Postoperative Nausea and Vomiting in Pediatric Patients

Kovac, Anthony L.

doi:10.1007/s40272-020-00424-0

Cited by 58 publications

(54 citation statements)

References 246 publications

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“…PONV has a high incidence in pediatric patients, especially for tonsillectomy and strabismus surgery (40)(41)(42). Recent studies had shown that PONV could lead to several adverse consequences, such as dehydration, electrolyte imbalance, and the wound dehiscence (43,44).…”

Section: Discussionmentioning

confidence: 99%

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

Zhao

Feng²,

Liu³

et al. 2022

Front. Surg.

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BackgroundPropofol and sevoflurane are the most used anesthetics for pediatric surgery. Emergence agitation, postoperative nausea and vomiting and postoperative pain are the primary adverse effect of these general anesthetics. Many clinical studies had compared the safety of propofol and sevoflurane in pediatric surgery, but the results were controversial.ObjectivesTo evaluate the evidence surrounding the safety of propofol versus sevoflurane for general anesthesia in children.MethodsDatabases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data and Vip Data were searched to collect relevant articles. Trials were strictly selected according to previously defined inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analyses.ResultsTwenty randomized controlled trials recruiting 1,550 children for general anesthesia were included, with overall low-moderate methodological quality. There was evidence that compared with sevoflurane anesthesia, propofol anesthesia significantly decreased the incidence of emergence agitation (OR = 4.99, 95% CI, 3.67–6.80; P < 0.00001), postoperative nausea and vomiting (OR = 1.91, 95% CI, 1.27–2.87; P = 0.002) and postoperative pain (OR = 1.72, 95% CI, 1.11–2.64; P = 0.01) in children. However, patients who received sevoflurane tended to have shorter times to eye opening (MD = −2.58, 95% CI, −2.97– −2.19; P < 0.00001) and times to extubation (MD = −1.42, 95% CI, −1.81– −1.02; P < 0.00001).ConclusionsThis review reveals that the children who received propofol anesthesia had the lower risks of emergence agitation, postoperative nausea and vomiting and postoperative pain when compared with sevoflurane anesthesia. But the children who received sevoflurane recovered slightly faster than those received propofol. Considering the limitations of the included studies, better methodological quality and large controlled trials are expected to further quantify the safety of propofol and sevoflurane for general anesthesia in children.

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Section: Discussionmentioning

confidence: 99%

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

Zhao

Feng²,

Liu³

et al. 2022

Front. Surg.

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“…According to the current literature, there are conflicting data concerning the influence of fluid management in the perioperative period on the rate of presence of PONV [50][51][52]. The perioperative administration of an adequate volume of intravenous fluid was reported to be able to correct the intravascular volume deficits, finally reducing PONV [53,54].…”

Section: Discussionmentioning

confidence: 99%

Adverse Events during Vitreoretinal Surgery under Adequacy of Anesthesia Guidance—Risk Factor Analysis

et al. 2022

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Vitreoretinal surgeries require the administration of general anesthesia (GA) in selected groups of patients. The administration of intraoperative rescue narcotic analgesia (IRNA) during GA poses the risk of postoperative nausea and vomiting (PONV). The surgical pleth index (SPI), a crucial component of the adequacy of anesthesia (AoA) guidance of GA, optimizes the intraoperative titration of IRNA. The current analysis evaluated the risk factors for the occurrence of PONV and the oculo-cardiac reflex (OCR) in patients undergoing pars plana vitrectomy (PPV) under AoA guidance. In total, 175 patients undergoing PPV were randomly allocated to receive either GA with SPI-guided IRNA administration using fentanyl alone or in addition to different preoperative analgesia techniques. Any incidence of PONV or OCR was recorded. Obesity, overweight, smoking status, motion sickness, postoperative intolerable pain perception, female gender, fluid challenge and arterial hypertension did not correlate with an increased incidence of PONV or OCR under AoA guidance. Diabetes mellitus, regardless of insulin dependence, was found to correlate with the increased incidence of PONV. The AoA regimen including SPI guidance of IRNA presumably created similar conditions for individual subjects, so no risk factors of the occurrence of PONV or OCR were found, except for diabetes mellitus. We recommend using AoA guidance for GA administration to reduce OCR and PONV rates.

