Evaluation and Comparison of the Effect of Different Intraoperative Oxygen Concentrations on Reduction of Nausea and Vomiting after Laparoscopic Cholecystectomy under General Anesthesia

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Postoperative nausea and vomiting (PONV) is one of the most common complications after anesthesia, and causes discomfort in many people. In some studies, the administration of high oxygen concentration during surgery has reduced postoperative nausea and vomiting. The purpose of this study was to evaluate the effect of different intraoperative oxygen concentrations on reduction of nausea and vomiting after laparoscopic cholecystectomy under general anesthesia.Methods: In this randomized clinical trial study, 105 patients who underwent laparoscopic cholecystectomy under general anesthesia were randomly assigned to three groups; the first group received 30% oxygen + 70% air, the second group 50% oxygen + 50% air, and the third group 70% oxygen + 30% air. Pain and nausea intensity was assessed using visual analogue scale. The data of this study were compared between the groups.Findings: There were significant differences between the groups based on the number vomits, and nausea and pain intensity at end of recovery, and 6, 12, and 18 hours postoperatively (P < 0.050 for all).Conclusion: High concentrations of oxygen reduces postoperative nausea, vomiting, and pain in laparoscopic cholecystectomy compared with lower concentrations, but does not reduce the need for metoclopramide.

Keywords


  1. Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg 2006; 102(6): 1884-98.
  2. Eberhart LH, Hogel J, Seeling W, Staack AM, Geldner G, Georgieff M. Evaluation of three risk scores to predict postoperative nausea and vomiting. Acta Anaesthesiol Scand 2000; 44(4): 480-8.
  3. Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014; 118(1): 85-113.
  4. Tang DH, Malone DC. A network meta-analysis on the efficacy of serotonin type 3 receptor antagonists used in adults during the first 24 hours for postoperative nausea and vomiting prophylaxis. Clin Ther 2012; 34(2): 282-94.
  5. Smith HS, Smith EJ, Smith BR. Postoperative nausea and vomiting. Ann Palliat Med 2012; 1(2): 94-102.
  6. Kranke P, Eberhart LH. Possibilities and limitations in the pharmacological management of postoperative nausea and vomiting. Eur J Anaesthesiol 2011; 28(11): 758-65.
  7. heidari m, kashefi p, rahimi m, eskandari m. The effect of different concentrations of oxygen on postoperative nausea and vomiting after spinal anesthesia. J Shahrekord Univ Med Sci 2006; 8(2): 9-15.
  8. Goll V, Akca O, Greif R, Freitag H, Arkilic CF, Scheck T, et al. Ondansetron is no more effective than supplemental intraoperative oxygen for prevention of postoperative nausea and vomiting. Anesth Analg 2001; 92(1): 112-7.
  9. Hovaguimian F, Lysakowski C, Elia N, Tramer MR. Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: Systematic review and meta-analysis of randomized controlled trials. Anesthesiology 2013; 119(2): 303-16.
  10. Greif R, Laciny S, Rapf B, Hickle RS, Sessler DI. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology 1999; 91(5): 1246-52.
  11. Purhonen S, Turunen M, Ruohoaho UM, Niskanen M, Hynynen M. Supplemental oxygen does not reduce the incidence of postoperative nausea and vomiting after ambulatory gynecologic laparoscopy. Anesth Analg 2003; 96(1): 91-6.
  12. Meyhoff CS, Wetterslev J, Jorgensen LN, Henneberg SW, Hogdall C, Lundvall L, et al. Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. JAMA 2009; 302(14): 1543-50.
  13. Ho CM, Wu HL, Ho ST, Wang JJ. Dexamethasone prevents postoperative nausea and vomiting: benefit versus risk. Acta Anaesthesiol Taiwan 2011; 49(3): 100-4.
  14. Jolley S. Managing post-operative nausea and vomiting. Nursing Standard 2001; 15(40): 47-52.