Göğüs cerrahisi ameliyatı geçiren torakal epidural kateter takılan hastalarda postoperatif bulantı/kusmayı öngörmedeki parametreler

Abstract

Aim: In thoracic surgery, many factors; such as long duration of surgery and the use of volatile anesthetics may increase the frequency of postoperative nausea/ vomiting (PONV). Recent studies suggests that inflammatory markers such as neutrophils lymphocytes ratio (NLR) can predict PONV. The aim of this study is to postoperatively examine the role of demographic, laboratory, and clinical data in predicting PONV in patients who underwent thoracotomy and received thoracic epidural analgesia (TEA).
 Material and Methods:Data were collected for patients who underwent elective thoracic surgery and were administered TEA between March 2017 and December 2020. Patients' demographic data, laboratory parameters, and clinical characteristics; such as American Association of Anesthesiologists (ASA) I-II-III, erythrocyte distribution width (RDW), NLR, postoperative visual analog scale (VAS), were scanned. All patients who developed PONV were included in Group 1. Hospital records were used to select Group 2 patients who did not develop PONV.
 Results: The incidence of PONV was determined as 14.77%. There was a statistically significant difference between the groups in terms of ASA and 24-hour VAS scores (p < 0.05). Patients with PONV had statistically significantly higher 24-hour VAS scores(p < 0.05). PONV was statistically significantly higher in patients with ASA III compared to other ASA groups (p < 0.05). Multivariate analysis suggests that ASA, RDW and 24-hour VAS are significant in predicting PONV. Lower RDW, higher ASA and 24-hour VAS increase the risk of PONV.
 Conclusion: Demographic data, laboratory parameters, and clinical characteristics were evaluated concerning their correlation with PONV in this study. It was observed that the frequency of PONV might increase in patients with low RDW levels. In addition, higher VAS values and ASA physical score were also found to increase the risk of PONV in patients who underwent thoracotomy and administered TEA