PurposeWe evaluated the effects of body mass index (BMI) on thermoregulation in obese patients scheduled to undergo laparoscopic abdominal surgery.MethodsSixty patients scheduled to undergo laparoscopic abdominal surgery with no pre-medication were included in the study. The patients were classified into 4 groups according to BMI <24.9, 25–39.9, 40–49.9, and >50. Anesthesia was provided with routine techniques. Tympanic and peripheral temperatures were recorded every 5 minutes starting with the induction of anesthesia. The mean skin temperature (MST), mean body temperature (MBT), vasoconstriction time, and vasoconstriction threshold that triggers core warming were calculated with the following formulas: MST = 0.3 (Tchest + Tarm) + 0.2 (Tthigh + Tcalf). MBT was calculated using the equation 0.64Tcore+0.36Tskin, and vasoconstriction was determined by calculating Tforearm−Tfinger.ResultsThere was no significant difference between the groups in terms of age, gender, duration of operation, and room temperature. Compared to those with BMI <24.9, the tympanic temperature was significantly higher in those with BMI =25–39.9 in the 10th, 15th, 20th, and 50th minutes. In addition, BMI =40–49.9 in the 5th, 10th, 15th, 20th, 25th, 30th, 40th, 45th, 50th, and 55th minutes and BMI >50 in the 5th, 10th, 15th, 20th, 25th, 30th, 50th, and 55th minutes were less than those with BMI <24.9 (P<0.05). There was no significant difference in terms of MST and MBT. Vasoconstriction occurred later, and that vasoconstriction threshold was significantly higher in patients with higher BMIs.ConclusionUnder anesthesia, the core temperature was protected more easily in obese patients as compared to nonobese patients. Therefore, obesity decreases the negative effects of anesthesia on thermoregulation.

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Nausea and vomiting are among the most common complaints in the postoperative period. The type of surgical technique and the site of intervention, as well as the anesthetic drugs and methods directly contribute to the rates of postoperative nausea and vomiting (PONV). One of the most important factors affecting the frequency of postoperative nausea and vomiting is the anesthetic drugs and methods used. Many antiemetic drugs are used to prevent postoperative nausea and vomiting. With the use of these drugs, side effects especially such as delayed recovery from anesthesia, dry mouth, undesirable changes in blood pressure and the occurrence of extrapyramidal symptoms are seen. Several antiemetic drugs are commonly used for the treatment of postoperative nausea and vomiting; including scopolamine, chlorpromazine, diphenhydramine, metoclopramide, promethazine, and ondansetron. Low-dose haloperidol and metoclopramide are effective in opioid-induced nausea and vomiting. Dexamethasone reduces the incidence of postoperative nausea in the first 6 hours after surgery. Oral intake starts in patients with severe vomiting parenteral fluid and electrolyte treatment is required. Sometimes provide may need gastric decompression with nasogastric tube. Parenteral fluid and electrolyte treatment and in severe cases gastric decompression with a nasogastric tube may be necessary. Alternative medicine such as acupuncture and acupressure can help prevent or reduce postoperative nausea and vomiting. The aim of this review is to examine the medical therapies and drug-free methods used for the treatment of PONV in the light of the literatüre

Background: Simplified risk models, such as the Apfel score, have been developed to calculate the risk of postoperative nausea-vomiting (PONV) for adult patients. In the absence of any risk factors, PONV risk is assumed to be 10%. While the presence of one of the four risk factors determined as female gender, non-smoking, PONV/car sickness history, and postoperative opioid use is associated with 20% risk for PONV, the risk increases by 20% with the addition of each risk factor, and reaches to 80% if four factors are present. Aim: Our aim in this study is to investigate the prevalence of PONV, and whether the scoring systems used for nausea-vomiting in the literature are still valid. Patients and Methods: Five groups of patients were included in the study with an Apfel score of 0, 1, 2, 3, 4. Each case was taken to the recovery room at the end of the operation. They were observed whether had nausea-vomiting was recorded according to the Abramowitz emesis score. Results: While the PONV risk for women is 24.637 times higher than men, the PONV risk of those who had gynecological surgery is 6.27 times higher than that of the other type of surgery. Those who had urological surgery are 0.345 times less than the other type of surgery. Those who had lower abdominal surgery had a risk of PONV of 4.56 times higher than the others. As the duration of the case increases, the risk of PONV increases 1.01 times (P values P < 0.001, P < 0.001, P < 0.001, P = 0.048, P < 0.001, respectively). Conclusion: As a result, our PONV prevalence is considerably lower than the frequency rates mentioned in the literature. PONV scoring systems need long-term studies with larger populations to be updated.

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