Droperidol
Ondansetron
Neuroleptanalgesia
Adjuvants, Anesthesia
Promethazine
Ambulatory Surgical Procedures
Preanesthetic Medication
Encyclopedias as Topic
Psychomotor Agitation
Clonazepam
Preproopiomelanocortin and preprodynorphin mRNA expressions in rat brain after electroacupuncture + droperidol. (1/100)
AIM: To study the expression of preproopiomelanocortin (POMC) and preprodynorphin (PPD) mRNA following the combination of electroacupuncture (EA) with droperidol (Dro), a dopamine receptor antagonist. METHODS: The brains and spinal cords of Sprague-Dawley rats were sectioned after combination of EA with Dro, and the gene expression was investigated using nonradioactive in situ hybridization histochemistry (ISHH). RESULTS: Ten hours after EA, the POMC mRNA expression was enhanced; the expression was further enhanced when EA was combined with Dro. The expression of PPD mRNA showed regional difference in central nervous system (CNS): in spinal cord, EA enhanced the PPD mRNA expression and the combination of EA with Dro further promoted the expression; in the brain, the PPD mRNA expression after EA or combination of EA with Dro showed no obvious change in most regions (caudate-putamen, accumbens, arcuate nucleus of hypothalamus) or was decreased in supraoptic nucleus. CONCLUSION: Dro combined with EA promoted the expression of POMC mRNA in CNS and PPD mRNA in spinal cord, but reduced or had no effect on PPD mRNA expression in the brain. (+info)Ondansetron and droperidol in the prevention of postoperative nausea and vomiting. (2/100)
We have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients received: saline i.v. (group I, n = 62); droperidol 2.5 mg i.v. (group 2, n = 60); ondansetron 4 mg i.v. (group 3, n = 57); or droperidol 2.5 mg with ondansetron 4 mg i.v. (group 4, n = 63). Nausea occurred in 45%, 37%, 32% and 29% (P = 0.234) and vomiting in 23%, 17%, 9% and 5% (P = 0.016) of patients in groups 1, 2, 3 and 4, respectively, during the first 24 h. Groups 2 and 4 had greater sedation scores than group 1 during the first 3 h (P < 0.01). We conclude that both droperidol and ondansetron showed a significant antiemetic effect, ondansetron was not significantly better than droperidol, and the combination of droperidol and ondansetron was better than droperidol but no better than ondansetron alone. (+info)Cost-effectiveness of prophylactic antiemetic therapy with ondansetron, droperidol, or placebo. (3/100)
BACKGROUND: In an era of growing economic constraints on healthcare delivery, anesthesiologists are increasingly expected to understand cost analysis and evaluate clinical practices. Postoperative nausea and vomiting (PONV) are distressing for patients and may increase costs in an ambulatory surgical unit. The authors compared the cost-effectiveness of four prophylactic intravenous regimens for PONV: 4 mg ondansetron, 0.625 mg droperidol, 1.25 mg droperidol, and placebo. METHODS: Adult surgical outpatients at high risk for PONV were studied. Study drugs were administered intravenously within 20 min of induction of nitrous oxide-isoflurane or enflurane anesthesia. A decision-tree analysis was used to group patients into 12 mutually exclusive subgroups based on treatment and outcome. Costs were calculated for the prevention and treatment of PONV. Cost-effectiveness analysis was performed for each group. RESULTS: Two thousand sixty-one patients were enrolled. Efficacy data for study drugs have been previously reported, and the database from that study was used for pharmacoeconomic analysis. The mean-median total cost per patient who received prophylactic treatment with 4 mg ondansetron, 0.625 mg droperidol, 1.25 mg droperidol, and placebo were $112 or $16.44, $109 or $0.63, $104 or $0.51, and $164 or $51.20, respectively (P = 0.001, active treatment groups vs. placebo). The use of a prophylactic antiemetic agent significantly increased patient satisfaction (P < 0.05). Personnel costs in managing PONV and unexpected hospital admission constitute major cost components in our analysis. Exclusion of nursing labor costs from the calculation did not alter the overall conclusions regarding the relative costs of antiemetic therapy. CONCLUSION: The use of prophylactic antiemetic therapy in high-risk ambulatory surgical patients was more effective in preventing PONV and achieved greater patient satisfaction at a lower cost compared with placebo. The use of 1.25 mg droperidol intravenously was associated with greater effectiveness, lower costs, and similar patient satisfaction compared with 0.625 mg droperidol intravenously and 4 mg ondansetron intravenously. (+info)Differential block of fast and slow inactivating tetrodotoxin-sensitive sodium channels by droperidol in spinal dorsal horn neurons. (4/100)
