title: Perioperative gastric emptying is not a predictor of early postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.
abstract: It is not known whether patients with postoperative nausea and vomiting (PONV) have delayed gastric emptying compared with patients without PONV. We compared the perioperative rate of gastric emptying in patients experiencing PONV with the rate in those without PONV immediately after laparoscopic cholecystectomy. Gastric emptying was studied by the acetaminophen method. Acetaminophen is not absorbed from the stomach but is rapidly absorbed from the small intestine, and the rate of gastric emptying therefore determines the rate of absorption of acetaminophen administered into the stomach. Forty patients (ASA physical status I and II) were included in the study. After the induction of anesthesia, a gastric tube was positioned in the stomach and 1.5 g of acetaminophen dissolved in 200 mL of water was administered. Venous blood samples for the determination of serum acetaminophen concentrations were taken before and at 15-min intervals during a period of 180 min after the administration of acetaminophen. Twenty-six patients experienced nausea during the first 4 h postoperatively. The other 14 patients had no nausea. There were no statistically significant differences in the maximal acetaminophen concentration, the time taken to reach the maximal concentration, or the area under the serum acetaminophen concentration time curves from 0 to 60, 0-120, and 0-180 min between the groups of patients with or without PONV. We did not find any relationship between postoperative gastric emptying and PONV, and therefore gastric emptying is not a predictor of PONV.
  
  
  CONCLUSIONS
  The incidence of postoperative nausea and vomiting is frequent after laparoscopic cholecystectomy. This study has shown that perioperative gastric emptying is not a predictor of early postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesiology, Orebro University Hospital, Orebro, Sweden. magnus@orebroll.se
authors.forename: M
authors.initials: M
authors.lastname: Wattwil
authors.forename: S-E
authors.initials: SE
authors.lastname: Thörn
authors.forename: A
authors.initials: A
authors.lastname: Lövqvist
authors.forename: L
authors.initials: L
authors.lastname: Wattwil
authors.forename: H
authors.initials: H
authors.lastname: Klockhoff
authors.forename: L-G
authors.initials: LG
authors.lastname: Larsson
authors.forename: I
authors.initials: I
authors.lastname: Näslund
mesh_terms: D000082:Acetaminophen / Q000493:pharmacokinetics; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000493:pharmacokinetics; D019540:Area Under Curve; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen