• 제목/요약/키워드: postoperative nausea and vomiting

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Postoperative nausea and vomiting after general anesthesia for oral and maxillofacial surgery

  • Apipan, Benjamas;Rummasak, Duangdee;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권4호
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    • pp.273-281
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    • 2016
  • Background: Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Despite this, few papers have reported the incidence and independent risk factors associated with PONV in the context of oral and maxillofacial surgery (OMFS). Therefore, we sought to determine the incidence of PONV, as well as to identify risk factors for the condition in patients who had undergone OMFS under general anesthesia. Methods: A total of 372 patients' charts were reviewed, and the following potential risk factors for PONV were analyzed: age, sex, body mass index, smoking status, history of PONV and/or motion sickness, duration of anesthesia, amount of blood loss, nasogastric tube insertion and retention and postoperative opioid used. Univariate analysis was performed, and variables with a P-value less than 0.1 were entered into a multiple logistic regression analysis, wherein P-values < 0.05 were considered significant. Results: The overall incidence of PONV was 25.26%. In the multiple logistic regression analysis, the following variables were independent predictors of PONV: age < 30 years, history of PONV and/or motion sickness, and anesthesia duration > 4 h. Furthermore, the number of risk factors was proportional to the incidence of PONV. Conclusions: The incidence of PONV in patients who have undergone OMFS varies from center to center depending on patient characteristics, as well as on anesthetic and surgical practice. Identifying the independent risk factors for PONV will allow physicians to optimize prophylactic, antiemetic regimens.

경막외 Morphine에 의한 통증 조절 환자에서 Butorphanol의 첨가시 부작용 감소 효과 (Addition of Butorphanol Reduces the Degree of Pruritus in Pain-controlled Patients by Epidural Morphine)

  • 이종남;조인찬;박영철
    • The Korean Journal of Pain
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    • 제9권2호
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    • pp.385-389
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    • 1996
  • Background: Nowadays, epidural morphine is commonly used in postoperative pain control. But epidural morphine may produce some side-effects, e.g. pruritus, nausea, vomiting, urinary retention and respiratory depression. Especially, pruritus is the most common complaint in pain-controlled patients by epidural morphine. So we evaluated whether addition of epidural butorphanol affects the degree of pruritus and pain score in pain controlled patients who by epidural morphine after hysterectomy. Methods: Group 1(N=15) received postoperative epidural 0.1% bupivacaine 100ml plus morphine 10 mg, group 2(N=15) received the mixture of butorphanol 2 mg with same regime as in group 1, group 3(N=15) received the mixture of butorphanol 4 mg with same regime as in group 1. All of the three groups received these solutions by infusion pump, 1 ml/hour, for postoperative 4 days. all groups received additional morphine 1.2 mg in 0.2% bupivacaine 6ml epidurally when the peritoneum was closed under general anesthesia. The severity of pain, pruritus, nausea and vomiting was estimated by 10 cm VAS(visual analogue scale) and somnolence by positive or negative during postoperative 4 days. Results: Severity of pruritus, but not nausea and vomiting was decreased in group 2 and 3 compared with group 1(p<0.05). Pain score was increased in group 3 at postoperative day(POD) 0 and 2 compared with group 1(p<0.05). Incidence of somnolence in group 1, 2 and 3 were $2.7{\pm}0.7,\;5.3{\pm}0.7$ and $10.0{\pm}1.0$ respectively. Conclusion: These results suggest that butorphanol reduce the degree of pruritus, the most common side effect of morphine, but increase the incidence of somnolence.

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수술후 오심구토에 대한 이침요법의 임상적 연구 (Effect of Auricular acupuncture on Postoperative Nausea and Vomiting)

  • 김용석;김창환;김건식
    • 대한한의학회지
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    • 제17권2호
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    • pp.331-336
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    • 1996
  • 본 논문은 수술후 오심, 구토증에 대한 이침요법의 효과를 연구하기 위하여 시도되었다. 경희대학교 의과대학 부속병원에서 전신마취하에 복식 자궁절제술을 받기로 예정된 100명의 환자를 두 군으로 나누어 이침요법을 하지 않은 대조군과 이침요법을 시행한 실험군을 대상으로 연구를 하였다. 대상환자의 연령, 체중, 신장, 마취시간은 두 군간에 통계적으로 유의성있는 차이는 없었다. 수술후 12시간이내에 한번이라도 오심, 구역 및 구토가 발생된 환자는 대조군이 68%, 실험군이 30%으로 실험군이 대조군에 비하여 유의성있는 효과를 보였다. 이침요법에 의한 부작용은 나타나지 않았다. 이침요법은 복식 자궁절제술 후 오심, 구토를 부작용없이 예방하는데 상당한 효과가 있는 것으로 사려된다.

