Postoperative care

Failure of drip and suck in postoperative ileus: A faulty non-perforated NG tube (2019)

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Type of publication:
Journal article

Author(s):
*Bristow D.; *Shaw J.

Citation:
BMJ Case Reports; Jun 2019; vol. 12 (no. 6)

Abstract:
A 55-year-old woman developed a postoperative ileus with associated nausea and vomiting following an
elective laparotomy. A wide bore nasogastric (NG) tube was inserted for gastric decompression and symptom
relief. Aspiration of the tube was unsuccessful and the patient continued to vomit. Imaging to investigate the
acute abdomen demonstrated the nasogastric tube to be correctly sited and within pooled gastric contents.
Gentle initial attempts were made to unblock the NG but to no avail and therefore it was removed. On
inspection it was discovered that the NG tube had no distal perforations to allow drainage, causing failure and
increasing the patient's risk of aspiration. The aim of this report is draw attention to the importance of
scrutinising all medical equipment prior to use to prevent avoidable and potentially serious patient harm.

Link to full-text [NHS OpenAthens account required]

Incidence of postoperative nausea and vomiting following gynecological laparoscopy: A comparison of standard anesthetic technique and propofol infusion (2016)

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Type of publication:
Journal article

Author(s):
Bhakta P., Ghosh B.R., Singh U., Govind P.S., Gupta A., Kapoor K.S., *Jain R.K., Nag T., Mitra D., Ray M., Singh V., Mukherjee G.

Citation:
Acta Anaesthesiologica Taiwanica, March 2016(no pagination)

Abstract:
Objective: To determine the safety, efficacy, and feasibility of propofol-based anesthesia in gynecological laparoscopies in reducing incidences of postoperative nausea and vomiting compared to a standard anesthesia using thiopentone/isoflurane. Design: Randomized single-blind (for anesthesia techniques used) and double-blind (for postoperative assessment) controlled trial. Setting: Operation theater, postanesthesia recovery room, teaching hospital. Patients: Sixty ASA (American Society of Anesthesiologists) I and II female patients (aged 20-60 years) scheduled for gynecological laparoscopy were included in the study. Interventions: Patients in Group A received standard anesthesia with thiopentone for induction and maintenance with isoflurane-fentanyl, and those in Group B received propofol for induction and maintenance along with fentanyl. All patients received nitrous oxide, vecuronium, and neostigmine/glycopyrrolate. No patient received elective preemptive antiemetic, but patients did receive it after more than one episode of vomiting. Measurements: Assessment for incidence of postoperative nausea and vomiting as well as other recovery parameters were carried out over a period of 24 hours. Main Results: Six patients (20%) in Group A and seven patients (23.3%) in Group B experienced nausea. Two patients (6.66%) in Group B had vomiting versus 12 (40%) in Group A (p . <. 0.05). Overall, the incidence of emesis was 60% and 30% in Groups A and B, respectively (p . <. 0.05). All patients in Group B had significantly faster recovery compared with those in Group A. No patient had any overt cardiorespiratory complications. Conclusion: Propofol-based anesthesia was associated with significantly less postoperative vomiting and faster recovery compared to standard anesthesia in patients undergoing gynecological laparoscopy.

Link to full-text: http://www.sciencedirect.com/science/article/pii/S1875459716300145/pdfft?md5=23ae5cc15830c8a727672ad3ea135958&pid=1-s2.0-S1875459716300145-main.pdf