Incidence Of Early Postoperative Nausea And Vomiting Research Articles

Effects of menstrual cycle on nausea and vomiting after general anesthesia.

To investigate the impact of menstrual cycle on patients undergoing gynecological endoscopic surgery. 220 patients scheduled for gynecological endoscopic surgery under general anesthesia were selected. The patients were divided into three groups based on 3 phases of menstrual cycle which are the follicular phase (Group F), ovulatory phase (Group O) or luteal phase (Group L). It is based on their duration of menstruation and the last day of menstrual bleeding from the date of surgery. Primary outcomes were the incidences of early and late postoperative nausea and vomiting (PONV) in the three patient groups. Preoperative venous blood was taken to determine the estrogen and progesterone levels of the patients. A total of 207 patients were enrolled. The incidence of early PONV was highest in group O (22.22% vs 43.33% vs 17.86%, P < 0.01). Multivariate logistic regression showed that menstrual cycle (P < 0.01) and sufentanil dosage (P < 0.05) were independent risk factors for early PONV, menstrual cycle (P = 0.03) and intraoperative hypotension (P = 0.03) were independent risk factors for late PONV. After the propensity matching, the incidences of early and late PONV in group O were both higher than that in other two groups (19.23% vs 44.68% vs 16.90%, P < 0.01; 53.80% vs 72.34% vs 45.07%, P = 0.01). The incidence of PONV after gynecological endoscopic surgery was different in patients with different menstrual cycles, with the highest incidence in ovulation.

Recovery from Anesthesia after Robotic-Assisted Radical Cystectomy: Two Different Reversals of Neuromuscular Blockade.

During robot-assisted radical cystectomy (RARC), specific surgical conditions (a steep Trendelenburg position, prolonged pneumoperitoneum, effective myoresolution until the final stages of surgery) can seriously impair the outcomes. The aim of the study was to evaluate the incidence of postoperative nausea and vomiting (PONV) and ileus and the quality of cognitive function at the awakening in two groups of patients undergoing different reversals. In this randomized trial, patients that were American Society of Anesthesiologists physical status (ASA) ≤III candidates for RARC for bladder cancer were randomized into two groups: In the sugammadex (S) group, patients received 2 mg/kg of sugammadex as reversal of neuromuscolar blockade; in the neostigmine (N) group, antagonization was obtained with neostigmine 0.04 mg/kg + atropine 0.02 mg/kg. PONV was evaluated at 30 min, 6 and 24 h after anesthesia. Postoperative cognitive functions and time to resumption of intestinal transit were also investigated. A total of 109 patients were analyzed (54 in the S group and 55 in the N group). The incidence of early PONV was lower in the S group but not statistically significant (S group 25.9% vs. N group 29%; p = 0.711). The Mini-Mental State test mean value was higher in the S group vs. the N group (1 h after surgery: 29.3 (29; 30) vs. 27.6 (27; 30), p = 0.007; 4 h after surgery: 29.5 (30; 30) vs. 28.4 (28; 30), p = 0.05). We did not observe a significant decrease of the PONV after sugammadex administration versus neostigmine use. The Mini-Mental State test mean value was greater in the S group.

A comparative study of the antiemetic effect of intravenous palonosetron with granisetron for the prevention of postoperative nausea and vomiting following laparoscopic cholecystectomy under general anesthesia

