The impact of postoperative nausea and vomiting on the practice of day surgery for Chinese women with breast diseases.
Background: Day surgery for breast disease is becoming popular but a key limiting factor of success is the development of postoperative nausea and vomiting (PONV). Methods: A prospective study of PONV was conducted on 62 patients undergoing breast surgery under general anaesthesia. Lumpectomy was performed in 40 patients. The other 22 patients underwent major breast operations including modified radical mastectomy and wide local excision and axillary dissection. A total of 10 mg of metoclopramide was injected intravenously on induction of anaesthesia and oral metoclopramide was prescribed as required to treat PONV. Results: PONV occurred in six (15%) and 14 (63.6%) patients undergoing minor and major operations respectively. The onset of PONV occurred earlier following minor than major operations. Eleven patients required antiemetics. Univariate analysis showed that the incidence and the first onset of PONV was significantly associated with major breast operation and duration of operation. Multiple regression analysis demonstrated that duration of operation was the only independent factor that affects the rate of PONV. However, the onset of nausea was associated with major surgery and the onset of vomiting with the duration of the operation. Patients with minor breast surgery were all discharged on the day of surgery. None of the six patients with PONV required readmission. Conclusion: Minor breast surgery can be readily performed as a day case. More effective antiemetic measures against PONV may be required in major breast surgery.
Choi
H K.
HK
Department of Surgery, University of Hong Kong Medical Centre, Tung Wah Hospital, Hong Kong
Chow
L W.C.
LW
Goh
L C.
LC
Tsui
S L.
SL
Lee
F C.W.
FC