Abstract
The aim of our study was to evaluate the efficacy of a PONV prophylaxis protocol (PPP) in fast-track cardiac anaesthesia. To perform this retrospective observational study, data were gathered from anaesthesia and PACU electronic reports, before and after implementation of PPP. A sample of at least 132 patients per group was calculated as necessary to achieve a 40% reduction in PONV. A standardized anaesthetic regimen was applied to all patients and they received piritramid 0,1mg/Kg upon arrival in PACU followed by immediate termination of anaesthesia. After implementation of PPP all patients received dexamethason 4 mg at the induction of anaesthesia and in PACU droperidol 1,25mg was injected to all women and those men who underwent thoracotomy. Those with a past history of PONV received ondansetron 4mg as well. Qualitative data were statistically analysed by X2 test and quantitative data by t student. Results are presented as mean (±SD) and percentage (p<0.05). Records of 313 patients (72% males/ 28% females) were studied, 154 cases before and 159 after PPP. The overall PONV incidence was 42% before vs statistically significant reduction to 5% after PPP. Pre-prophylaxis PONV incidence was higher in women with sternotomy, however it was similar in both genders with thoracotomy. Reduction of PONV incidence was statistically significant in all subgroups after implementation of prophylaxis protocol.Tabled 1PONVSternotomy (n= 226)Thoracotomy (n=87)M (n=169)F (n=57)M (n=56)F (n=31)Pre-prophylaxis21.3%75%63.3%50%Post-prophylaxis4.5%3.4%3.8%13.3%p0.0010.0000.0000.035 Open table in a new tab Our prophylactic regimen significantly reduced the incidence of PONV. Due to its benefits to a high quality care of patients, this prophylactic regimen could be considered as part of a successful fast-track approach after cardiac surgery.
Published Version
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