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Introduction: Nausea and vomiting are a common manifestation in anatomic and functional disorders and these are current complication after general anesthesia and are unpleasent and with secondary complication. Nausea and vomiting are the most common complications after general anesthesia. Materials and Methods: In this study we compared three methods which one of them is droperidol with other methods consisting of IV metoc1opramide and placebo. This controlled study was done in teaching Vali Asr hospital. Total number of patient was 300. Type of sampling was random. Type of operation was laparatomy and all of them had general anesthesia. We divided them in three equal groups (droperidol group, metoclopramide group and placebo group). In this study we used from history and examination and we finished puzzles and we use from statistication. Results: We concluded that there is valuable difference between metoclopramide and droperidol group (with considering P=0.000). The results were shown that: droperidol is more effective than metoclopramide in the prevention of postoperative vomiting after abdominal surgery. Conclusion: With comparison of these data we fined that droperidol is a suggestive and valuable method also effective method in preventing postoperative vomiting. Also finding were shown that there isn't a meaning relation between age the kind of abdominal surgery and postoperative vomiting.

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Introduction: Nausea and vomiting are among the prevalent complaints in pregnancy, but there is a controversy about their treatments. At present, because of the problems caused by these complaints for mothers and incompatibility with drug treatments physicians prefer to use non-drug interventions such as acupressure. In this study, we evaluated the effectiveness of acuptessure in treatment of nausea and vomiting in pregnancy.
Materials and Methods: This was a randomised clinical trial study. 120 pregnant women with nausea and vomiting complaints that submitted in prenatal clinics and referred to Alavi pain clinic in Arak were investingated.
After filling out of questionnaires, the participants were alternatively divided into case and control groups. In case and groups, wrist band (for 90 minutes) was fastened in appropriate and non-appropriate sites, respectively. The subjects were followed up at 24 hours in 3 times visit and their responses to treatment were evaluated.
Results: The incidence of nausea and vomiting in the case group was significantly lower than control group. The rate of improvement of patient symptoms in the case group was six times higher than control group. No serious side-effect was observed in studied population.
Conclusion: Our findings indicated that acupressure is a safe and appropriate method used for treatment of nausea and vomiting in pregnancy.

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Introduction: Postoperative nausea and vomiting is one of the most common problems in postoperative period. Patients' who are at high risk of PONV, may receive anti-nausea and vomiting drugs. The most common drug is Metoclopramide, but it,s extrapiramidal signs and side effects such as lethargy, dizziness and headache especially in children lead us to perform this study, in order to compare Dexamethasone and Metoclopramide effects in PONV prevention. Materials and Methods: This study was a double-blind randomized controlled clinical trial. 262 patients (2-25 years) in ASA class I,II which were candidates for ENT, eye and laparatomy surgeries, divided into two groups randomly. One group received 0.1 mg/kg Dexamethasone IV and the other group received 0.1mg/kg Metoclopramide IV, 10-15 minuets before operation ending time. During recovery, the frequency of PONV was assessed. Data was analyzed by Pearson test. Results: PONV frequency in the two groups had no significant difference. Also PONV rate in the two groups had no significant difference in male and female. Conclusion: In prevention and treatment of PONV, Dexamethasone effect was same as Metoclopramide. Considering low expense, avalibility and low side effects, Dexamethasone is a proper substitute for Metoclopramide in surgeries with high risk of PONV.