Background: Postoperative nausea and vomiting (PONV) is commonly experienced unpleasant complications of general anesthesia following laparoscopic cholecystectomy (LC). The present study was undertaken to compare the efficacy of palonosetron with granisetron in the prevention of PONV following LC under general anesthesia (GA). Materials and Methods: In a randomized, double-blinded study, after Ethical Committee approval, 100 adult patients aged 18–65 years, American Society of Anesthesiologists I/II undergoing elective LC under GA during a 2-year period in a Tertiary Care Hospital in Imphal were assigned into one of two groups. Group P (n = 50) received palonosetron 0.075 mg intravenous (IV) and Group G (n= 50) received granisetron 40 μg/kg body weight in 4 ml NS (0.9% normal saline added to get desired volume), 10 min before induction of anesthesia. Standardized anesthetic technique was used, and data were collected for PONV in postanesthesia care unit for 0–2 h and in the postoperative ward for 2–48 h. Results: The incidence of early PONV (0–2 h) was 28% in Group P (palonosetron) and 32% in Group G (granisetron), whereas the incidence of late PONV (2–48 h) was 18% in Group P and 32% in Group G. However, palonosetron had lesser delayed onset nausea (2–48 h) compared to granisetron (P = 0.037). Common side effects observed in the two groups were similar with no statistically significant difference between the groups. Conclusion: Prophylactic IV palonosetron was as effective as granisetron in preventing early (0–2 h) PONV. However, palonosetron was significantly better in the prevention of late onset nausea (2–48 h) in patients undergoing LC under GA without any major adverse effects.

Effect of Dexamethasone on Nausea, Vomiting, and Pain in Paediatric Tonsillectomy

Hermans, V.*; De Pooter, F.*; De Groote, F.*; De Hert, S.†; Van Der Linden, P.* Author Information

A comparative study between ramosetron and granisetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

Background: The reported incidence of postoperative nausea and vomiting (PONV) following laparoscopic cholecystectomy (LC) is very high. Various treatment modalities have been tried by several workers with varying results. This study was undertaken to compare the efficacy of ramosetron and granisetron with the intention to prevent postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy in this part of the country. Materials and Methods: In a randomized, double-blind study in our tertiary care hospital, 80 inpatients of ASA I and II were enrolled and received either 3 mg granisetron or 0.3 mg ramosetron i.v. (n = 40 each) ten minutes before induction of anesthesia. Standardized anesthetic technique was used, and data was collected for early (0-2 hr) PONV in the post-anesthetic care unit (PACU) and late (2-24 hr) PONV in the ward. Results: The incidence of early PONV (0-2 hr) was 22.5% for granisetron and 15% for ramosetron (P > 0.05; 95% Confidence interval (CI) = 0.20 to 1.97; OR = 0.63), late PONV (2-24 hr) was 25% and 15%, respectively (P > 0.05; CI = 0.18 to 1.68; OR = 0.56). The most common side-effects observed in the two groups were headache and drowsiness, and these were mild and self-limiting. There was no significant difference in the side-effects of drugs between the two groups. Conclusion: PONV is a distressing symptom in laparoscopic cholecystectomy cases, and ramosetron is as effective as granisetron in preventing early (0-2 hr) and late (2-24 hr) PONV.

Effect of dexamethasone on nausea, vomiting, and pain in paediatric tonsillectomy

The efficacy of dexamethasone (DEX) to reduce morbidity after paediatric tonsillectomy remains controversial. We evaluated the effect of 0.15 and 0.5 mg kg(-1) DEX on the incidence of postoperative nausea and vomiting (PONV) and on pain intensity after paediatric tonsillectomy. A total of 147 children aged 2-8 yr undergoing elective tonsillectomy were included in this prospective randomized double-blind study. At the induction of anaesthesia, subjects received 0.15 mg kg(-1) (DEX 0.15), 0.5 mg kg(-1) (DEX 0.5) DEX, or an equivalent volume of saline solution (placebo). Anaesthetic and surgical techniques were standardized. The incidence of PONV and the need for anti-emetic drugs and additional analgesia (tramadol and/or morphine) were recorded. Postoperative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale, the visual analogue scale, and the postoperative pain measure for parents. The incidence of early PONV (primary outcome variable) was lower in both DEX groups (DEX 0.15: 21%; DEX 0.5: 22%; placebo: 49%; P=0.001). The incidence of severe pain was reduced in the DEX groups on the second postoperative day (DEX 0.15: 20%; DEX 0.5: 5%; placebo: 47%; P<0.001). The study was not powered to assess a difference between the two DEX dose groups. A single i.v. injection of DEX at the induction of anaesthesia was effective in reducing the incidence of early and late PONV and the level of pain on the second postoperative day. A 0.15 mg kg(-1) DEX dose appeared to be as effective as a 0.5 mg kg(-1) dose to reduce the incidence of PONV.