A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto
Autor(a) principal: | |
---|---|
Data de Publicação: | 2012 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFMT |
Texto Completo: | http://ri.ufmt.br/handle/1/1576 |
Resumo: | Laparoscopic bariatric surgery is associated with increase of postoperative nausea and vomiting (PONV). The hypothesis of this study was that the combination of haloperidol, dexamethasone, and ondansetron may reduce PONV. Objective: To compare the efficacy of three regimens for antiemetic prophylaxis in patients submitted to laparoscopic sleeve gastrectomy (LSG). Method: A clinical, randomized, controlled, double-blind study was performed in 90 patients with body mass index ≥ 35 kg/m2 , of both genders, submitted to LSG. The patients were divided into three groups: Group O (n=30): ondansetron 8 mg before the end of surgery (BES), Group DO (n=30): ondansetron 8 mg BES and dexamethasone 8 mg at induction of anesthesia (IA) and Group HDO (n=30): ondansetron 8 mg BES, dexamethasone 8 mg and haloperidol 2 mg in IA. We have evaluated the occurrence and intensity of nausea, vomiting, the rescue antiemetic use, pain intensity, the morphine consumption and drugs side effects in 0-2, 2-12, 24- 36 and 0-36 hours (h) postoperative (PO) period. The volume of fluid infused during the hospital stay and length of hospital stay were also evaluated. Results: There was no difference between groups regarding demographic variables, ASA physical status, Apfel score, comorbidities, surgical team, the volume of fluids infused during surgery and the length of preoperative fasting, duration of anesthesia and duration of postanesthesia care unit stay. As for the main clinical outcomes, the incidence of nausea was lower in the Group HDO as compared to Group O (23.7% versus 56.7%, p=0.016) in the period of 0-2 h, in the Group HDO (23.3%) and in the Group DO (26.7%) compared to the Group O (60%) (p=0.008 and p=0.009 respectively) within 12-24 h, and also the incidence of nausea was lower in the Group HDO in relation to the Group O (53.3 versus 86.7 %, p=0.013) in the period 0- 36 h PO. The Group HDO presented lower incidence of vomiting than the Group O (20% versus 53.3%, p=0.015) in the period 0-36 h. The intensity of nausea was less in the Group HDO than in the Group O (p=0.001). The time to first rescue antiemetic administration was higher in the Group HDO compared to the Group O (p=0.006). Moreover, the number of rescues used in the Group HDO was two times less than in the Group O (p=0.002). Regarding secondary outcomes, there was less intensity of pain in the Group HDO when compared to the Group O (p=0.046) and less consumption of morphine in Group HDO than in Group O (p=0.007) and in Group DO (p=0,01). The volume of fluids administered in the PO period in Group O was approximately 1 liter greater than in the Group HDO (p=0.026). Length of stay and adverse events were similar between groups. Conclusion: The combination of haloperidol, dexamethasone and ondanseron promoted reduction of PONV, increased time to first administration of rescue antiemetic and reduced amount of them. Reduced also the pain intensity, the morphine consumption and the volume of fluids infused in the postoperative period of pacientes undergoing LSG. |
id |
UFMT_0a19bd3b61f056992ef8d98a5641ce64 |
---|---|
oai_identifier_str |
oai:localhost:1/1576 |
network_acronym_str |
UFMT |
network_name_str |
Repositório Institucional da UFMT |
repository_id_str |
|
spelling |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encobertoCirurgia bariátricaNáusea e vômito pós-operatórioHaloperidolOndansetronaDexametasonaCNPQ::CIENCIAS DA SAUDE::MEDICINABariatric surgeryNausea and vomiting postoperativeHaloperidolOndansetronDexamethasoneLaparoscopic bariatric surgery is associated with increase of postoperative nausea and vomiting (PONV). The hypothesis of this study was that the combination of haloperidol, dexamethasone, and ondansetron may reduce PONV. Objective: To compare the efficacy of three regimens for antiemetic prophylaxis in patients submitted to laparoscopic sleeve gastrectomy (LSG). Method: A clinical, randomized, controlled, double-blind study was performed in 90 patients with body mass index ≥ 35 kg/m2 , of both genders, submitted to LSG. The patients were divided into three groups: Group O (n=30): ondansetron 8 mg before the end of surgery (BES), Group DO (n=30): ondansetron 8 