The frequency of postoperative nausea and vomiting in young women receiving general anesthesia while combating Breast Augmentation surgery has been thought to be as high as 59 to 80 percent. So it's not surprising that patients are as frightened of postoperative nausea and vomiting and therefore are of postoperative pain.
Over the last 10 years, I've performed Breast Augmentation surgery under general anesthesia on more than 3, 000 patients. In each case, I placed saline breast augmentation behind the muscle. During this period, in conjunction with the actual precise anesthesia department at Nazareth Middle in Philadelphia, I come up with a protocol of medications and anesthetics to attack the multiple pathways that lead to nausea and vomiting.
Because I figured that patient satisfaction was associated with low incidences of PONV, I conducted a patient survey to get a more objective measure of the importance of this particular protocol. The survey, conducted over seven much longer, included 241 women age range 18 to 57.
The Protocol: Before surgery, all however two patients (who was allergic to sulfa) turned 200 mg of Celebrex capsule, a cyclooxygenase (COX)-2 inhibitor, accompanied with Alka Seltzer Gold or even Bicitra. They were also given the option of taking 5 mg of a lot of Valium. Six patients with a prior history of nausea and vomiting were given 40 mg of Emend inside three hours of surgical procedure. (Benadryl was withheld on a these six patients to evaluate caused by Emend. ) All customers received intravenous propofol, Versed, and fentanyl for the development of general anesthesia.
During surgery, women were given intravenous Zofran (4 mg), Benadryl (25 mg), moreover Decadron (8 mg). Sevofluorane gas has been utilized, and no nitrous gas obtained.
Postoperatively, patients were advised to carry Celebrex. They were is often given prescriptions for Zofran ODT check out mg and Valium 5 mg. Patients were also advised that they could use antacids as with Rolaids or Tums for postoperative nausea if required.
The Results: Patients filled out a questionnaire at involving first post-operative visit, five to seven days after surgery. They were asked to judge their level of nausea and vomiting on the day of surgery, the day after surgery the opposite day after surgery, using their satisfaction with the overall surgical experience, using a size of 0 to 10, with 10 as being the most severe. http: //www. lookingnatural. com/breastaugmentation. html
In all, 73% of the 241 potential customers reported no nausea and vomiting on the day of surgery. The numbers of issues who reported no nausea and vomiting on the first and second days after surgical removal were similar, at 73% and find out 75. 5%, respectively. On average, the remaining 27% consumed some PONV ("3" by the 0 to 10 scale) on all 3 days. A total of 94% of potential customers reported a "10" to rank their overall experience, and 90% gave each "10" rating for caused by their operation.
Conclusion: My approach, which evolved over 10 years with 3, 000 patients, has improved my signifies several days of definitely serious postoperative nausea and vomiting to nearly zero. I attribute these types of success to the consumption of Decadron, Zofran, Benadryl moreover Emend, all of which are affect multiple pathways so because of this nausea receptor sites. During surgery, I use a workout laryngeal mask airway (LMA) or even eliminate nitrous; I believe it might help decrease post-op nausea and vomiting. I also use Celebrex, which may possibly lower the amount of narcotic needed during after surgery.
The obvious result with them minimal to no nausea or vomiting after Breast Augmentation surgery is definitely an outstanding level of sufferer satisfaction. My patients used to name me for three to four days after surgery, uncomfortable and unhappy of these nausea and vomiting. Now, the phone is restful.
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