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        The impact of remifentanil on incidence and severity of postoperative nausea and vomiting in a university hospital-based ambulatory surgery center: a retrospective observation study

        Risa Hara,Kiichi Hirota,Masami Sato,Hiroko Tanabe,Tomoko Yazawa,Toshie Habara,Kazuhiko Fukuda 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.2

        Background: Ambulatory surgery, including short-stay surgery, has become a common choice in clinical practice. For the success of ambulatory surgery, perioperative care with safe and effective anesthesia and postoperative analgesia, which can reduce the occurrence of postoperative nausea and vomiting (PONV), is essential. The effect of remifentanil on the occurrence and severity of PONV has not been thoroughly examined, particularly, in an ambulatory surgery setting. Here, we investigate whether remifentanil influences the occurrence and severity of PONV in a university hospital-based ambulatory unit. Methods: We retrospectively analyzed a total of 1,765 cases of patients who had undergone general anesthesia at our ambulatory surgery unit. Parameters, such as occurrence and severity of nausea, vomiting or retching, use of antiemetic drugs, amount of postoperative analgesic and patient satisfaction, were extracted from the records and analyzed between the groups that received and not received remifentanil. Results: Within 565 patients of the RF group, 39 patients (6.6%) experienced nausea, 7 patients (1.2%) experienced vomiting or retching, and 10 patients (1.8%) were given antiemetic; in addition, the maximum VAS value for nausea was 12.1 mm. In 1,200 patients of the non RF group, 102 patients (8.5%) experienced nausea, 19 patients (1.6%) experienced vomiting or retching, and 34 patients (2.8%) were given antiemetic, and the maximum VAS value was 13.2 mm. There were no statistically significant differences between the two groups. Conclusions: Our results indicate that remifentanil did not increase the occurrence of PONV in patients within the ambulatory surgery unit.

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        Inhaled Corticosteroid and Secondary Glaucoma: A Meta-analysis of 18 Studies

        Ishii Mai,Horita Nobuyuki,Takeuchi Masaki,Matsumoto Hiromi,Ebina-Shibuya Risa,Hara Yu,Kobayashi Nobuaki,Mizuki Nobuhisa,Kaneko Takeshi 대한천식알레르기학회 2021 Allergy, Asthma & Immunology Research Vol.13 No.3

        Purpose Guidelines and systematic reviews frequently warn of inhaled corticosteroid (ICS)-induced glaucoma. However, most of the published studies deny it. Methods We performed a systematic review of randomized, cohort, nested-case control, cross-sectional studies by using Meta-analyses of Observational Studies in Epidemiology statement. Four major databases, PubMed, EMBASE, Cochrane Search Manager, and the Web of Science Core Collection as well as meta-analysis were used. Studies comparing incidence, prevalence and intraocular pressure (IOP) between patients who were treated with and without ICSs were included. A random-model meta-analysis was performed using the inverse variance method. Results Out of 623 studies screened, 18 with 31,665 subjects were finally included. No significant difference between the 2 groups was observed for crude glaucoma incidence (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.86–1.04; P = 0.26; I 2 = 0%; P for heterogeneity = 0.57) as a primary endpoint, adjusted glaucoma incidence (OR, 0.90; 95% CI, 0.65–1.24; P = 0.64), crude prevalence (OR, 1.82; 95% CI, 0.23–14.19; P = 0.57), adjusted prevalence (OR, 1.22; 95% CI, 0.50–2.96; P = 0.66), IOP change during ICS treatment (mean difference [MD] +0.01 mmHg; 95% CI, −0.19–0.20; P = 0.95), and single measurement IOP (MD +0.37 mmHg; 95% CI, −0.24–0.97; P = 0.23). Time-to-event analysis for glaucoma development as one of the secondary endpoints (adjusted hazard ratio, 0.52; 95% CI, 0.28–0.96) suggested a reverse association between ICS and glaucoma. Conclusions The ophthalmological side effects of ICSs, such as glaucoma and intraocular hypertension, should not be exaggerated.

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