mg BES and dexamethasone 8 mg at induction of anesthesia (IA) and Group HDO (n=30): ondansetron 8 mg BES, dexamethasone 8 mg and haloperidol 2 mg in IA. We have evaluated the occurrence and intensity of nausea, vomiting, the rescue antiemetic use, pain intensity, the morphine consumption and drugs side effects in 0-2, 2-12, 24- 36 and 0-36 hours (h) postoperative (PO) period. The volume of fluid infused during the hospital stay and length of hospital stay were also evaluated. Results: There was no difference between groups regarding demographic variables, ASA physical status, Apfel score, comorbidities, surgical team, the volume of fluids infused during surgery and the length of preoperative fasting, duration of anesthesia and duration of postanesthesia care unit stay. As for the main clinical outcomes, the incidence of nausea was lower in the Group HDO as compared to Group O (23.7% versus 56.7%, p=0.016) in the period of 0-2 h, in the Group HDO (23.3%) and in the Group DO (26.7%) compared to the Group O (60%) (p=0.008 and p=0.009 respectively) within 12-24 h, and also the incidence of nausea was lower in the Group HDO in relation to the Group O (53.3 versus 86.7 %, p=0.013) in the period 0- 36 h PO. The Group HDO presented lower incidence of vomiting than the Group O (20% versus 53.3%, p=0.015) in the period 0-36 h. The intensity of nausea was less in the Group HDO than in the Group O (p=0.001). The time to first rescue antiemetic administration was higher in the Group HDO compared to the Group O (p=0.006). Moreover, the number of rescues used in the Group HDO was two times less than in the Group O (p=0.002). Regarding secondary outcomes, there was less intensity of pain in the Group HDO when compared to the Group O (p=0.046) and less consumption of morphine in Group HDO than in Group O (p=0.007) and in Group DO (p=0,01). The volume of fluids administered in the PO period in Group O was approximately 1 liter greater than in the Group HDO (p=0.026). Length of stay and adverse events were similar between groups. Conclusion: The combination of haloperidol, dexamethasone and ondanseron promoted reduction of PONV, increased time to first administration of rescue antiemetic and reduced amount of them. Reduced also the pain intensity, the morphine consumption and the volume of fluids infused in the postoperative period of pacientes undergoing LSG.Cirurgia bariátrica laparoscópica está associada com aumento de náusea e vômito pós-operatório (NVPO). A hipótese deste estudo é que a associação de haloperidol, dexametasona e ondansetrona pode reduzir NVPO. Objetivo: Comparar a eficácia de três esquemas de profilaxia antiemética em pacientes submetidos à gastrectomia vertical laparoscópica (GVL). Método: Estudo clínico, randomizado, controlado e duplo cego realizado em 90 pacientes com índice de massa corporal ≥ 35 Kg/m2 , de ambos os gêneros, submetidos à GVL. Os pacientes foram distribuídos em três grupos: Grupo O (n=30): ondansetrona 8 mg antes do final da operação (AFO), Grupo DO (n=30): ondansetrona 8 mg AFO e dexametasona 8 mg na indução da anestesia (IA) e Grupo HDO (n=30): ondansetrona 8 mg AFO, dexametasona 8 mg e haloperidol 2 mg na IA. Foram avaliados a ocorrência e intensidade de náusea, ocorrência de vômito, utilização de resgate antiemético, intensidade de dor, consumo de morfina e efeitos colaterais dos fármacos em 0-2, 2-12, 12-24, 24-36 e 0-36 horas (h) de pósoperatório (PO). Foram avaliados, também, o volume de fluidos infundidos durante a internação e o tempo de permanência hospitalar. Resultados: Não houve diferença entre os grupos quanto às variáveis demográficas, estado físico da ASA, escore de Apfel, comorbidades, equipe cirúrgica, volume de fluidos infundidos durante cirurgia e os tempos de jejum préoperatório, de anestesia e de permanência na sala de recuperação pós-anestésica. Quanto aos desfechos clínicos principais, houve menor incidência de náusea no Grupo HDO que no Grupo O (23,7% versus 56,7%, p=0,016) no período de 0-2 h, no Grupo HDO (23,3%) e no Grupo DO (26,7%) comparado ao Grupo O (60%) (p=0,008 e p=0,009 respectivamente) no período de 12-24 h e Grupo HDO em relação ao Grupo O (53,3% versus 86,7%, p=0,013) no período 0-36 h de PO. O Grupo HDO apresentou menor incidência de vômito que o Grupo O (20% versus 53,3%, p=0,015) no período 0-36 horas. A intensidade de náusea foi menor no Grupo HDO em relação Grupo O (p=0,001). O tempo para