BACKGROUND: Dorsal horn neurons of the spinal cord participate in neuronal pain transmission. During spinal and epidural anesthesia, dorsal horn neurons are exposed to local anesthetics and opioids. Droperidol is usually given with opioids to avoid nausea and vomiting. A recently developed method of "entire soma isolation" has made it possible to study directly the action of droperidol on different components of Na+ current in dorsal horn neurons. METHODS: Using a combination of the whole-cell patch-clamp recording from spinal cord slices and the entire soma isolation method, we studied the direct action of droperidol on two types of Na+ currents in dorsal horn neurons of young rats. RESULTS: The tetrodotoxin-sensitive Na+ current in isolated somata consisted of a fast inactivating (tauF, 0.5-2 ms; 80-90% of the total amplitude) and a slow inactivating (tauS, 6-20 ms; 10-20% of the total amplitude) component. Droperidol, at concentrations relevant for spinal and epidural anesthesia, selectively and reversibly suppressed the fast component with a half-maximum inhibiting concentration (IC50) of 8.3 microm. The slow inactivating component was much less sensitive to droperidol; the estimated IC50 value was 809 microm. CONCLUSIONS: Droperidol selectively blocks fast Na+ channels, the fast and slow components of the Na+ current in dorsal horn neurons are carried through pharmacologically distinct types of Na+ channels, and the effects of droperidol differ from those of local anesthetics and tetrodotoxin, which equipotently suppress both components. Droperidol may be suggested as a pharmacologic tool for separation of different types of inactivating tetrodotoxin-sensitive Na+ channel. (+info)A comparison of antiemetic efficacy of droperidol alone and in combination with metoclopramide in day surgery anaesthesia. (5/100)
We have studied the antiemetic efficacy of droperidol alone, and in combination with metoclopramide in first trimester termination of pregnancy in day surgery. The aim was to determine whether the addition of metoclopramide could further reduce the incidence of postoperative nausea and vomiting (PONV) but avoid excessive sedation. Group I (control, n = 40) received i.v. droperidol 0.625 mg at induction. Group II (study, n = 40) received i.v. droperidol 0.625 mg and i.v. metoclopramide 10 mg at induction. The incidence of nausea at 1 and 2 hours postoperatively was 23% and 10% in group I, and 5% and nil in group II respectively. The difference in the incidence of nausea was significant at p < 0.05 at one hour but not at two hours postoperatively. No patients vomited. There was no difference in the sedation and pain score between them. We did not observe any significant side effects attributable to either drug. All patients were discharged home within 3 hours. We conclude that in the prevention of PONV, the combination of metoclopramide and droperidol is superior to the use of droperidol alone at one hour but not at two hours postoperatively. (+info)Effects of fentanyl and droperidol on canine left ventricular performance. (6/100)
The effects of fentanyl and droperidol on left ventricular performance were evaluated in the neurally intact dog right-heart-bypass preparation under conditions of constant cardiac output, arterial pressure, and heart rate. Fentanyl, .01 and .02 mg/kg body weight, and droperidol, 0.5 mg/kg, did not affect left ventricular performance. However 1.0 mg/kg droperidol caused a significant (P less than .05) increase in left ventricular end-diastolic pressure and a small decrease in maximum left ventricular dP/dt (.05 less than P less than .10). No significant change in myocardial oxygen consumption was observed. This study indicates that large doses of droperidol may depress left ventricular performance and may account for a portion of the hypotension observed after its administration in man. (Key words: Anesthetics, intravenous, fentanyl; Anesthetics; intravenous, droperidol; Heart, function, fentanyl; Heart, function, droperidol.). (+info)Hemodynamic and ventilatory responses to fentanyl, fentanyl-droperidol, and nitrous oxide in patients with acquired valvular heart disease. (7/100)
