Naslov
Does Nitrous Oxide Increase Postoperative Nausea and Vomiting in Gynecological Laparoscopic Surgery?

Autori
Mraović, Boris ; Šimurina, Tatjana ; Sonicki, Zdenko ; Dukić, Branko ; Marić, Marinko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
World Congress of Minimally Invasive Gynecologic Surgery. Book of Abstracts / Reich, Harry ; Loffer, Franklin D. ; Kopjar, Miroslav - Zagreb : The International Society for Gynecologic Endoscopy, 2006, 21-21

Skup
World Congress of Minimally Invasive Gynecologic Surgery

Mjesto i datum
Hrvatska, 21.06.2006. - 24.06.2006

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
postoperative nausea and vomiting; nitrous oxide; gynecologic laparoscopy

Sažetak
Background: Increased body of evidence suggests that general anesthesia with nitrous oxide increasing incidence of postoperative nausea and vomiting (PONV). Whether the use of nitrous oxide has an impact on PONV in gynecological laparoscopic surgery is not clear (1). The influence of general anesthesia with and without nitrous oxide on PONV was studied in this randomized, double-blind, controlled study. Methods: After obtaining ethical approval and informed consents, 66 patients ASA I - II, 19-75 years old, scheduled for gynecological laparoscopic surgery were included in the study. The exclusion criteria were: obesity, gestation, diabetes, use of antiemetics, steroids and psychotropic drugs. Induction was with thiopental 5 mg/kg, vecuronium 0.1 mg/kg and fentanyl 1-2 &#956; g/kg, followed by saline 10 ml/kg/h. Maintenance was with sevoflurane. Patients were randomized to receive 30% oxygen with nitrous oxide (G1, n =33) or 30% oxygen with air (G2, n=33). Pain control was with diclofenac IM and pethidine IV and PONV was treated with metoclopramide IV, as needed. PONV and pain were evaluated using a visual analogue scale (VAS) 0-100 mm during first 24h postop. Data were analyzed using &#967; &sup2 ; or Fisher's Exact test and Mann-Whitney test and expressed as median and range. P < 0.05 was considered significant. Results: There were no significant differences between groups for age, weight, height, BMI, phase of menstrual cycle, history of smoking and motion sickness, duration of surgery and anesthesia. Total amounts of opioids given during surgery and postop. were not different between groups. Average pain VAS scores at 2h postop. in G1 and G2 were 25 (0-65) and 20 (0-64), (p=0.94) and at 24h postop. were 10 (0-40) and 8 (0-29) (p=0.19), respectively. In G1 more patients received metoclopramide 7 vs. 3 (p=0.17). G1 had significantly higher incidence of PONV 69.7% vs. 33.3% (p=0.003) and nausea VAS score 30 (0-80) vs. 0 (0-55) (p=0.003). Conclusion: General anesthesia without nitrous oxide was associated with significantly less PONV in the first 24 hours in patients underwent gynecological laparoscopic surgery. Since the surgery is usually done as outpatients' procedure, we do not recommend use of nitrous oxide in gynecological laparoscopic surgery to avoid patients' dissatisfaction and possible readmissions. Reference: 1. Hartung J. Anesth Analg 1996 ; 83:114-6.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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