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당일수술 후 최초 경구수분섭취 시간단축이 소아에서의 갈증감소 및 오심, 구토 발생에 미치는 영향 (The Effects of Early First Oral Water Intake on Thirsty Feeling, Nausea, and Vomiting in Child under Ambulatory Surgery)

  • 김경자;이윤영;현동수;박광옥
    • Journal of Korean Biological Nursing Science
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    • 제6권1호
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    • pp.43-52
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    • 2004
  • Purpose : The purpose of this study was to find effects of early oral water intake on thirsty feeling, nausea, and vomiting after ambulatory surgery. Method : Sixty patients who received PET(Pressure Equalizing Tube) insertion surgery under general anesthesia were conveniently sampled and divided into two groups. Experimental group was instructed to drink water after two hours and control group was directed to intake water after three hours postoperatively. Data were collected from May 1, 2002 to August 31, 2002 at ambulatory surgery center of Asan Medical Center. The thirsty feeling, nausea and vomiting score between experimental and control group were compared at the time of recovery, recovering consciousness, 2hr, 3hr, right before discharge and/or 24hr(telephone interview) postoperatively. The collected data were analyzed by SPSS 8.0 statistic program. Result : Result of this study are as follows. 1) There was a statistically significant difference(t=-10.31, p=0.00) in the occurrence of thirsty feeling at the 3hr postoperatively between experimental and control groups. 2) There was a statistically significant difference($x^2=6.66$, p=0.02) in the incidence of nausea during the 2hr postoperatively between experimental and control groups. 3) There was no difference($x^2=0.35$, p=0.55) between groups in vomiting scores. Conclusion : It was generally known that the delay of oral water intake decreases post operative complications. But, this study shows that early oral water intake decreases discomfort of thirsty and there was no adverse effects on the occurrence of postoperative nausea and vomiting.

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수술 후 오심과 구토의 영향요인 (Influence Factors for Predicting Postoperative Nausea and Vomiting)

  • 조은아;장지선;김계하
    • 한국콘텐츠학회논문지
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    • 제17권6호
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    • pp.632-642
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    • 2017
  • 본 연구의 목적은 수술 후 24시간 동안 수술 후 오심과 구토의 영향요인을 파악하고자 시도되었다. 연구 대상은 G시에 소재한 일 대학병원 일반외과, 신경외과, 정형외과, 산부인과, 이비인후과 수술을 받은 332명의 환자였다. 자료수집은 2014년 12월부터 2015년 12월까지 이루어졌으며, 자료는 t-test, $x^2$-test와 logistic regression analysis를 이용하여 분석하였다. 대상자 중 수술 후 오심과 구토가 발생한 유발군은 41.0%였다. 다변량 분석으로 분석한 결과, 흡연을 하지 않는 경우(p=.009), 멀미 과거력이 있는 경우(p=.016), 수술 후 오심과 구토 과거력이 있는 경우(p=.006), 수술 후 통증(p=.001)이 수술 후 오심과 구토 발생의 영향요인으로 나타났다. 따라서 비흡연, 멀미 과거력, 수술 후 오심과 구토 과거력이 있는 경우 수술전부터 집중적인 관리가 필요하며 수술 후 통증에 대한 적극적인 중재가 필요하다.

에탄올 비강흡입이 수술 후 자가통증조절기 사용 환자의 오심에 미치는 효과 (The Effect of Ethanol Inhalation on Postoperative Nausea in Patients using Patient Controlled Analgesia)

  • 오소영;박경숙;황윤영
    • 성인간호학회지
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    • 제21권4호
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    • pp.379-390
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    • 2009
  • Purpose: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). Methods: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. Results: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). Conclusion: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.

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부인과 수술 후 Ondansetron과 병용한 Dexamethasone의 오심, 구토 예방과 제통 효과의 비교 (Comparison of Ondansetron with Ondansetron and Dexamethasone in Preventing of PONV in Major Gynecologic Surgery)