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Introduction: Spinal anesthesia is a conventional way of anesthesia for cesarean section (CS), which nausea and vomiting is a common complication of it. Metoclopramide is the standard medication used for preventing intraoperative nausea and vomiting (IONV). Because of extrapyromidal side effects of Metoclopramide and known antiemetic effects of low-dose Propofol and Dexamethasone, this study was performed to compare the effectiveness of these drugs for preventing IONV. Materials and Methods: This study, is a randomized clinical trial which is done on 144 parturients who were admitted for emergency CS. Patients were divided randomly into four groups and received: Metoclopramide 0.1 mg/kg IV, Dexamethasone 150 g/kg IV, Propofol 0.1mg/kg every 5 minutes from clamping umbilical cord till the end of operation and the fourth group received 2 ml distilled water. During the operation parturients were monitored for IONV. Data was analyzed using Kruskal-Wallis and one way ANOVA. Results: The Number of patients having nausea was lowest in Propofol and highest in Dexamethasone group. There was no statistical significant difference between Dexamethasone and placebo groups. The lowest rate of vomiting was in Metoclopramide and Propofol groups and there was no significant difference between them. Also the lowest level of retching was in the Prepofol group. Conclusion: According to results, the antiemetic effects of Propofol and Metoclopramide are similar. Amount of retching in Propofol was slightly lower than Metoclopramide and administration of Propofol was simple, cheap and without serious complications, so we recommend it for emergency CS.

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Introduction: Post operative pain, nausea and vomiting are common complications after hemorrhoidectomy and cause unpleasant expriences for patients. Today, scientists are increasingly moving forward to find new drugs with fewer side effects and costs to control these complications. So this study was planned to evaluate the effect of Dexamethasone on post operative pain, nausea and vomiting. Materials and Methods: This study was a double blind randomized controlled clinical trial that carried out on 112 patients scheduled for hemorrhoidectomy. Patients were diveded into two groups. Case group received 8mg Dexamethasone and control group received 2 ml normal saline intramuscularly 30 minutes before the operation. The method of surgery and general anesthesia were the same in all patients. Pain and nausea score were recorded using visual analog scale (VAS) and vomiting was recorded by asking of them at 0, 2, 4, 6 hours after operation. The patients were followed for 6 hours after the end of the operation and data was analyzed using t and chi square tests. Results: There was a significant difference between the two groups regarding prevention of post operative pain and nausea (p=0.00001). But there was no significant difference between the two groups regarding prevention of post operative vomiting. Conclusion: The result of this study suggested that injection of Dexamethasone before hemorrhoidectomy can decrease incidence of postoperative pain and nausea but dose not have any effects on postoperative vomiting. Therefore Dexamethasone is recommended before hemorrhoidectomy.

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Introduction: Oral Ketamine is used as a low side effect analgesic in comparison with opioids, in different pain syndromes. This study is designed to evaluate the effect of oral Ketamine in renal colic treatment. Materials and Methods: In this clinical trial study 104 patients with renal colic, hospitalized in emergency department, were divided in to two groups by Random block design. Group B received Pethidine (1 mg/kg up to 100 mg) and placebo, and group A received Pethidine with the same dose and Ketamine (0.5 mg/kg). All patients were assessed for pain by using VAS chart, for nausea by a 0-3 scale and for the number of vomiting at baseline and 1, 2 and 3 hours after taking drug. The results were analyzed by t-test. Results: Average pain score and vomiting in all times and nausea score in one and three hours after receiving drugs were reduced significantly in patients who took Pethidine and Ketamine comparing patients who took Pethidine and placcbo(p < 0.05). Conclusion: Regarding the significant effect of Ketamine in reduction of pain, nausea and vomiting without side effects, it is possible to use Ketamine as an adjuvant drug in treatment of renal colic and to reduce narcotic dosage.

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Background: Post operative nausea and vomiting (PONV) is a very common and distressing complication after surgeries which may result in more serious problems such as incisional hernia wound dehiscence and aspiration. Cataract surgery following increase in intraocular pressure is sensitive to POVN. This study was designed to evaluate the effect of capsicum ointment on Korean acupressure points in reducing PONV and the amont of anti- emetic medications was used. Methods and Materials: This study is a double-blinded clinical trial which was done on 200 patients who were referred to Amir Kabir hospital for cataract surgery. The patients were randomized assigned to two groups, one who received capsicum ointment and the other placebo (vaseline ointment) at the pressure points (K-K9 and K-KD2). After applying the ointments and during the first 12 hours after the operation the patients were assessed for the incidence and intensity of PONV. Results: The incidence of nausea and vomiting during the first 6 and 12 hours was higher in the placebo group in compare to the capsicum group (p=0.001). Nausea scores were also higher in the 6 and 12 hours in the placebo group (p=0.0005). Uses of metoclopramide was significant higher in the placebo group in compare to the capsicum group (p=0.001). There was no significant difference between the two groups for vomiting during first 12 hours ofter opration. Conclusion: Stimulating of both K-D2 & K-K9 Korean acupressure points simultaneously is a simple, noninvasive, cheap and effective method for reducing PONV.

