BACKGROUND: This study was designed to determine the effectiveness of the continuous infusion of ondansetron for the prevention of postoperative nausea and vomiting (PONV) in intravenous patient-controlled analgesia (PCA). METHODS: One hundred and sixty patients undergoing spinal surgery were randomized into four groups according to the method of ondansetron administration, placebo (n = 40, group 1), ondansetron 8 mg mixed to IV PCA (n = 40, group 2), ondansetron 4 mg IV before induction or after surgery in addition to 8 mg mixed to IV PCA (n = 40, group 3 or n = 40, group 4). The incidences of nausea, vomiting, and side effects were recorded for 48 hr postoperatively. RESULTS: The incidence of nausea in group 1 (43 %) was significantly higher than in the other groups (group 2; 18%, group 3; 15%, group 4; 18%) (P < 0.05), and vomiting was one in group 1. CONCLUSIONS: Continuous ondansetron infusion is effective at preventing PONV, but the effects of additional bolus injections to continuous infusion of ondansetron were not different from continuous infusion only.
Analgesia, Patient-Controlled* ; Humans ; Incidence ; Nausea* ; Ondansetron* ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Vomiting*

BACKGROUND: The aim of this study was to examine the safety and efficacy of sedation and analgesia using remifentanil during percutaneous endoscopic lumbar discectomy (PELD). METHODS: Eighty ASA patients with physical status 1 or 2 who underwent a PELD were enrolled in this study. They were randomized to receive one of two treatments: a fentanyl bolus of 0.7microgram/kg 5 min before the procedure and of 0.7microgram/kg during the procedure (n = 40, group F), or a remifentanil titration at an infusion rate of 0.1-0.3microgram/kg/min available throughout the procedure according to the appeal of pain, level of sedation and side-effects (n = 40, group R). The observer's assessment of alertness/sedation (OAA/S) scale, blood pressure, heart rate, respiratory rate, SpO2, and end tidal CO2 were assessed and measured during and/or after the procedures. The visual analogue scale of pain (VAS), and the patient and endoscopist satisfaction scale were assessed after the procedures. RESULTS: There were no significant differences between the two groups in terms of the recovery characteristics, incidence of complications and satisfaction score of patients. In 92.5% of the cases among the remifentanil group, the spine surgeon made uniform judgements that remifentanil worked better than the usually used fentanyl procedure, whereas in 7.5% of the cases the effects were indifferent. The VAS score of the R group was significantly lower than that of the F group. CONCLUSIONS: We concluded that sedation and analgesia with remifentanil is very useful for painful local procedures such as PELDs.
Analgesia ; Blood Pressure ; Diskectomy* ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Respiratory Rate ; Spine