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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ENausea and vomiting occur in a large number of disease conditions and as side effects of many drug treatments, including the use of analgesics and anesthesia in surgery. Despite the introduction of many new antiemetic therapies, the incidence of postoperative nausea and vomiting (PONV) remains high, occurring in up to 30% of all surgical cases. This article presents results of a randomized blinded clinical trial on the use of sugammadex vs neostigmine for reducing PONV.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENeuromuscular Blockade Analgesic Drugs\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthetic Drugs\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthesiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENeuromuscular Blockade\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnalgesic Drugs\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthetic Drugs\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthesiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ENausea and vomiting occur in a large number of disease conditions and as side effects of many drug treatments, including the use of analgesics and anesthesia in surgery [Horn CC. \u003Cem\u003EDrug Discov Today Ther Strateg\u003C\/em\u003E. 2007]. Despite the introduction of many new antiemetic therapies, the incidence of postoperative nausea and vomiting (PONV) remains high, occurring in up to 30% of all surgical cases [Watcha M, White PF. \u003Cem\u003EAnesthesiology\u003C\/em\u003E. 1992]. Onur Koyunco, Assistant Professor, Mustafa Kemal University, Hatay, Turkey, presented results of a randomized blinded clinical trial on the use of sugam\u2013madex vs neostigmine for reducing PONV.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EBradycardia, increased gastric secretion, and gastrointestinal motility are among the side effects caused by the cholinesterase inhibitor neostigmine. Sugammadex, a new neuromuscular antagonist, has a different mechanism of action. The primary outcome of this study was to determine whether sugammadex causes less PONV than neostigmine.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EA total of 100 patients undergoing extremity surgery with a standardized general anesthetic were randomly assigned to receive neostigmine (70 \u03bcg\/kg) and atropine (0.4 mg\/mg neostigmine) or sugammadex (2 mg\/kg) for neuromuscular antagonism at the end of anesthesia, when 4 twitches of train\u2013of\u2013four were visible with fade. PONV, recovery parameters, antiemetic consumption, and side effects were recorded.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EPostoperative antiemetic and analgesic consumption was similar between the sugammadex and neostigmine groups. Extubation, first eye opening, and head lift times were shorter in patients who received sugam\u2013madex vs neostigmine (\u003Cem\u003EP\u003C\/em\u003E \u0026lt; .001 for each). Postoperative heart rates were significantly lower in all of the measured times in patients who received neostigmine as opposed to sugammadex. There were no differences in nauseavomiting scores at all measured times other than arrival in the postanesthesia care unit, when PONV was significantly lower (\u003Cem\u003EP\u003C\/em\u003E = .037) in the sugammadex group as compared with the neostigmine group.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EIn patients who do not warrant low heart rates in the postoperative period, sugammadex may be the drug of choice for those at high risk for PONV.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EUse of volatile anesthetics (vs propofol) for maintenance of anesthesia increases PONV in the early postoperative period [Apfel CC et al. \u003Cem\u003EBr J Anaesth\u003C\/em\u003E. 2002]. Current antiemetics provide relief from only some sources of vomiting, with more limited benefits for the control of nausea. A significant need exists to identify more effective antiemetic targets; current therapeutics have limitations in controlling certain sources of vomiting, and some patients do not respond to these medicines [Horn CC. \u003Cem\u003EDrug Discov Today Ther Strateg\u003C\/em\u003E. 2007].\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EHorn [\u003Cem\u003EDrug Discov Today Ther Strateg\u003C\/em\u003E. 2007] reports an even greater necessity to develop antinausea medications. It is clear that available antiemetic drugs, although they inhibit emesis, are much less potent for controlling nausea.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EPONV may increase patients\u0027 discomfort and raise costs (eg, antiemetics, readmission) and unwanted side effects (eg, pulmonary aspiration). Improving perioperative efficiency and throughput has become increasingly important in the modern practice of anesthesiology [White PF et al. \u003Cem\u003EAnesth Analg.\u003C\/em\u003E 2007]. As costs assume an evermore important role in the practice of medicine, the ability to avoid such postoperative side effects as nausea and vomiting has become a high\u2013priority issue.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/40\/15.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzomq2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}