administração do primeiro resgate antiemético foi maior no Grupo HDO comparado ao Grupo O (p=0,006), e além disso, o número de resgates antieméticos utilizados no Grupo HDO foi duas vezes menor que no Grupo O (p=0,002). Quanto aos desfechos secundários, houve menor intensidade da dor no Grupo HDO em relação ao Grupo O (p=0,046) e o consumo de morfina no Grupo HDO foi menor que no Grupo O (p=0,007) e no Grupo DO (p=0,01). O volume de fluidos administrados no PO foi, aproximadamente, 1 litro a mais no Grupo O quando comparado ao grupo HDO (p=0,026). O tempo de internação e os efeitos colaterais foram semelhantes entre os grupos. Conclusão: A associação de haloperidol, dexametasona e ondansetrona promoveu redução de NVPO, aumentou o tempo para administração do primeiro antiemético de resgate e reduziu a quantidade dos mesmos. Reduziu, também, a intensidade de dor, o consumo de morfina e o volume de fluídos infundidos PO dos pacientes submetidos à GVLUniversidade Federal de Mato GrossoBrasilFaculdade de Medicina (FM)UFMT CUC - CuiabáPrograma de Pós-Graduação em Ciências da SaúdeNascimento, José Eduardo de Aguilar Siqueira dohttp://lattes.cnpq.br/0439577158192249Nascimento, José Eduardo de Aguilar Siqueira do142.196.031-15http://lattes.cnpq.br/0439577158192249Caporossi, Cervantes108.334.471-49http://lattes.cnpq.br/9507253213103285142.196.031-15Ashmawi, Hazem Adel051.939.468-28http://lattes.cnpq.br/0885913183990095Benevides, Márcio Luiz2019-11-08T14:22:36Z2012-06-082019-11-08T14:22:36Z2012-05-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisBENEVIDES, Márcio Luiz. A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica: estudo clínico, aleatorizado, controlado e duplamente encoberto. 2012. 118 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Mato Grosso, Faculdade de Medicina, Cuiabá, 2012.http://ri.ufmt.br/handle/1/1576porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMTinstname:Universidade Federal de Mato Grosso (UFMT)instacron:UFMT2019-11-12T06:02:41Zoai:localhost:1/1576Repositório InstitucionalPUBhttp://ri.ufmt.br/oai/requestjordanbiblio@gmail.comopendoar:2019-11-12T06:02:41Repositório Institucional da UFMT - Universidade Federal de Mato Grosso (UFMT)false |
dc.title.none.fl_str_mv |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto |
title |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto |
spellingShingle |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto Benevides, Márcio Luiz Cirurgia bariátrica Náusea e vômito pós-operatório Haloperidol Ondansetrona Dexametasona CNPQ::CIENCIAS DA SAUDE::MEDICINA Bariatric surgery Nausea and vomiting postoperative Haloperidol Ondansetron Dexamethasone |
title_short |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto |
title_full |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto |
title_fullStr |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto |
title_full_unstemmed |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto |
title_sort |
A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica : estudo clínico, aleatorizado, controlado e duplamente encoberto |
author |
Benevides, Márcio Luiz |
author_facet |
Benevides, Márcio Luiz |
author_role |
author |
dc.contributor.none.fl_str_mv |
Nascimento, José Eduardo de Aguilar Siqueira do http://lattes.cnpq.br/0439577158192249 Nascimento, José Eduardo de Aguilar Siqueira do 142.196.031-15 http://lattes.cnpq.br/0439577158192249 Caporossi, Cervantes 108.334.471-49 http://lattes.cnpq.br/9507253213103285 142.196.031-15 Ashmawi, Hazem Adel 051.939.468-28 http://lattes.cnpq.br/0885913183990095 |
dc.contributor.author.fl_str_mv |
Benevides, Márcio Luiz |
dc.subject.por.fl_str_mv |
Cirurgia bariátrica Náusea e vômito pós-operatório Haloperidol Ondansetrona Dexametasona CNPQ::CIENCIAS DA SAUDE::MEDICINA Bariatric surgery Nausea and vomiting postoperative Haloperidol Ondansetron Dexamethasone |
topic |
Cirurgia bariátrica Náusea e vômito pós-operatório Haloperidol Ondansetrona Dexametasona CNPQ::CIENCIAS DA SAUDE::MEDICINA Bariatric surgery Nausea and vomiting postoperative Haloperidol Ondansetron Dexamethasone |
description |
