Gastric Decompression Decreases Postoperative Nausea and Vomiting in ENT Surgery

Abstract

There is a passive blood flow to the stomach during oral and nasal surgery. It may cause postoperative nausea and vomiting (PONV). We researched the relationship between gastric decompression (GD) and severity of PONV in ear, nose, and throat (ENT) surgery. 137 patients who have been into ENT surgery were included in the study. In Group I (n = 70), patients received GD after surgery before extubation; patients in Group II (n = 67) did not receive GD. In postoperative 2nd, 4th, 8th, and 12th hours, the number and ratio of patients demonstrating PONV were detected to be significantly more in Group II as compared to Group I. PONV was also significantly more severe in Group II as compared to Group I. In Group I, the PONV ratio in the 2nd hour was significantly more for those whose amounts of stomach content aspired were more than 10 mL as compared to those whose stomach content aspired was less than 10 mL. In the 4th, 8th, and 24th hours, there is no statistically significant difference between the stomach content aspired and PONV ratio. GD reduces the incidence and severity of PONV in ENT surgery.

Ultrasound assessment of gastric contents in children undergoing elective ear, nose and throat surgery: a prospective cohort study

“…The results of our study have several implications. Firstly, they question the usefulness of suctioning gastric contents through a gastric tube before tracheal extubation in children undergoing ENT surgery , because we did not find any significant increase in the gastric content volume during the surgical procedure, and no child had a full stomach at the end of surgery. Some previously reported cases of blood aspiration that occurred after tracheal extubation and during the recovery period after oral and maxillofacial surgery, for which the mechanism remained uncertain, may therefore possibly be due to incomplete surgical haemostasis at the end of the surgery or to postoperative bleeding.…”

“…One of the main risk factors for aspiration is an increase in the volume of gastric contents. Passive blood loss from the surgical field into the stomach may occur during ear, nose and throat (ENT) and maxillofacial surgical procedures; therefore, aspiration of gastric contents through a gastric tube before tracheal extubation has been suggested in order to minimise the risk of postoperative regurgitation and vomiting, and, consequently, to decrease the risk of pulmonary aspiration . However, the clinical significance of passive ingestion of blood during ENT surgery remains uncertain.…”

“…In fact, aspiration of ingested blood that has clotted may be difficult when attempted through a gastric tube; it does not ensure that the stomach is totally emptied, and does not allow accurate assessment of the amount of blood ingested. Furthermore, conflicting results have been reported regarding the clinical benefits of gastric decompression before tracheal extubation in terms of reduced incidence of postoperative vomiting in children undergoing ENT surgery .…”

Sensitivity and Specificity Comparison Between APFEL, KOIVURANTA, and SINCLAIR Score As PONV Predictor In Post General Anesthesia Patient

“…On the other hand, during the head and neck surgery operation, the passive blood flow from the oral cavity and nasal cavity to the stomach triggered PONV (Erkalp et al, 2014). Based on Sinclair's study (about Sinclair score), the type of operation is included in one of the predictor scores of PONV incidence.…”

Overstay and Readmission in Ear, Nose, and Throat Day Surgery—Factors Affecting Postanesthesia Course

“…13 After ENT surgery, gastric decompression seems to be effective in the prevention of postoperative nausea and vomiting. 14 The most common reason for both readmissions and contacts for ENT patients was operation site bleeding after tonsil and adenoid surgery. Adult patients had a post-tonsillectomy contact rate of 11.6% in a US study.…”