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M Creed

Publications and source records attributed to M Creed.

4 recordsLinked to original sources
PubMed1997

Intravenous ondansetron for postsurgical opioid-induced nausea and vomiting. S3A-255 Study Group.

The use of opioids for postoperative analgesia may be limited by side effects such as nausea and vomiting. Because ondansetron, a selective serotonin type 3 (5-hydroxytryptamine [5-HT3]) antagonist, is effective for chemotherapy and general anesthesia-induced nausea and vomiting, we hypothesized that it may also be effective for opioid-induced nausea and vomiting. ASA physical status I-III patients undergoing regional anesthesia were eligible for the study. Those who requested an antiemetic after postsurgical opioid administration were randomized to receive a single dose of ondansetron (0.1 mg, 4 mg, or 16 mg intravenously [I.V.]) or placebo in a double-blind fashion. Emetic episodes, nausea and pain ratings, and adverse events were recorded for 24 h after study drug administration. Patient satisfaction scores were obtained 24 h after study drug infusion. A significantly (P < 0.05) larger proportion of patients treated with ondansetron 4 mg and 16 mg experienced no emetic episodes, received no rescue antiemetic, and completed the study compared with placebo. Nausea scores and patient satisfaction scores in the ondansetron 16-mg group were significantly (P < 0.05) more favorable than in the placebo group. Postsurgical pain scores did not differ among groups. The incidence of adverse events was similarly low across groups. The results of this study support our hypothesis that I.V. ondansetron is effective for postsurgical opioid-induced nausea and vomiting.

Adult↗
PubMed1996

Intravenous ondansetron in established postoperative emesis in children. S3A-381 Study Group.

BACKGROUND: In pediatric postsurgical patients, postoperative vomiting is a common occurrence that can delay recovery and result in unplanned hospital admissions after outpatient surgery. This randomized, double-blind, placebo-controlled, multicenter study evaluated the efficacy and safety of ondansetron in the control of established postoperative emesis in outpatients aged 2-12 yr. METHODS: Screened for the study were 2,720 ASA physical status 1-3 children undergoing outpatient surgery during general anesthesia, which included nitrous oxide. Children experiencing two emetic episodes within 2 h of discontinuation of nitrous oxide were given intravenous ondansetron (n = 192; 0.1 mg/kg for children weighing < or = 40 kg; 4 mg for children weighing > 40 kg) or placebo (n = 183). RESULTS: The proportion of children with no emetic episodes and no use of rescue medication was significantly greater (P < 0.001) in the ondansetron group compared with placebo for both 2- and 24-h periods after study drug administration (78% of the ondansetron group and 34% of the placebo group for 2 h; 53% of the ondansetron group and 17% of the placebo group for 24 h). Among patients with at least one emetic episode or with rescue medication use, the median time to onset of emesis or rescue was 127 min in the ondansetron group compared with 58 min in the placebo group (P < 0.001). The median time from study drug administration until discharge was significantly shorter (P < 0.01) in the ondansetron group (153 min, range 44-593 min) compared with the placebo group (173 min, range 82-622 min). The incidence of potentially drug-related adverse events was similar in the ondansetron (3% of patients) and the placebo (4% of patients) groups. CONCLUSION: A single dose of ondansetron (0.1 mg/kg up to 4 mg) is effective and well tolerated in the prevention of further episodes of postoperative emesis in children after outpatient surgery. Administration of ondansetron also may result in a shorter time to discharge.

Antiemetics↗
PubMed1994

Tight glucose control results in normal perinatal outcome in 150 patients with gestational diabetes.

OBJECTIVE: To determine whether tight control of blood glucose is associated with normal outcomes in gestational diabetes. METHODS: We studied 150 consecutive patients with gestational diabetes referred to a diabetes in pregnancy clinic. Selection criteria were an abnormal glucose tolerance test, diabetic management by one physician, capillary blood glucose monitoring in the prenatal period, and delivery at Grace Hospital. Degree of glucose control during pregnancy and maternal and perinatal outcomes were determined by chart review. RESULTS: Overall average glucose levels were 4.9 mmol/L (89 mg/dL) before meals and 6.7 mmol/L (122 mg/dL) 1 hour after meals. Thirty-one percent of the patients were treated with insulin in the prenatal period. In this series, there was no perinatal mortality and no increased incidence of large or small for gestational age infants, cesarean delivery, preterm labor, pregnancy-induced hypertension, neonatal respiratory distress, hypoglycemia, polycythemia, symptomatic hyperbilirubinemia, symptomatic hypocalcemia, or congenital malformations. CONCLUSIONS: Tight glucose control is associated with normal perinatal outcome in gestational diabetes.

Adult↗