Naslov
Does menstrual phase influence nausea and vomiting after gynecologic laparoscopic surgery?

Autori
Šimurina, Tatjana ; Mraović, Boris ; Sonicki, Zdenko ; Sulen, Nina ; Dukić, Branko

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

Izvornik
Abstracts of The American Society of Anesthesiologists Annual Meeting ; u: Anesthesiology (S) / - San Francisco (CA) : Wolters Kluwer ; Lippincott Williams and Wilkins, 2007, A1016-A1016

Skup
The American Society of Anesthesiologists Annual Meeting

Mjesto i datum
San Francisco (CA), Sjedinjene Američke Države, 13.10.2007. - 17.10.2007

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
menstrual phase; nausea; vomiting; gynecologic laparoscopic surgery

Sažetak
The incidence of postoperative nausea and vomiting (PONV) in adult women is 2-4 times that in men. Gynecologic laparoscopic surgery increases incidence of PONV. Whether the phase of menstrual cycle is a risk factor for PONV after gynecologic laparoscopy is controversial (1, 2, 3). We investigated in prospective, double-blind, observational study if the phase of menstrual cycle has influence on the incidence of PONV in patients undergone general anesthesia for gynecologic laparoscopic surgery. After obtaining IRB approval and informed consents, 72 women in child bearing age, ASA PS I and II, scheduled for laparoscopic gynecological surgery were assigned into three groups according to phase of the menstrual cycle at the time of anesthesia: G1 - follicular phase (days 1-8), G2 - ovulatory phase (days 9-15) and G3 - luteal phase (days 16 to the end). The day of menstrual cycle was calculated from the first day of the last cycle. The exclusion criteria were: obesity, diabetes, gastrointestinal paresis, pregnancy, breast-feeding, irregular cycles, use of antiemetics, hormones, steroids and psychotropic drugs before surgery. Patients received 7.5 mg of midazolam PO 1 h before the surgery. No PONV prophylaxis was given. Anesthesia was induced with thiopental 5mg/kg, vecuronium 0.1 mg/kg and fentanyl 1-2 μ g/kg, followed by 10 mL/kg saline and maintained with sevoflurane ∼ 1MAC and air in 40% oxygen. Patients were considered to have had PONV if at least one episode of nausea, vomiting or retching or any combination of these occurred during 24 hours postop. Diclofenac IM and pethidine IV was used for postoperative pain and metoclopramide IV for PONV. Data were analyzed using Χ ² ; , Kruskal Wallis and Mann-Whitney test and expressed as mean (SD). P<0.05 was considered significant. There were no significant differences among groups for age, weight, height, BMI, h/o smoking, h/o motion sickness or previous PONV, type of surgery (removal of the ovarian tumors and cysts, myomectomy, infertility), duration of surgery and anesthesia, total amounts of opioids received perioperatively. Incidence of PONV was not overall significantly different: G1=5/17 (29%), G2=14/35 (40%) and G3=3/20 (15%) p=0.15. Metoclopramide use was also not significantly different among groups: G1=2, G2=7 and G3=2 patients. There were no difference in pain scores (VAS 0-100 mm) at 2h postoperatively: G1=19.71 (9.74), G2=25.34 (12.94) and G3=19.7 (10.07) (p=0.2) and 24h postoperatively G1=9.76 (9.8), G2=9.31 (10.09) and G3 10.25 (10.78) (p=0.92). Although higher incidence of PONV and more usage of metoclopramide in ovulatory phase of cycle compared with follicular and luteal phase, our data suggest that menstrual phase did not influence PONV after general anesthesia for gynecologic laparoscopic surgery. A study with larger groups and more power would need to show if ovulatory phase has significat increase of incidence of PONV in this clinical setting.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

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