Fentanyl (10 mug/kh) or fentanyl (10 mug/kg) plus droperidol (100 mug/kg) administered intravenously during 20 minutes to adult patients with acquired valvular heart disease produced minimal circulatory changes. The trend during drug infusion was for mean arterial pressure and systemic vascular resistance to decrease, and for cardiac index and stroke volume index to increase without change in heart rate. Central venous pressure increased during drug infusion (P less than 0.05) but decreased to awake levels following controlled ventilation and skeletal-muscle paralysis, probably reflecting thoracoabdominal-muscle rigidity rather than a circulatory response. Hypoventilation during drug infusion necessitated assisted or controlled ventilation, with or without skeletal muscle paralysis, in 14 of 16 patients. Addition of 60 per cent nitrous oxide following fentanyl or fentanyl-droperidol infusion significantly decreased mean arterial pressure, heart rate, and cardiac index. All circulatory changes were similar in direction and extent to those previously found during morphine-nitrous oxide anesthesia. (Key words: Anesthetics, intravenous, fentanyl; Anesthetics, gases, nitrous oxide; Heart, effect of fentanyl, dorperidol, and nitrous oxide.). (+info)Suppression of potassium conductance by droperidol has influence on excitability of spinal sensory neurons. (8/100)
BACKGROUND: During spinal and epidural anesthesia with opioids, droperidol is added to prevent nausea and vomiting. The mechanisms of its action on spinal sensory neurons are not well understood. It was previously shown that droperidol selectively blocks a fast component of the Na+ current. The authors studied the action of droperidol on voltage-gated K+ channels and its effect on membrane excitability in spinal dorsal horn neurons of the rat. METHODS: Using a combination of the patch-clamp technique and the "entire soma isolation" method, the action of droperidol on fast-inactivating A-type and delayed-rectifier K+ channels was investigated. Current-clamp recordings from intact sensory neurons in spinal cord slices were performed to study the functional meaning of K+ channel block for neuronal excitability. RESULTS: Droperidol blocked delayed-rectifier K+ currents in isolated somata of dorsal horn neurons with a half-maximum inhibiting concentration of 20.6 microm. The A-type K+ current was insensitive to up to 100 microm droperidol. At droperidol concentrations insufficient for suppression of an action potential, the block of delayed-rectifier K+ channels led to an increase in action potential duration and, as a consequence, to lowering of the discharge frequency in the neuron. CONCLUSIONS: Droperidol blocks delayed-rectifier K+ channels in a concentration range close to that for suppression of Na+ channels. The block of delayed-rectifier K+ channels by droperidol enhances the suppression of activity in spinal sensory neurons at drug concentrations insufficient for complete conduction block. (+info)Droperidol is a butyrophenone neuroleptic medication that is primarily used for its antiemetic (anti-nausea and vomiting) properties. It works by blocking dopamine receptors in the brain, which can help to reduce feelings of nausea and vomiting caused by various factors such as chemotherapy, surgery, or motion sickness.
Droperidol is also known for its sedative and anxiolytic (anxiety-reducing) effects, and has been used in the past as a premedication before surgery to help reduce anxiety and produce sedation. However, due to concerns about rare but serious side effects such as QT prolongation (a heart rhythm disorder), droperidol is now less commonly used for this purpose.
Droperidol is available in injectable form and is typically administered by healthcare professionals in a hospital or clinical setting. It should be used with caution and only under the close supervision of a healthcare provider, as it can cause a range of side effects including dizziness, drowsiness, dry mouth, and restlessness. More serious side effects such as seizures, irregular heartbeat, and neuroleptic malignant syndrome (a rare but potentially life-threatening condition characterized by muscle rigidity, fever, and autonomic instability) have also been reported with droperidol use.