Laparoscopic bariatric surgery is associated with increase of postoperative nausea and vomiting (PONV). The hypothesis of this study was that the combination of haloperidol, dexamethasone, and ondansetron may reduce PONV. Objective: To compare the efficacy of three regimens for antiemetic prophylaxis in patients submitted to laparoscopic sleeve gastrectomy (LSG). Method: A clinical, randomized, controlled, double-blind study was performed in 90 patients with body mass index ≥ 35 kg/m2 , of both genders, submitted to LSG. The patients were divided into three groups: Group O (n=30): ondansetron 8 mg before the end of surgery (BES), Group DO (n=30): ondansetron 8 mg BES and dexamethasone 8 mg at induction of anesthesia (IA) and Group HDO (n=30): ondansetron 8 mg BES, dexamethasone 8 mg and haloperidol 2 mg in IA. We have evaluated the occurrence and intensity of nausea, vomiting, the rescue antiemetic use, pain intensity, the morphine consumption and drugs side effects in 0-2, 2-12, 24- 36 and 0-36 hours (h) postoperative (PO) period. The volume of fluid infused during the hospital stay and length of hospital stay were also evaluated. Results: There was no difference between groups regarding demographic variables, ASA physical status, Apfel score, comorbidities, surgical team, the volume of fluids infused during surgery and the length of preoperative fasting, duration of anesthesia and duration of postanesthesia care unit stay. As for the main clinical outcomes, the incidence of nausea was lower in the Group HDO as compared to Group O (23.7% versus 56.7%, p=0.016) in the period of 0-2 h, in the Group HDO (23.3%) and in the Group DO (26.7%) compared to the Group O (60%) (p=0.008 and p=0.009 respectively) within 12-24 h, and also the incidence of nausea was lower in the Group HDO in relation to the Group O (53.3 versus 86.7 %, p=0.013) in the period 0- 36 h PO. The Group HDO presented lower incidence of vomiting than the Group O (20% versus 53.3%, p=0.015) in the period 0-36 h. The intensity of nausea was less in the Group HDO than in the Group O (p=0.001). The time to first rescue antiemetic administration was higher in the Group HDO compared to the Group O (p=0.006). Moreover, the number of rescues used in the Group HDO was two times less than in the Group O (p=0.002). Regarding secondary outcomes, there was less intensity of pain in the Group HDO when compared to the Group O (p=0.046) and less consumption of morphine in Group HDO than in Group O (p=0.007) and in Group DO (p=0,01). The volume of fluids administered in the PO period in Group O was approximately 1 liter greater than in the Group HDO (p=0.026). Length of stay and adverse events were similar between groups. Conclusion: The combination of haloperidol, dexamethasone and ondanseron promoted reduction of PONV, increased time to first administration of rescue antiemetic and reduced amount of them. Reduced also the pain intensity, the morphine consumption and the volume of fluids infused in the postoperative period of pacientes undergoing LSG. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-06-08 2012-05-25 2019-11-08T14:22:36Z 2019-11-08T14:22:36Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
BENEVIDES, Márcio Luiz. A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica: estudo clínico, aleatorizado, controlado e duplamente encoberto. 2012. 118 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Mato Grosso, Faculdade de Medicina, Cuiabá, 2012. http://ri.ufmt.br/handle/1/1576 |
identifier_str_mv |
BENEVIDES, Márcio Luiz. A associação de haloperidol, dexametasona e ondansetrona reduz náusea e vômito no pós-operatório de pacientes obesos, submetidos à gastrectomia vertical laparoscópica: estudo clínico, aleatorizado, controlado e duplamente encoberto. 2012. 118 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Mato Grosso, Faculdade de Medicina, Cuiabá, 2012. |
url |
http://ri.ufmt.br/handle/1/1576 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Mato Grosso Brasil Faculdade de Medicina (FM) UFMT CUC - Cuiabá Programa de Pós-Graduação em Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Mato Grosso Brasil Faculdade de Medicina (FM) UFMT CUC - Cuiabá Programa de Pós-Graduação em Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFMT instname:Universidade Federal de Mato Grosso (UFMT) instacron:UFMT |
instname_str |
Universidade Federal de Mato Grosso (UFMT) |
instacron_str |
UFMT |
institution |
UFMT |
reponame_str |
Repositório Institucional da UFMT |
collection |
Repositório Institucional da UFMT |
repository.name.fl_str_mv |
Repositório Institucional da UFMT - Universidade Federal de Mato Grosso (UFMT) |
repository.mail.fl_str_mv |
jordanbiblio@gmail.com |
_version_ |
1804648498805604352 |