Gender-Specific Differences in Low-Dose Haloperidol Response for Prevention of Postoperative Nausea and Vomiting: A Register-Based Cohort Study

Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after general anesthesia and surgery, with young non-smoking females receiving postoperative opioids being high-risk patients. This register-based study aims to evaluate the effect of low-dose haloperidol (0.5 mg intravenously) directly after induction of general anesthesia to reduce the incidence of PONV in the postoperative anesthesiological care unit (PACU).Multivariable regression models were used to investigate the association between low-dose haloperidol and the occurrence of PONV using a patient registry containing 2,617 surgical procedures carried out at an university hospital.Haloperidol 0.5 mg is associated with a reduced risk of PONV in the total collective (adjusted odds ratio = 0.75, 95% confidence interval: [0.56, 0.99], p = 0.05). The results indicate that there is a reduced risk in male patients (adjusted odds ratio = 0.45, 95% confidence interval: [0.28, 0.73], p = 0.001) if a dose of 0.5 mg haloperidol was administered while there seems to be no effect in females (adjusted odds ratio = 1.02, 95% confidence interval: [0.71, 1.46], p = 0.93). Currently known risk factors for PONV such as female gender, duration of anesthesia and the use of opioids were confirmed in our analysis.This study suggests that low-dose haloperidol has an antiemetic effect in male patients but has no effect in female patients. A confirmation of the gender-specific effects we have observed in this register-based cohort study might have major implications on clinical daily routine

ERP hoch 3: Energieraumplanung entlang von ÖV-Achsen

Im Rahmen des national geförderten Forschungsprojekt „ERP_hoch3“ wird der Themenschwerpunkt Energieraumplanung in drei Fokusebenen betrachtet, untersucht und simuliert. Während „ERP“ für Energieraum-planung steht, steht die „3“ für drei verschiedene Raumbezüge – Stadtquartiere, öffentliche Verkehrsachsen und interkommunale Flächenpotenziale erneuerbarer Energien (Region). ERP_hoch3 ist ein zweijähriges Grundlagenforschungsprojekt, gefördert vom österreichischen Klimafonds. Das Forschungsteam besteht aus 14 Expertinnen und Experten der Fachbereiche für Regionalplanung und für örtliche Raumplanung (TU Wien, Department für Raumplanung) und der Institute für Städtebau und Prozess- und Partikeltechnik (TU Graz)

Intraoperative simulation of the remnant liver function during anatomical liver resections with ICG Clearance (LiMON) measurements

AbstractObjectivePost-hepatectomy liver failure (PHLF) is the major cause of death following liver resection. The aim of this study was to evaluate the feasibility of an intraoperative simulation of post-resection liver function.MethodsIntraoperative liver function was measured by indocyanine green (ICG) clearance using the LiMON™ technology. In 20 patients undergoing anatomic liver resection, ICG plasma disappearance rate (PDR (%/min) and ICG retention at 15 min (R15) (%) were measured immediately after the induction of anaesthesia (t0), after selective arterial and portovenous inflow trial clamping (TC) of the resected liver segments (t1), after the completion of resection (t2) and before the closure of the abdominal cavity (t3).ResultsThe median baseline (t0) PDR was 16.5%/min. Trial clamping of the inflow (t1) resulted in a significant reduction in PDR to 10.5%/min. Results under TC were similar to those obtained after resection (t2) (median PDR: 10.5%/min). Linear regression modelling showed that post-resection liver volume could be accurately predicted by TC of liver inflow (P < 0.0001), but not by determining the resected liver volume. Simulated post-resection liver function under TC correlated well with PHLF and length of hospital stay.ConclusionsIntraoperative ICG clearance measurements allow real-time monitoring of intraoperative liver function during surgery. Trial clamping of arterial and portovenous inflow accurately predicts immediate post-resection liver function. The intraoperative measurement of liver function and simulation of post-resection liver function may help to avoid PHLF

Nonlinear covariate effects.

<p>Estimated nonlinear effects of anesthesia duration (A), intravenous sufentanil (B), remifentanil TCI total dosage (C), piritramide intravenous (D) and propofol infusion maximum rate (E). The solid black line visualizes the estimated effect (measured on log OR scale), the grey region corresponds to the 95% pointwise confidence interval for the estimated effect. The marks along the x-axis indicate the observed covariate values in the data.</p