Antiemetics are a class of medications that are used to prevent and treat nausea and vomiting. They work by blocking or reducing the activity of dopamine, serotonin, and other neurotransmitters in the brain that can trigger these symptoms. Antiemetics can be prescribed for a variety of conditions, including motion sickness, chemotherapy-induced nausea and vomiting, postoperative nausea and vomiting, and pregnancy-related morning sickness. Some common examples of antiemetic medications include ondansetron (Zofran), promethazine (Phenergan), and metoclopramide (Reglan).
Postoperative nausea and vomiting (PONV) are common complications following surgical procedures. It is defined as nausea, vomiting, or both that occurs within the first 24 hours after surgery. PONV can lead to dehydration, electrolyte imbalances, wound dehiscence, and impaired patient satisfaction. Risk factors for PONV include female gender, non-smoking status, history of motion sickness or PONV, use of opioids, and longer duration of surgery. Preventive measures and treatments include antiemetic medications, fluid therapy, and acupuncture or acupressure.
Ondansetron is a medication that is primarily used to prevent nausea and vomiting caused by chemotherapy, radiation therapy, or surgery. It is a selective antagonist of 5-HT3 receptors, which are found in the brain and gut and play a role in triggering the vomiting reflex. By blocking these receptors, ondansetron helps to reduce the frequency and severity of nausea and vomiting.
The drug is available in various forms, including tablets, oral solution, and injection, and is typically administered 30 minutes before chemotherapy or surgery, and then every 8 to 12 hours as needed. Common side effects of ondansetron include headache, constipation, and diarrhea.
It's important to note that ondansetron should be used under the supervision of a healthcare provider, and its use may be contraindicated in certain individuals, such as those with a history of allergic reactions to the drug or who have certain heart conditions.
Neuroleptanalgesia is a clinical state produced by the combined use of a neuroleptic (a drug that dampens down the activity of the brain, leading to decreased awareness of one's surroundings and reduced ability to initiate movements) and an analgesic (a pain-relieving drug). This combination results in a state of dissociative analgesia, where the patient remains conscious but detached from their environment, with reduced perception of pain. It has been used in certain medical procedures as an alternative to general anesthesia.
The term 'neurolept' refers to drugs that have a pronounced effect on the nervous system, reducing psychomotor agitation and emotional reactivity. Examples of neuroleptic drugs include phenothiazines (such as chlorpromazine), butyrophenones (such as haloperidol), and diphenylbutylpiperidines (such as pimozide).
Analgesics, on the other hand, are medications that primarily target pain perception pathways in the nervous system. Common examples include opioids (such as morphine or fentanyl) and non-opioid analgesics (such as acetaminophen or ibuprofen).
The combination of neuroleptic and analgesic drugs is used to achieve a balance between pain relief, sedation, and preservation of the patient's ability to communicate and cooperate during medical procedures. However, due to potential side effects such as respiratory depression, neuroleptanalgesia requires careful monitoring and management by anesthesiologists or other trained medical professionals.
An adjuvant in anesthesia refers to a substance or drug that is added to an anesthetic medication to enhance its effects, make it last longer, or improve the overall quality of anesthesia. Adjuvants do not produce analgesia or anesthesia on their own but work synergistically with other anesthetics to achieve better clinical outcomes.
There are several types of adjuvants used in anesthesia, including:
1. Opioids: These are commonly used adjuvants that enhance the analgesic effect of anesthetic drugs. Examples include fentanyl, sufentanil, and remifentanil.
2. Alpha-2 agonists: Drugs like clonidine and dexmedetomidine are used as adjuvants to provide sedation, analgesia, and anxiolysis. They also help reduce the requirement for other anesthetic drugs, thus minimizing side effects.
3. Ketamine: This NMDA receptor antagonist is used as an adjuvant to provide analgesia and amnesia. It can be used in subanesthetic doses to improve the quality of analgesia during general anesthesia or as a sole anesthetic for procedural sedation.
4. Local anesthetics: When used as an adjuvant, local anesthetics can prolong the duration of postoperative analgesia and reduce the requirement for opioids. Examples include bupivacaine, ropivacaine, and lidocaine.
