The association of intraoperative end-tidal carbon dioxide with the risk of postoperative nausea and vomiting

Fujimoto, Daichi; Egi, Moritoki; Makino, S; Mizobuchi, Satoshi

doi:10.1007/s00540-019-02715-4

Cited by 8 publications

(9 citation statements)

References 18 publications

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“…Second, due to the sedative and analgesic properties of dexmedetomidine, the amount of intraoperative remifentanil in the experimental group was significantly reduced compared with the control group. However, many studies have reported that remifentanil has a short halflife and quick elimination, and there is no effect on PONV (20)(21)(22). Therefore, although dexmedetomidine reduced the dose of intraoperative remifentanil, it fails to drop the occurrence of PONV.…”

Section: Discussionmentioning

confidence: 99%

Effects of Dexmedetomidine on Postoperative Nausea and Vomiting in Adult Patients Undergoing Ambulatory Thyroidectomy: A Randomized Clinical Trial

et al. 2021

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Background: Postoperative nausea and vomiting (PONV) is a common and disturbing problem in patients undergoing ambulatory thyroidectomy. This prospective trial aimed to explore whether dexmedetomidine (DEX) combined with azasetron (AZA) can further drop the incidence of PONV in patients undergoing ambulatory thyroidectomy compared with AZA.Methods: This single-center, randomized, double-blind trial involved 172 adult patients undergoing ambulatory thyroidectomy. The individuals were randomized to DEX + AZA group and AZA group. In the DEX + AZA group, patients received dexmedetomidine 0.5 μg kg−1 for 10 min and then the infusion rate was held at 0.1 μg kg−1 h−1 until the completion of the operation, while the same amount of 0.9% saline in the AZA group. At the completion of the surgery, 10 mg azasetron was administered to every patient in both groups. The primary outcome was the incidence of 24 h PONV after ambulatory thyroidectomy. The secondary outcomes included residence time in recovery room, pain scores, severity of nausea, and adverse events.Results: No significant difference was found in the incidence of 24-h PONV between the DEX + AZA group and the AZA group [36% (30 of 84) vs. 38% (32 of 84); relative risk, 0.94; 95% confidence interval (CI), 0.63–1.40; P = 0.749]. The incidence of severe nausea was similar between the DEX + AZA group and the AZA group [57% (12 of 21) vs. 43% (9 of 21); relative risk, 1.33; 95% CI, 0.72–2.50; P = 0.355].Conclusions: Intraoperative dexmedetomidine combined with azasetron failed to drop the incidence of 24-h PONV compared with azasetron alone in patients undergoing ambulatory thyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Effects of Dexmedetomidine on Postoperative Nausea and Vomiting in Adult Patients Undergoing Ambulatory Thyroidectomy: A Randomized Clinical Trial

et al. 2021

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“…We thank Fujimoto et al for probing the correlation of intraoperative end-tidal carbon dioxide (EtCO 2 ) with the risk of postoperative nausea and vomiting (PONV) in patients undergoing gynecological surgery [1]. We have some comments.…”

Section: To the Editormentioning

confidence: 99%

EtCO2 and PONV: are the results really important?

Sun

Feng

2020

J Anesth

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“…Animal studies have reported that serotonin levels in the brain, a highly emetogenic substance, increase with intestinal 13 , 14 and cerebral ischemia 15 . Based on the hypothesis associating hypocapnia with increased serotonin levels due to intestinal and cerebral ischemia, studies associate intraoperative hypocapnia with increased incidence of PONV 16 , 17 . However, the relationship between hypocapnia and PONV remains unclear because some studies had conflicting results 18 , 19 .…”

Section: Introductionmentioning

confidence: 99%

Association between intraoperative end-tidal carbon dioxide and postoperative nausea and vomiting in gynecologic laparoscopic surgery

Dong

Takeda

Yamazaki

et al. 2022

Sci Rep

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Gynecologic laparoscopic surgery has a high incidence of postoperative nausea and vomiting (PONV). Studies suggest that low intraoperative end-tidal carbon dioxide (EtCO2) is associated with an increased incidence of PONV, but the results have not been consistent among studies. This study investigated the association between intraoperative EtCO2 and PONV in patients undergoing gynecologic laparoscopic surgeries under general anesthesia. This retrospective cohort study involved patients who underwent gynecologic laparoscopic surgeries under general anesthesia at Kyoto University Hospital. We defined low EtCO2 as a mean EtCO2 of < 35 mmHg. Multivariable modified Poisson regression analysis examined the association between low EtCO2 and PONV during postoperative two days and the postoperative length of hospital stay (PLOS). Of the 739 patients, 120 (16%) had low EtCO2, and 430 (58%) developed PONV during postoperative two days. There was no substantial association between low EtCO2 and increased incidence of PONV (adjusted risk ratio: 0.96; 95% confidence interval [CI] 0.80–1.14; p = 0.658). Furthermore, there was no substantial association between low EtCO2 and prolonged PLOS (adjusted difference in PLOS: 0.13; 95% CI − 1.00 to 1.28; p = 0.816). Intraoperative low EtCO2, specifically a mean intraoperative EtCO2 below 35 mmHg, was not substantially associated with either increased incidence of PONV or prolonged PLOS.

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The association of intraoperative end-tidal carbon dioxide with the risk of postoperative nausea and vomiting

Abstract: The number of tables: 2 tablesThe number of figures: 2 figures The supplemental file: 1 figure and 1table

Cited by 8 publications

References 18 publications

Effects of Dexmedetomidine on Postoperative Nausea and Vomiting in Adult Patients Undergoing Ambulatory Thyroidectomy: A Randomized Clinical Trial

Effects of Dexmedetomidine on Postoperative Nausea and Vomiting in Adult Patients Undergoing Ambulatory Thyroidectomy: A Randomized Clinical Trial

EtCO2 and PONV: are the results really important?

Association between intraoperative end-tidal carbon dioxide and postoperative nausea and vomiting in gynecologic laparoscopic surgery

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