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Address for correspondence: Dr. Alper Kilicaslan, Department of Anaesthesiology, Meram Medical Faculty, Necmettin Erbakan University, Konya 42080, Turkey. E-mail: [email protected]
Frieden IJ, Reese V, Cohen D. PHACE syndrome.The association of posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities. Arch Dermatol 1996;132:307-11. Durr ML, Meyer AK, Huoh KC, Frieden IJ, Rosbe KW. Airway hemangiomas in PHACE syndrome. Laryngoscope 2012;122:2323-9. Metry DW, Dowd CF, Barkovich AJ, Frieden IJ. The many faces of PHACE syndrome. J Pediatr 2001;139:117-23. Haggstrom AN, Skillman S, Garzon MC, Drolet BA, Holland K, Matt B, et al. Clinical spectrum and risk of PHACE syndrome in cutaneous and airway hemangiomas. Arch Otolaryngol Head Neck Surg 2011;137:680-7. Tsujikawa S, Okutani R, Oda Y. Anesthesia in an adult patient with tracheal hemangiomas: One-lung ventilation for lung lobectomy. J Anesth 2012;26:269-72.
antiemetic prophylaxis for patients at high risk for PONV. In fact, patients with two of the four risk factors for PONV as per Apfel score were included in the study. Additional strategies to reduce baseline risk — use of propofol for maintenance of anesthesia, avoidance of nitrous oxide, avoidance of volatile anesthetics, use of nonsteroidal antiinflammatory drugs to spare opioids, etc., as suggested in the “Society for Ambulatory Anesthesia Guidelines for the Management of PONV” — If adopted, would probably influence the outcome. In addition, the emetogenic effect of inhaled anesthetics appears to be dose related. Hence, a comment regarding comparability of volatile anesthetic consumption between the groups would be relevant. Lastly, a comment about intraoperative hydration would be apt as it has been found to have a bearing on PONV. Shriram Vaidya, PV Sai Saran1, Kush A Goyal, Deependra Kamble Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, 1Department of Anaesthesiology and Critical Care, Fortis Hospital, Chandigarh, India
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Address for correspondence: Dr. Shriram Vaidya, Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India. E-mail: [email protected]
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Caffeine for the prevention of postoperative nausea and vomiting — Few comments Sir, We found the article “caffeine for the prevention of postoperative nausea and vomiting (PONV)”  by Steinbrook et al. interesting as well as pleasing because of authors’ humility to report a finding which may not fit into popular belief (read: Increased incidence of PONV after intravenous caffeine). Not to take away the credit from authors but as critics, we would like to raise few comments, which we consider relevant.
Steinbrook RA, Garfield F, Batista SH, Urman RD. Caffeine for the prevention of postoperative nausea and vomiting. J Anaesthesiol Clin Pharmacol 2013;29:526-9. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, et al. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2007;105:1615-28. Apfel CC, Kranke P, Katz MH, Goepfert C, Papenfuss T, Rauch S, et al. Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: A randomized controlled trial of factorial design. Br J Anaesth 2002;88:659-68. Gan TJ, Joshi GP, Zhao SZ, Hanna DB, Cheung RY, Chen C. Presurgical intravenous parecoxib sodium and follow-up oral valdecoxib for pain management after laparoscopic cholecystectomy surgery reduces opioid requirements and opioid-related adverse effects. Acta Anaesthesiol Scand 2004;48: 1194-207. Maharaj CH, Kallam SR, Malik A, Hassett P, Grady D, Laffey JG. Preoperative intravenous fluid therapy decreases postoperative nausea and pain in high risk patients. Anesth Analg 2005;100: 675-82. Access this article online Quick Response Code:
The readers would benefit if authors could clearly state whether the type of surgeries considered as surgical risk factors for PONV were included in the study, e.g., laparoscopy, laparotomy, maxillofacial surgeries etc. Authors have rightly chosen propofol as an induction agent and administered routine as well as additional Journal of Anaesthesiology Clinical Pharmacology | October-December 2014 | Vol 30 | Issue 4
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