5. Neostigmine: This cholinesterase inhibitor is used as an adjuvant to reverse the neuromuscular blockade produced by non-depolarizing muscle relaxants at the end of surgery.
6. Dexamethasone: A corticosteroid used as an adjuvant to reduce postoperative nausea and vomiting, inflammation, and pain.
7. Magnesium sulfate: This non-competitive NMDA receptor antagonist is used as an adjuvant to provide analgesia, reduce opioid consumption, and provide neuroprotection in certain surgical settings.
The choice of adjuvants depends on the type of surgery, patient factors, and the desired clinical effects.
Metoclopramide is a medication that is primarily used to manage gastrointestinal disorders. It is classified as a dopamine antagonist and a prokinetic agent, which means it works by blocking the action of dopamine, a chemical in the brain that can slow down stomach and intestine function.
The medical definition of Metoclopramide is:
A synthetic congener of procainamide, used as an antiemetic and to increase gastrointestinal motility. It has a antidopaminergic action, binding to D2 receptors in the chemoreceptor trigger zone and stomach, and it may also block 5HT3 receptors at intrapyloric and central levels. Its actions on the gut smooth muscle are mediated via cholinergic muscarinic receptors. (Source: Dorland's Medical Dictionary)
Metoclopramide is commonly used to treat conditions such as gastroesophageal reflux disease (GERD), gastritis, and gastroparesis, which is a condition that affects the normal movement of food through the digestive tract. It can also be used to prevent nausea and vomiting caused by chemotherapy or radiation therapy.
Like any medication, Metoclopramide can have side effects, including drowsiness, restlessness, and muscle spasms. In some cases, it may cause more serious side effects such as tardive dyskinesia, a condition characterized by involuntary movements of the face, tongue, or limbs. It is important to use Metoclopramide only under the supervision of a healthcare provider and to follow their instructions carefully.
Vomiting is defined in medical terms as the forceful expulsion of stomach contents through the mouth. It is a violent, involuntary act that is usually accompanied by strong contractions of the abdominal muscles and retching. The body's vomiting reflex is typically triggered when the brain receives signals from the digestive system that something is amiss.
There are many potential causes of vomiting, including gastrointestinal infections, food poisoning, motion sickness, pregnancy, alcohol consumption, and certain medications or medical conditions. In some cases, vomiting can be a symptom of a more serious underlying condition, such as a brain injury, concussion, or chemical imbalance in the body.
Vomiting is generally not considered a serious medical emergency on its own, but it can lead to dehydration and other complications if left untreated. If vomiting persists for an extended period of time, or if it is accompanied by other concerning symptoms such as severe abdominal pain, fever, or difficulty breathing, it is important to seek medical attention promptly.
Promethazine is an antihistamine and phenothiazine derivative, which is commonly used for its sedative, anti-emetic (prevents vomiting), and anti-allergic properties. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms, and by blocking the action of dopamine, a neurotransmitter in the brain that helps transmit signals.
Promethazine is used to treat various conditions such as allergies, motion sickness, nausea and vomiting, and as a sedative before and after surgery or medical procedures. It may also be used for its calming effects in children with certain behavioral disorders.
Like all medications, promethazine can have side effects, including drowsiness, dry mouth, blurred vision, and dizziness. More serious side effects may include seizures, irregular heartbeat, and difficulty breathing. It is important to follow the instructions of a healthcare provider when taking promethazine and to report any unusual symptoms or side effects promptly.
Ambulatory surgical procedures, also known as outpatient or same-day surgery, refer to medical operations that do not require an overnight hospital stay. These procedures are typically performed in a specialized ambulatory surgery center (ASC) or in a hospital-based outpatient department. Patients undergoing ambulatory surgical procedures receive anesthesia, undergo the operation, and recover enough to be discharged home on the same day of the procedure.
