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Author Chen, Chien-Chuan ♦ Lin, Chia-Shiang ♦ Ko, Yuan-Pi ♦ Hung, Yu-Chun ♦ Lao, Hsuan-Chih ♦ Hsu, Yung-Wei
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Lippincott Williams & Wilkins
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Philosophy & psychology ♦ Psychology ♦ Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Incidence & prevention of disease ♦ Pharmacology and therapeutics ♦ Diseases ♦ Surgery & related medical specialties ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Nervous System Diseases ♦ Pathological Conditions, Signs and Symptoms ♦ Diseases ♦ Heterocyclic Compounds ♦ Chemical Actions and Uses ♦ Chemicals and Drugs ♦ Diagnosis ♦ Anesthesia and Analgesia ♦ Surgical Procedures, Operative ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Behavior and Behavior Mechanisms ♦ Psychiatry and Psychology ♦ Physical Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons
Subject Keyword Discipline Anesthesiology ♦ Anti-anxiety Agents ♦ Therapeutic Use ♦ Antiemetics ♦ Anxiety ♦ Prevention & Control ♦ Gynecologic Surgical Procedures ♦ Mianserin ♦ Analogs & Derivatives ♦ Postoperative Nausea And Vomiting ♦ Preanesthetic Medication ♦ Serotonin Antagonists ♦ Adult ♦ Analgesics, Opioid ♦ Adverse Effects ♦ Double-blind Method ♦ Female ♦ Humans ♦ Middle Aged ♦ Morphine ♦ Pain Measurement ♦ Pain, Postoperative ♦ Time Factors ♦ Treatment Outcome ♦ Journal Article ♦ Randomized Controlled Trial
Abstract BACKGROUND: Mirtazapine is a new antidepressant that blocks 5-HT2 and 5-HT3 receptors. With this receptor profile, it is possible that mirtazapine could provide both anxiolysis and efficacy for postoperative nausea and vomiting (PONV). We therefore tested the hypothesis that premedication with mirtazapine can reduce preoperative anxiety and PONV. METHODS: Eighty female patients with at least two PONV risk factors scheduled for gynecological surgery were enrolled. Dexamethasone 8 mg was given before induction of anesthesia and patients were randomly assigned to group M + D (mirtazapine plus dexamethasone) or group dexamethasone. An oral disintegrating mirtazapine 30 mg or placebo tablet was given 1 h before surgery. Preoperative anxiety level was assessed by a visual analog scale (VAS) before mirtazapine administration and 1 h thereafter. General anesthesia was induced with 1% propofol at the rate of 200 mL/h (until loss of consciousness) and was then maintained with sevoflurane in oxygen and air. An auditory evoked potentials index monitor was used to titrate sevoflurane. The incidence of PONV, the use of rescue antiemetic, complete response, postoperative Ramsay Sedation Scores, and VAS pain scores were assessed 1, 2, and 24 h after surgery and compared. RESULTS: The VAS anxiety scale was lower in group M + D after mirtazapine administration. There were no differences in the induction dose of propofol, the concentrations of sevoflurane during anesthesia, and recovery times between the two groups. The incidence of complete response to PONV over 0-24 h was lower in group M + D (80% vs 50%, P < 0.01). CONCLUSIONS: Premedication with mirtazapine 30 mg reduces the level of preoperative anxiety and the risk of PONV in moderate and high-risk female patients.
Description Country affiliation: Taiwan
Author Affiliation: Chen CC ( Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan.)
ISSN 00032999
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2008-01-01
Publisher Place United States
e-ISSN 15267598
Journal Anesthesia & Analgesia
Volume Number 106
Issue Number 1


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Source: WHO-Global Index Medicus