / Chapter 3.1.2 --- Emetic Action of Vanilloids --- p.52 / Chapter 3.1.3 --- Anti-Emetic action of Vanilloids against Copper Sulphate --- p.55 / Chapter 3.1.4 --- Vanilloid-induced Hypothermia --- p.58 / Chapter 3.1.5 --- RTX-induced Genital Grooming --- p.65 / Chapter 3.1.6 --- Effects of Vanilloids on Locomotor Activity --- p.67 / Chapter 3.1.7 --- Summary of Central Agonist Studies --- p.76 / Chapter 3.2 --- Effects of Intracerebroventricularly Administered Capsazepine on Vanilloid-induced Responses --- p.78 / Chapter 3.2.1 --- Effect of Capsazepine on Vanilloid-induced Emesis --- p.78 / Chapter 3.2.2 --- Effect of Capsazepine on the Anti-Emetic Action of Vanilloids --- p.82 / Chapter 3.2.3 --- Effect of Capsazepine on Vanilloid-induced Hypothermia --- p.84 / Chapter 3.2.4 --- Effect of Capsazepine on RTX-induced Genital Grooming --- p.88 / Chapter 3.2.5 --- Effect of Capsazepine on Locomotor Activity of Vanilloid-treated Animals --- p.90 / Chapter 3.3 --- "Peripheral Studies with RTX，,Capsazepine, and Ruthenium Red" --- p.93 / Chapter 3.1.1 --- Experiment 1: Actions of Resiniferatoxin --- p.93 / Chapter 3.1.2 --- Experiment 2: Effects of Capsazepine and Ruthenium Red administered alone --- p.99 / Chapter 3.1.3 --- Experiment 3: Effects of Capsazepine and Ruthenium Red on RTX- induced Responses --- p.104 / Chapter CHAPTER 4 --- DISCUSSION --- p.113 / Chapter 4.1 --- General Considerations --- p.113 / Chapter 4.2 --- Emetic Action of Vanilloids --- p.116 / Chapter 4.3 --- Anti-Emetic Action of Vanilloids --- p.124 / Chapter 4.4 --- Hypothermic Action of Vanilloids --- p.133 / Chapter 4.5 --- Resiniferatoxin-induced Genital Grooming --- p.147 / Chapter 4.6 --- Actions of Capsazepine and Ruthenium Red --- p.152 / Chapter 4.7 --- Locomotor Activity --- p.157 / Chapter CHAPTER 5 --- SUMMARY --- p.162 / REFERENCES --- p.167

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 4 uppsatser.

Background: The incidence of postoperative nausea and vomiting (PONV) can be reduced by dexamethasone. Single dose administration may cause elevated blood glucose levels in obese adults. No data are available for children. Objective: The aim was to evaluate perioperative blood glucose changes related to body weight in children who received dexamethasone. Methods: This prospective observational study included 62 children. All patients received total intravenous anesthesia and a single dose of dexamethasone (0.15mg/kg, maximum 8mg). Blood glucose levels were measured up to 6 hours. Standard deviation scores (SDS) were calculated using age- and gender-specific BMI percentiles, p<0.05. Results: 62 children (11.5±2.9years, median SDS 0.43, 29% overweight/obese) were included. Blood glucose level increased from 5.52±0.52 to 6.74±0.84mmol/l 6h after dexamethasone without correlation to the BMI-SDS. Conclusions: This study shows an increase of perioperative blood glucose (normoglycemic ranges) after single dose of dexamethasone but no BMI-dependent effect in children. Therefore, low-dose dexamethasone may be used in obese children for PONV prophylaxis.

A náusea e o vômito são um importante efeito adverso do tratamento antineoplásico. Impactam na redução da qualidade de vida, sendo citados como as piores manifestações pelos pacientes oncológicos. O fator de risco primário para o desenvolvimento destes sintomas é o Potencial Emetogênico da Quimioterapia. Sendo assim, é importante a utilização de uma adequada farmacoterapia antiemética com as alternativas terapêuticas eficazes e seguras disponíveis. Neste contexto, os Estudos de Utilização de Medicamentos são uma ferramenta valiosa para verificar padrões de utilização de medicamentos em instituições de cuidado em saúde. Além disto, alia-se a importância da discussão sobre este tema em crianças, visto que esta faixa etária é especialmente vulnerável e não participa de estudos clínicos para a aprovação de fármacos. O objetivo deste estudo foi avaliar a prescrição e utilização dos medicamentos antieméticos na unidade de oncologia pediátrica do Hospital de Clínicas de Porto Alegre. Trata-se de um estudo descritivo, transversal e retrospectivo, através de consulta ao prontuário eletrônico dos pacientes. Foram analisadas um total de 262 internações. Observou-se o predomínio da prescrição de quimioterapia de moderado e de alto Potencial Emetogênico. Constatou-se a presença de vômito em 82 internações, enquanto que a náusea ocorreu em 117 internações. Na maioria das internações foram administrados de 2 a 3 antieméticos com intervalos fixos, porém uma grande parte das prescrições não seguiu o recomendado pelos guidelines consultados, observando-se a falta de um protocolo antiemético. É importante a escolha do tratamento apropriado para cada paciente, levando-se em consideração a história pregressa do aparecimento de náuseas e vômitos para que se obtenha a melhor resposta terapêutica. A oncologia pediátrica necessita continuidade de Estudos de Utilização de Medicamentos para ampliar o conhecimento nesta área de forma a garantir a melhor qualidade de vida destes pacientes. / Nausea and vomiting are an important adverse effect of antineoplastic treatment. Their impact consists of a significant reduction in the quality of life, being mentioned by these patients as the worst side effects. The primary risk factor for the development of these symptoms is the emetogenic potential of chemotherapy. Therefore, it is important to use an appropriate antiemetic pharmacotherapy with the safest and most effective therapeutic alternatives available. In this context, the Drug Utilization Studies are a valuable tool to check patterns of medication use in health care institutions. Furthermore, it is necessary to emphasize the importance of discussion on this topic concerning children, since this age group is particularly vulnerable and does not participate in clinical trials for the approval of drugs. The objective of this study was to evaluate the prescription and use of antiemetic medications in the pediatric oncology unit in Hospital de Clínicas de Porto Alegre. This is a descriptive, cross-sectional retrospective study, made by consulting the electronic medical records of patients. A total of 262 hospitalization cases were analyzed. There was a predominance of prescriptions of chemotherapy with moderate and high emetogenic potential. There was vomiting in 82 cases, while there was nausea in 117 cases. In most hospitalizations, 2-3 antiemetics were administered at fixed intervals, but a large proportion of prescriptions did not follow what is recommended by the guidelines consulted, which highlights the fact that no antiemetic protocol is followed. It is important to choose the appropriate treatment for each patient, taking into account their past history of nausea and vomiting in order to obtain the best therapeutic response. The pediatric oncology needs further Drug Utilization Studies to contribute to the knowledge in this area to ensure the best quality of life of these patients.