Examples of common ambulatory surgical procedures include:
1. Arthroscopy (joint scope examination and repair)
2. Cataract surgery
3. Colonoscopy and upper endoscopy
4. Dental surgery, such as wisdom tooth extraction
5. Gallbladder removal (cholecystectomy)
6. Hernia repair
7. Hysteroscopy (examination of the uterus)
8. Minor skin procedures, like biopsies and lesion removals
9. Orthopedic procedures, such as carpal tunnel release or joint injections
10. Pain management procedures, including epidural steroid injections and nerve blocks
11. Podiatric (foot and ankle) surgery
12. Tonsillectomy and adenoidectomy
Advancements in medical technology, minimally invasive surgical techniques, and improved anesthesia methods have contributed to the growth of ambulatory surgical procedures, offering patients a more convenient and cost-effective alternative to traditional inpatient surgeries.
Preanesthetic medication, also known as premedication, refers to the administration of medications before anesthesia to help prepare the patient for the upcoming procedure. These medications can serve various purposes, such as:
1. Anxiolysis: Reducing anxiety and promoting relaxation in patients before surgery.
2. Amnesia: Causing temporary memory loss to help patients forget the events leading up to the surgery.
3. Analgesia: Providing pain relief to minimize discomfort during and after the procedure.
4. Antisialagogue: Decreasing saliva production to reduce the risk of aspiration during intubation.
5. Bronchodilation: Relaxing bronchial smooth muscles, which can help improve respiratory function in patients with obstructive lung diseases.
6. Antiemetic: Preventing or reducing the likelihood of postoperative nausea and vomiting.
7. Sedation: Inducing a state of calmness and drowsiness to facilitate a smooth induction of anesthesia.
Common preanesthetic medications include benzodiazepines (e.g., midazolam), opioids (e.g., fentanyl), anticholinergics (e.g., glycopyrrolate), and H1-antihistamines (e.g., diphenhydramine). The choice of preanesthetic medication depends on the patient's medical history, comorbidities, and the type of anesthesia to be administered.
An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.
Psychomotor agitation is a state of increased physical activity and purposeless or semi-purposeful voluntary movements, usually associated with restlessness, irritability, and cognitive impairment. It can be a manifestation of various medical and neurological conditions such as delirium, dementia, bipolar disorder, schizophrenia, and substance withdrawal. Psychomotor agitation may also increase the risk of aggressive behavior and physical harm to oneself or others. Appropriate evaluation and management are necessary to address the underlying cause and alleviate symptoms.
Clonazepam is a medication that belongs to a class of drugs called benzodiazepines. It is primarily used to treat seizure disorders, panic attacks, and anxiety. Clonazepam works by increasing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that has a calming effect on the nervous system.
The medication comes in tablet or orally disintegrating tablet form and is typically taken two to three times per day. Common side effects of clonazepam include dizziness, drowsiness, and coordination problems. It can also cause memory problems, mental confusion, and depression.
Like all benzodiazepines, clonazepam has the potential for abuse and addiction, so it should be used with caution and only under the supervision of a healthcare provider. It is important to follow the dosage instructions carefully and not to stop taking the medication suddenly, as this can lead to withdrawal symptoms.
It's important to note that while I strive to provide accurate information, this definition is intended to be a general overview and should not replace professional medical advice. Always consult with a healthcare provider for medical advice.
Butyrophenones are a group of synthetic antipsychotic drugs that are primarily used to treat symptoms of schizophrenia and other psychotic disorders. They act as dopamine receptor antagonists, which means they block the action of dopamine, a neurotransmitter in the brain associated with mood, motivation, and pleasure.
Some examples of butyrophenones include haloperidol, droperidol, and benperidol. These drugs are known for their potent antipsychotic effects and can also be used to manage agitation, aggression, and other behavioral disturbances in patients with various psychiatric and neurological disorders.
In addition to their antipsychotic properties, butyrophenones have been used off-label for their sedative and analgesic effects. However, they are associated with a range of side effects, including extrapyramidal symptoms (EPS), such as involuntary muscle spasms and tremors, as well as other neurological and cardiovascular adverse reactions. Therefore, their use is typically reserved for cases where other treatments have been ineffective or contraindicated.