  • 이기흥;신효상;전영훈;김시오;홍정길
    • The Korean Journal of Pain
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    • 제14권1호
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    • pp.76-82
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    • 2001
  • Background: Postoperative nausea and vomiting (PONV) are common after general anesthesia and patient controlled analgesia (PCA) using opioids. This study was designed to compare the effectiveness of ondansetron plus dexamethasone versus ondansetron alone in the prevention of PONV in a patient undergoing a PCA. Methods: We studied 166 ASA I, and II in-patients undergoing general anaesthesia for major gynecological surgery. After induction of anesthesia, Group 1 (n = 64) received intravenous (IV) dexamethasone 10 mg and Group 2 (n = 102) received IV saline 2 ml before the surgical incision. Each patient received IV meperidine 50 mg as a loading dose. Meperidine 5 mg/kg, ketorolac 3.6 mg/kg and ondansetron 8 mg diluted in 40 ml solutions were connected to PCA pump for postoperative pain control. Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 1, 4, 8, 16, 24, and 36 hours after the PCA connection. Results: For Group 1 and Group 2, respectively, the overall incidence of PONV was 12.5% and 23.5%. The pain scores were lower in patients receiving a combination of ondansetron and dexamethasone than those on ondansetron alone at 4 hr (P < 0.05), 8 hr (P < 0.05) and 16 hr (P < 0.05). Conclusions: This study suggests that the combination of ondansetron and dexamethasone is not more effective than ondansetron alone in the prevention of postoperative nausea and vomiting in women having PCA following major gynecological surgery but is more effective for pain control.

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Erector spinae plane block for spinal surgery: a systematic review and meta-analysis

  • Liang, Xiao;Zhou, Weilong;Fan, Yuchao
    • The Korean Journal of Pain
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    • 제34권4호
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    • pp.487-500
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    • 2021
  • Background: Although the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery. Methods: We searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery. Results: Twelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation. Conclusions: Erector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.

술후 통증 치료를 위한 몰핀 경막외 주입시 경피적 Scopolamine에 의한 구역 예방 효과 (Prophylactic Effects of Transdermal Scopolamine Patches on Nausea in Postoperative Patients Receiving Epidural Morphine)

  • 김재완;이청;서병태
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.178-182
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    • 1996
  • Background: To evaluate the effect of prophylactic transdermal scopolamine in reducing nausea associated with postoperative epidural morphine. Methods: 30 healthy patients scheduled for cesarean section were given local anesthetics epidurally for surgical anesthesia. After delivery of the baby, transdermal scopolamine patch($Kimite^{(R)}$ Myung Moon Pharm. Co., Seoul, Korea) was applied to the study group(n=15) and placebo patch to the control group(n=15). Postoperative analgesia was provided soley with epidural morphine. Nausea was treated with metoclopramide. Results: During 24 hours postoperatively, the mean nausea score was significantly lower in the study group than in the control group. But the nausea incidence was not significantly different between the two groups. The mean number of times antiemetic drugs which were administered to patients were lower in the study group than in the control group($1.5{\pm}0.5$ vs $3.3{\pm}1.3$, p<0.05). Conclusion: Transdermal scopolamine patch provides antiemetic effect simply, continuously and safely, preventing nausea which could occur during administration of epidural morphine after cesarean section.

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전슬관절치환술 후 경막외 자가조절진통 약제에 혼합한 Naloxone의 효과 (Effects of Naloxone Mixed with Patient-Controlled Epidural Analgesia Solution after Total Knee Replacement Surgery)

  • 권민아;박효원;이애령;김태형;이관우;김석곤;최덕환
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.187-191
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    • 2006
  • Background: Patient-controlled epidural analgesia (PCEA), using a local anesthetic-opioid mixture, has been effectively applied after total knee replacement (TKR) surgery, which is associated with intense postoperative pain that requires postoperative analgesia for both rehabilitation and the pain itself. However, adverse opioid-related effects, such as nausea, vomiting and pruritus, are commonly encountered. It was our hypothesis that the adverse opioid-related effects could be reduced by the addition of naloxone, an opioid antagonist, to a mixture of fentanyl-ropivacaine PCEA. Methods: In 120 patients undergoing elective TKR surgery, epidural or combined spinal-epidural (CSE) anesthesia was performed and PCEA applied. In the control group (n = 65), 0.16% ropivacaine and $3{\mu}g/ml$ fentanyl ($2.4{\mu}g/ml$ for those older than 65 yrs) were administered. In the naloxone group (n = 55), naloxone ($2{\mu}g/ml$) was coadministered with the above regimen. The incidence and severity of postoperative nausea and vomiting, and the frequency of pruritus, the visual analog score (VAS) and the PCEA volume used were assessed 6 and 24 hrs after surgery. Results: The incidence of nausea and vomiting during the early postoperative period, and those of pruritus during the late postoperative period were significantly lower in the naloxone group. The VAS pain scores, the PCEA volume used and amount of rescue IV meperidine were similar in the two groups. Conclusions: A small dose of naloxone mixed with an opioid significantly reduces the incidence and severity of adverse opioid-related effects in PCEA, without reducing the analgesic effect.