Postoperative nausea and vomiting. A comparison between intravenous and inhalation anaesthesia in breast surgery

Abstract

Nausea and vomiting during the first 24 postoperative hours after breast surgery were studied. Ninety patients scheduled for elective breast surgery were randomly assigned to one of three anaesthetic methods: total intravenous anaesthesia with propofol, or propofol or thiopental for induction followed by isoflurane anaesthesia. All three groups received fentanyl for peroperative analgesia. A total of 46 (51%) patients experienced emetic sequelae: 19 (21%) complained about nausea and another 27 (30%) vomited once or more during the postoperative course. More than 50% of the patients with nausea and 70% with vomiting first suffered from these symptoms in the surgical wards after leaving the postoperative unit. Nausea and vomiting were seen in 18 (60%), 13 (43%) and 15 (50%) for the groups propofol-propofol, propofol-isoflurane and thiopental-isoflurane, respectively. In conclusion, every second patient experienced nausea or vomiting after breast surgery, the majority of these emetic symptoms occurring after leaving the postoperative unit. Propofol for induction or as a main anaesthetic did not make any major difference with regard to postoperative nausea or vomiting.

Omission of fentanyl during sevoflurane anesthesia decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in major breast cancer surgery

“…Breast cancer surgery performed under general anesthesia using a volatile anesthetic is associated with high incidences (33%-85%) of postoperative nausea and vomiting (PONV) [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Recently, not only minor breast operations, such as lumpectomy, but major operations, such as mastectomy, have been performed as ambulatory surgery or "drive-through mastectomy" in order to decrease healthcare costs and improve the patients' emotional and psychological well-being [11,[15][16][17].…”

A COMPARATIVE STUDY OF OUTCOMES AFTER MODIFIED RADICAL MASTECTOMY DONE UNDER THORACIC EPIDURAL vs. GENERAL ANAESTHESIA

“…Incidence of postoperative nausea-vomiting 5,6 was also more frequent in GA group with statistical significance (p value 0.01). Immediate pain scores 7 were more in GA group, which resulted in more analgesic dosage with possible side effects.…”

Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: Results of a controlled clinical trial

“…Propofol is used to maintain the effect of the anaesthesia and has a positive effect in reducing the incidence of early PONV (Hammas et al, 2002;Oddby-Muhrbeck et al, 1994;Sadhasivam et al, 1999). After surgery, the administration of opioids might contribute to these episodes (Jenkins & Lahay, 1971).…”

“…Post operative nausea and vomiting (PONV) is a common complication after anaesthesia and surgery (Kovac, 2000;Watcha & White, 1992). Women undergoing mastectomy are at particularly high risk for developing PONV, and the reported incidence is 60%-80% in patients not receiving antiemetic medication (Hammas, Thorn & Wattwil, 2002;Oddby-Muhrbeck, Jakobsson, Andersson & Askergren, 1994;Sadhasivam et al, 1999). Emetic episodes predispose patients to numerous complications, such as gastric aspiration, wound dehiscence, psychological distress, and delayed recovery and discharge times (Watcha & White, 1992).…”