The Effect of Fluid Therapy in Acute Post - operative Complications of Breast Cancer; Pain and Post - operative Nausea and Vomiting

Abstract

Background: Post - operative nausea and vomiting (PONV) still continues to be a serious problem. Incidence of PONV is more than 20% to 30%. Intravenous fluid administration seems to decrease PONV. Objectives: The aim of this study was to evaluate the effect of pre - operative and intraoperative intravenous hydration in comparison to routine hydration on PONV in breast cancer surgery. Methods: This study was performed on 105 female patients with ASA class grade I and II; they were randomly divided to 3; group 1: routine hydration (1.5 cc/kg/h normal saline). Group 2: routine hydration + 5 cc/kg of ringer lactate serum 80 to 90 minutes before surgery, and group 3: routine hydration + 5 cc/kg post - operative pain, anti - emetic and analgesic administration were compared between 3 groups, using VAS and cortila questionnaire. Results: There were no significant difference between 3 groups considering demographic data (age, literacy, weight, height, etc.) duration of breast cancer, cancer stage, pre - operative fasting time, duration of surgery, etc. Blood loss was significantly lower in intraoperative fluid supplementation group (P < 0.05), but PONV and post - operative pain were significantly lower in those who received pre - operative fluid supplementation. They also needed less anti - emetic or analgesic administration. Conclusions: Pre - operative fluid supplementation showed to be an effective prophylactic strategy in PONV. Type of fluid and its volume need more evaluation in future studies.