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Background: Nausea and vomiting are prevalent after laparoscopic cholecystectomy surgery and physicians need to use drugs, such as ondansetron, propofol, metoclopramid, and ramostrogen, for controlling them. This study was done to evaluate the effect of gabapentin 300mg and 600mg administration on controlling nausea and vomiting after laparoscopic cholecystectomy surgery. Materials and Methods: In this clinical trial, 105 ASA patients (classes 1 and 2) were randomly divided into 3 equal groups including placebo group, 300 mg gabapentin group, and 600 mg gabapentin group. The same technique of anesthesia was used for all groups. The patients were controlled for nausea and vomiting each 2 to 6 hours and after that every 4 to 18 hours. Data were analyzed using SPSS software. Results: The mean degree of nausea in the control group was 2.8, in second group which took 300 mg gabapentin was 0.67, and in third group which took 600 mg of gabapentin was 0.55 (p<0.001). In addition, the severity of vomiting in the control group was 0.326, in second group was 0.126, and in third group was 0.053 (p<0.001). Conclusion: Administration of one dose of 300 mg gabapentin can reduce nausea and vomiting, and with increasing gabapentin dosage to 600 mg, these complications will decrease even more. Therefore, using gabapentin in laparoscopic cholecystectomy surgery is recommended

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Background: Caesarean section is one of the most common gynecologic surgeries. Nausea and vomiting after pain is the most common side effect of surgeries, today, we most widely use of serotonin receptor antagonists, that are most effective antiemetic and have less side effect rather than other drug. Ondansetron is typical serotonin antagonists.

Materials and Methods: This is a randomized, double-blind clinical trial on 162 women undergoing cesarean section. 4mg intravenous ondansetron was given to first group and 8mg oral ondansetron was given to second group and thired group recived placebo. Blood pressure and heart rate were measured before and immediately after performing spinal and every 5 minute until 20 minute. Post operative nausea and vomiting and APGAR score were recorded after operation in recovery and 2, 4, and 6 houres after surgery.

Results: There was no significant difference among 3 groups according to age, gravidity, mean atrial pressure and heart rate before and during surgery. Nausea and vomiting in oral and intravenous groups at recovery, 2 and 4 hours after surgery were significantly less nausea and vomiting than placebo group (p<0.05). Whereas there was no significant difference between oral and intravenous groups.

Conclusion: It was concluded that using oral ondansetron with the same antiemetic effect is more convience to women undergoing cesarean section with spinal anesthesia.

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Background: Intrathecal morphine side effect is Nausea & Vomiting after surgery. The aim of the study was to evaluate the effect of intrathecal atropine on PONV in patients receiving intrathecal morphine in lower limb surgeries.

Materials and Methods: In this clinical trial , 120 patients undergoing lower limb surgery were randomly divided into 2 groups . Experimental group received 0.1 mg (1cc) Intrathecal atropine and control group received 1cc saline 0.9% . PONV during the first 24 hours and hemodynamic changes in minute 3, 5, 10 and 15 after surgery in both groups were measured. Data were analyzed using SPSS software (verision14). independent t-test, repeated measures manova,and chi-square were used to compare comparison of variables.

Results: Hemodynamic cheanges before injection and 3, 5, 10 and 15 after injection in two groups was not significant (P>0.05). None of the patients in the intervention group were PONV, but 17 patients in the control group had PONV that this difference was statistically significant (p =0.000 ). Pain in the control group was great than intervention group while 26 patients in the control group and 14 patients in the intervention group had vas greater than 3 that this difference was statistically significant( P = 0.04).

Conclusion: Intrathecal atropine without interfering Hemodynamic and pain relief prevent nausea and vomiting caused by Intrathecal morphine in patients undergoing surgery to the lower limbs..

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