Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Relationship between End Tidal Volume Carbon Dioxide Pressure and the Incidence and Severity of Nausea and Vomiting After General Anesthesia in Laparoscopic Cholecystectomy

Document Type : Original Article (s)

Authors
Khosrou Naghibi 1
Seyed Taghi Hashemi 2
Mahdi Mianji 3
1 Professor of Anesthesia and Intensive Care, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor of Anesthesia and Intensive Care, Isfahan University of Medical Sciences, Isfahan, Iran
3 Resident of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v43.i814.0481
Abstract
Background: Considering the complaints of some patients regarding the incidence of postoperative nausea and vomiting (PONV) after surgery and the role of end-tidal carbon dioxide levels, this study aimed to determine the effect of two different levels of end tidal carbon dioxide pressure on the incidence and severity of PONV in patients undergoing laparoscopic cholecystectomy under general anesthesia.
Methods: In this clinical trial study, 88 patients aged 18–65 years were randomly divided into two groups. In the first group, end-tidal CO₂ pressure was maintained at 35–40 mmHg, and in the second group, at 40–45 mmHg. The incidence of nausea and vomiting was compared between the two groups at 2, 4, and 6 hours postoperatively in the recovery room. Data were analyzed using inferential statistical tests with a significance level of 5%.
Findings: The frequency distribution of PONV and the number of vomiting episodes decreased non-significantly in both groups. The incidence of PONV in the first group decreased from 34% to 4.6% and in the second group from 40.9% to 6.8% within six hours after surgery. The frequency of vomiting decreased from 29.5% to 4.5% in the first group and from 31.8% to 6.8% in the second group. in all cases the difference between the two groups was not statistically significant.
Conclusion: Since end-tidal CO₂ in the range of 35–45 mmHg had no effect on nausea and vomiting in patients undergoing LC under general anesthesia, further studies in this field are needed.

Highlights

Khosro Naghibi: Google Scholar 

Seyed Taghi Hashemi: Google Scholar 

Keywords
Nausea
Vomiting
Laparoscopic Cholecystectomy
General Anesthesia
Carbon Dioxide

Subjects

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Journal of Isfahan Medical School
Volume 43, Issue 814
2nd Week, July
July and August 2025
Pages 481-487

  • Receive Date 26 March 2025
  • Accept Date 09 June 2025