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E Oddby-Muhrbeck

Publications and source records attributed to E Oddby-Muhrbeck.

4 recordsLinked to original sources

Blood-borne factors possibly associated with post-operative nausea and vomiting: an explorative study in women after breast cancer surgery.

BACKGROUND: The pathophysiology behind post-operative nausea and vomiting (PONV) is still not fully understood, especially with respect to gender. According to PONV risk scores, female gender is the strongest predictor for PONV. The risk for PONV after general anaesthesia for breast cancer surgery is 50-80%. The aim of the present explorative study was to identify blood-borne factors that might be associated with the development of PONV in women undergoing breast cancer surgery as a basis for further studies. METHODS: Fifty patients were enrolled prospectively in the study. A standardized sevoflurane-based anaesthetic was used. Blood samples for the analysis of vasopressin, gastrin, cholecystokinin, epinephrine, norepinephrine, dopamine, serotonin, platelet count and blood glucose were taken at six pre-determined time points peri-operatively, and PONV was assessed during 24 h. RESULTS: PONV was found in 27 of 47 patients completing the study. Patients with PONV had a larger variability of the platelet count (P = 0.001), a reduced platelet count on the first post-operative day (P = 0.02) and a less pronounced relationship between the platelet count and whole blood serotonin (P = 0.004) compared with non-PONV patients. A lack of a decrease in epinephrine levels in response to the induction of anaesthesia (P = 0.03) and increased levels of vasopressin (P < 0.001), epinephrine (P = 0.005) and blood glucose (P = 0.004) were observed in the early post-operative period in PONV patients. CONCLUSION: Three different platelet-associated factors and an altered epinephrine pattern were found to be associated with the occurrence of PONV after breast cancer surgery.

Adult↗

Implicit processing and therapeutic suggestion during balanced anaesthesia.

The effect of therapeutic suggestion--implicit processing during balanced anaesthesia was studied in 70 female patients scheduled for elective breast surgery. The patients were randomly allocated to listen to a message with reassuring information focused on minimising postoperative nausea and vomiting, or just a blank tape during surgery. Occurrence of nausea and vomiting was studied during the postoperative period. No patient recalled any explicit memories during the peroperative period. No major differences were observed in the number of patients who experienced nausea or vomiting during the 24 hour observation period. The patients exposed to positive suggestion did, however, have a lower frequency of recall for nausea and vomiting compared to those just listening to the blank tape. We did not observe any major effect of peroperative suggestion for postoperative nausea and vomiting. However, we cannot rule out some implicit processing during balanced anaesthesia.

Adult↗

Postoperative nausea and vomiting. A comparison between intravenous and inhalation anaesthesia in breast surgery.

Nausea and vomiting during the first 24 postoperative hours after breast surgery were studied. Ninety patients scheduled for elective breast surgery were randomly assigned to one of three anaesthetic methods: total intravenous anaesthesia with propofol, or propofol or thiopental for induction followed by isoflurane anaesthesia. All three groups received fentanyl for peroperative analgesia. A total of 46 (51%) patients experienced emetic sequelae: 19 (21%) complained about nausea and another 27 (30%) vomited once or more during the postoperative course. More than 50% of the patients with nausea and 70% with vomiting first suffered from these symptoms in the surgical wards after leaving the postoperative unit. Nausea and vomiting were seen in 18 (60%), 13 (43%) and 15 (50%) for the groups propofol-propofol, propofol-isoflurane and thiopental-isoflurane, respectively. In conclusion, every second patient experienced nausea or vomiting after breast surgery, the majority of these emetic symptoms occurring after leaving the postoperative unit. Propofol for induction or as a main anaesthetic did not make any major difference with regard to postoperative nausea or vomiting.

Aged↗

Recall of music: a comparison between anaesthesia with propofol and isoflurane.

Sixty patients undergoing laparoscopy were randomly assigned to receive total intravenous anaesthesia with propofol or inhalation anaesthesia with isoflurane. Patients in these two groups were also randomly assigned to three subgroups listening to soft music, hard rock music or no music at all. Twenty-four hours after surgery all patients were interviewed and asked if they had heard music during the operation. A tape with seven different pieces of music was also played for the patients. The music they heard during surgery was one of these. No patient had any memories or experiences from the operation. Four patients had dreams, three from the total intravenous anaesthesia group and one from the inhalation anaesthesia group. Twelve patients believed they had heard music, ten from the total intravenous anaesthesia group and two from the inhalation anaesthesia group (P < 0.05). Two patients, one from each group, picked the right melody. In conclusion, there was no difference between the two groups with respect to recall during anaesthesia. Patients in the TIVA group were significantly more inclined to state that they had been exposed to music.

Adult↗