Nausea and Vomiting After Surgery Under General Anesthesia

Rüsch, Dirk; Eberhart, Leopold; Wallenborn, Jan; Kranke, Peter

doi:10.3238/arztebl.2010.0733

Cited by 80 publications

(53 citation statements)

References 109 publications

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“…In humans, nitrous oxide general anaesthesia is associated with a risk of postoperative nausea and vomiting, apart from other risk factors, interestingly also with motion sickness in the patient’s history [19,20]. The pathogenesis of postoperative nausea and vomiting is still largely unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of postoperative nausea and vomiting is still largely unclear. Several drugs, recommended for prevention of postoperative nausea and vomiting (due to nitrous oxide anaesthesia) could have an impact on myoelectric activity of the stomach, influencing serotonin 5-HT3 receptors (setrons), dopamine D2 receptors (droperidol, metoclopramide), muscarinergic acetylcholine receptors (scopolamine) or neurokinin NK1 receptors (aprepitant) [19]. Total intravenous anaesthesia is associated with less postoperative nausea and vomiting compared to inhalational anaesthesia [21].…”

Section: Discussionmentioning

confidence: 99%

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The effect of general anaesthesia on gastric myoelectric activity in experimental pigs

et al. 2013

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BackgroundSurface electrogastrography (EGG) is a non-invasive method for clinical assessment of gastric myoelectrical activity. Different forms of general anaesthesia might have various effects on porcine EGG. The aim of this study was to evaluate the impact of different anaesthetic agents on EGG in experimental pigs.MethodsFour 15-minute EGG intervals were recorded and analysed. A baseline EGG recording was started 20 minutes after intramuscular injection of ketamine and azaperone (periods A and B). Four different regimens of general anaesthesia followed immediately after the baseline EGG (5 pigs in each experimental group): thiopental, isoflurane, nitrous oxide and isoflurane plus nitrous oxide. EGG recordings followed for the next 30 minutes under general anaesthesia (periods C and D). The dominant frequencies of slow waves were compared between the baseline intervals A and B and periods C and D under general anaesthesia.ResultsThe mean dominant frequency was within the normal range (2.3 – 3.5 cycles per minute) in all animals in all regimens. Thiopental general anaesthesia did not influence any change of the dominant frequency of slow waves. Nitrous oxide general anaesthesia increased the dominant frequency of slow waves in a statistically significant manner (baseline: 2.93 ± 0.53 and 3.01 ± 0.53; under general anaesthesia: 3.25 ± 0.34 and 3.29 ± 0.38 cycles per minute; p < 0.001, p = 0.003, p < 0.001, p < 0.001). Nitrous oxide together with isoflurane induced a statistically significant decrease of dominant frequency in the last 15-minute interval (2.66 ± 0.55 cycles per minute) compared to the baseline recording (2.81 ± 0.49; p = 0.030).ConclusionsAll changes of porcine gastric myoelectric activity assessed by the dominant frequency of slow waves during EGG remained within the normal range although some of them achieved statistical significance. Thus all tested agents used for general anaesthesia can be recommended in preclinical studies with porcine models focused on gastric myoelectric activity without any risk of compromising the results. Thiopental seems to be the most suitable as it did not cause any changes at all.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of general anaesthesia on gastric myoelectric activity in experimental pigs

et al. 2013

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“…The administration of the prophylactic antiemetic might have served the role for this phenomenon, as the participants in this study were at high risk for PONV [16,17]. Furthermore, a sufentanil infusion of 0.2-0.3 µg/kg/hr may be an insufficient dose to induce PONV.…”

Section: Discussionmentioning

confidence: 99%

Sufentanil infusion before extubation suppresses coughing on emergence without delaying extubation time and reduces postoperative analgesic requirement without increasing nausea and vomiting after desflurane anesthesia

Lee

Lim

Park

et al. 2012

Korean J Anesthesiol

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BackgroundCoughing, hypertension, tachycardia, and even laryngospasm can occur due to airway irritation during emergence from anesthesia. We investigated the effect of maintaining a sufentanil infusion during emergence from anesthesia by evaluating the incidence of cough and recovery profiles at extubation.MethodsIn total, eighty-four patients undergoing an elective laparoscopic hysterectomy were randomly divided into two sufentanil groups and a control group. During emergence, sufentanil was administered in the sufentanil groups at a rate of 0.2 µg/kg/hr (Group S1) or 0.3 µg/kg/hr (Group S2), and saline was administered to the control group. Cough score, hemodynamic changes, and recovery profiles, such as duration from skin closure to a bispectral index of 80, to eye opening at verbal command, to tracheal extubation and the total duration of study solution infusion, were recorded. The pain score, the total volume of administered patient-controlled analgesia (PCA), and the postoperative nausea and vomiting (PONV) score were evaluated 1, 6, and 24 hours after surgery.ResultsGroups S1 and S2 showed significantly lower cough scores and smaller hemodynamic changes on extubation compared to Group C. Recovery profiles showed no significant differences among the three groups. Pain score, PONV at 1 hour postoperatively, and the total volume of PCA administered at all evaluation times were significantly lower in Groups S1 and S2 than in the control group. However, pain score, and PONV at 6 hours and 24 hours postoperatively showed no significant differences.ConclusionsA sufentanil infusion (0.2-0.3 µg/kg/hr) during emergence from desflurane anesthesia may suppress coughing on extubation in patients with body mass indexes (BMI) of 21-26 without delaying extubation time. It may also reduce the postoperative analgesic requirement without increasing PONV.

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“…Accordingly, the health care professionals could find themselves obligated to convert their approaches to more complicated alternatives such as conscious sedation or even providing the dental intervention under general anesthesia (Patır Münevveroğlu, Ballı Akgöl, & Erol, 2014). Both techniques could yield unpleasant side effects as nausea, vomiting, sore throat, confusion, muscle aches, itching, and hypothermia with general anesthesia, whereas for conscious sedation, motor imbalance, gastro-intestinal effects, and restlessness present possible complication (Rusch, Eberhart, Wallenborn, & Kranke, 2010).…”

Section: Introductionmentioning

confidence: 99%

The motivational effect of multicolored dental restoration on dental behavior of first preliminary school children

Melebari

Attas

Arafa

2019

Clinical & Exp Dental Res

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Objectives To assess the motivational effect of multi‐colored restoration on the anxiety level of pediatric patients at thedental clinic and its motivational effect on their oral hygiene status. Material and methods A total of 30 participants. Results Both groups revealed reduction in the anxiety level and improvement in their behavior at the dental office but did not reach significance. Plaque index showed a significant reduction per group and a near significance as compared between test groups. Conclusions The use of the multicolored restoration could provide a potential advantage to improve the oral health status of children and might aid in enhancing their behavior at dental clinic particularly younger age groups.

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Nausea and Vomiting After Surgery Under General Anesthesia

Abstract: PONV lowers patient satisfaction but is treatable. The effective, evidence-based measures of preventing and treating it should be implemented in routine practice.

Cited by 80 publications

References 109 publications

The effect of general anaesthesia on gastric myoelectric activity in experimental pigs

The effect of general anaesthesia on gastric myoelectric activity in experimental pigs

Sufentanil infusion before extubation suppresses coughing on emergence without delaying extubation time and reduces postoperative analgesic requirement without increasing nausea and vomiting after desflurane anesthesia

The motivational effect of multicolored dental restoration on dental behavior of first preliminary school children

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