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“…Other reports suggest that the anti-emetic effect of propofol is due to modulation of the subcortical pathways (16,17). In many recent reports, propofol should be the first choice among anesthetic agents, especially since it prevents the development of PONV in strabismus surgery of pediatric patients (18).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Different Anesthesia Techniques on Strabismus Surgery: A Prospective Observational Study

Güven¹,

Mutlu²,

Türkmen³

2022

hamidiyemedj

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Strabismus düzeltme operasyonları çocuklarda en sık yapılan göz operasyonlarındandır. Bu çalışmada amacımız şaşılık cerrahisi anestezisinde nöromusküler blokör ajan (NMA) kullanılarak yapılan oratrakeal entübasyon (OTE) uygulaması ile NMA kullanılmadan total intravenöz anestezi kullanılarak yapılan laringeal maske airway (LMA) uygulamasının şaşılık cerrahisi sonrası ölçülen kayma açılarına etkisini değerlendirmektir. Gereç ve Yöntemler:Genel anestezi altında şaşılık cerrahisi planlanan concomitant horizontal yönde şaşılığı bulunan, ASA I-II grubu, 14 yaş altındaki hastalar çalışma için prospektif olarak değerlendirmeye alındı. Restriktif tip strabismusu olanlar, vertikal yönde kayması olanlar veya intraoperatif vertikal kas gruplarına da müdahale edilenler, anizometropisi bulunanlar ve düzeltilmiş görme keskinliği 0,8'in altında olanlar çalışma dışı bırakıldı. Hastalara genel anestezi için geliş sırasına göre ya NMA uygulanarak OTE yapıldı ya da NMA uygulanmadan LMA (LMA-group) kullanıldı.Bulgular: LMA-grubu (n=24) ve OTE-grubu (n=25) olmak üzere toplam 49 hasta çalışmaya alındı. Hastaların yaş ortalaması 8,04±3,63 yıl idi. Hastalıkların %63'ünde (n=31) esotropia varken, %37'sinde (n=18) eksotropia vardı ve gruplar arasındaki dağılımı benzerdi. Postoperatif birinci ayın sonundaki kayma açısı LMA-grubunda 1 hastada, OTE-grubunda ise 2 hastada 10 prizma diyoptri üstünde ÖZ Background: Strabismus correction surgery is the most common eye operation in children. This present study aims to evaluate the effects of orotracheal intubation using a neuromuscular blocking agent (NMA) in strabismus surgery anesthesia and laryngeal mask airway (LMA) application using total intravenous anesthesia without using NMA on the deviation angles measured following strabismus surgery.Materials and Methods: ASA I-II group patients with concomitant horizontal strabismus, aged under 14, scheduled for strabismus surgery under general anesthesia were prospectively examined for the study. The study did not include those with restrictive type strabismus, vertical deviation, intraoperative vertical muscle group treatments, anisometropia, and corrected visual acuity less than 0.8. According to the order of arrival, either OTE was conducted with NMA, or LMA (LMA-group) was used without NMA for general anesthesia in patients. Results:The study included 49 patients, divided into LMA (n=24) and OTE (n=25). The patients' mean age was 8.04±3.63 years. The distribution was similar between groups, with 63% (n=31) having esotropia and 37% (n=18) having exotropia. Angles of deviation were measured to be above 10 prism diopter in 1 patient in the LMA group and two patients in the OTE group at the end of postoperative 1 st month. There was no statistically significant difference between the groups regarding decreased postoperative deviation angles and preoperative-postoperative deviation angle measurements. Conclusion:The tone changes in the eye muscles using NMAs in strabismus surgery anesthesia caused no changes in the postoperative deviation angles or th...

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Postoperative Nausea and Vomiting in Pediatric Patients

Cited by 58 publications

References 246 publications

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

Adverse Events during Vitreoretinal Surgery under Adequacy of Anesthesia Guidance—Risk Factor Analysis

The Effect of Different Anesthesia Techniques on Strabismus Surgery: A Prospective Observational Study

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