Polpun Boonmak

Antiemetic effect of ondansetron 0.2 mg mL −1 in PCA morphine solution

Background and objectives: To study the effect of 0.2 mg mL−1 of ondansetron added to morphine patient‐controlled analgesia solution after a 4 mg loading dose on the incidence and severity of postoperative nausea and vomiting. Methods: One hundred and sixty patients scheduled for elective surgery, between 18 and 65 yr old, were studied. Patients who smoked, received antiemetics and hormonal therapy, had a history of motion sickness or gastrointestinal disease, a body mass index >35 or menstruation at the time of the study were excluded. Patients were assigned to the ondansetron and control groups by block randomization. At the end of anaesthesia, all patients received 4 mg of ondansetron intravenously and the same patient‐controlled analgesia regimen of morphine. The ondansetron group (n = 80) received 0.2 mg of ondansetron per 1 mg of morphine. The nausea score, vomiting score and the requested ondansetron dose were evaluated at 1, 2, 6, 12 and 24 h. Patient‐satisfaction for nausea/vomiting was recorded at the end of the study. Results: Patient characteristics and cumulative morphine consumption were similar but ondansetron group had higher pain scores (P = 0.006). The ondansetron group had a lower nausea and vomiting scores, and more patients were free from nausea and vomiting than the control group (41 vs. 26, respectively, P = 0.025). The ondansetron group had fewer cumulative ondansetron doses than the control group and better patient satisfaction than the control group (P < 0.05). Conclusion(s): Ondansetron 4 mg plus 0.2 mg mL−1 given with PCA morphine can reduce nausea and vomiting thus improving patient satisfaction.

Parental satisfaction in ambulatory anesthesia for children in suburban and rural areas in Thailand: 2AP2-1

Background and Goal of Study: Ambulatory anesthesia for children in developing countries is growing. However, we found many obstacles to improving quality especially in our hospital which serves patients from suburban and rural areas. So, we aim to study the parental satisfaction and its associated factors including characteristic of patients and their parents. Materials and Methods: This study is an observation prospective descriptive study. We included children who were scheduled for ambulatory anesthetic service between birth and 14 years of age at Srinagarind hoispital, Khon Kaen, Thailand. We excluded patients whose parents were unable to be reached by telephones. Before anesthesia, we recorded patients’ data (sex, age, ASA physical status, operation) and parental data (sex, age, education, anxiety score). After anesthesia, we recorded type and duration of anesthesia, adequacy in information reception (pre, post anesthesia, complication). The day after anesthesia, we made phone calls to same patients to record parental satisfaction score (overall, pre, post anesthesia care) and anesthesia related complications. Data were based on mean (SD), median (range), or percentage as appropriate. Associated factors were based on multiple logistic regressions. A p<0.05 was needed for statistical significance. Results and Discussion: Ninety-two patients and their parents were included to our study. Overall good parental satisfaction was 96.7% (95%CI 90.8-99.3). Associated factors with dissatisfaction were poor postanesthesia care (RR 22.5 (95%CI 3.2-158)) and inadequate information about postanesthesia care at home (RR 13.3 (95%CI 1.3-136.0)). Patients’ characteristics: male (58.7%), 3.6 (0.25-14) (median (range)) years old, ASA class I (73.9%); procedures general surgery (63.0%) and MRI (19.6%); anesthetic techniques GA inhalation (66.5%), GA balance (25%); anesthesia period < 2 hr (98.1%); and anesthesia related complication PONV (11.9%). Parental characteristics: female (86.6%), 33.5±7.5 years old; 65.2% education below tertiary; with none to little anxiety score (90.2%); require public transportation 29.3%. Adequacy on information about pre, post anesthesia care, and complication were 61.6%, 39.1%, and 33.7%, respectively. Conclusion(s): Our study showed high percentage of parental satisfaction. Dissatisfaction associated factors were postanesthesia care and adequacy on information about postanesthesia care at home. We hence found that improvement could be made on information providing for patients and their parents.