The effect of nasogastric tube application during cardiac surgery on postoperative nausea and vomiting--a randomized trial.
OBJECTIVE
Postoperative nausea and vomiting (PONV) are significant morbidities following cardiac surgery. The purpose of this study was to determine if application of a nasogastric (NG) tube during cardiac surgery can reduce the prevalence of postoperative PONV.


METHODS
This study was a prospective randomized controlled trial.


METHODS
University tertiary referral center.


METHODS
Two hundred two patients undergoing elective cardiac procedures.


METHODS
Patients were prospectively enrolled and randomized to either receive or not receive an NG tube after induction of anesthesia. Standard anesthetic technique and postoperative care were employed in all patients. Preoperative demographic data, pain score, nausea score and incidence of vomiting were recorded early (0-8 hours) and late (8-16 hours) following extubation. Antiemetic and analgesic medications were compared between the 2 groups.


RESULTS
One hundred three patients were randomized to no an NG tube (controls) and 99 received an NG tube as part of their perioperative management. Demographic data and surgical characteristics were similar between the 2 groups. However, the control group had more smokers. Incidence and severity of nausea, pain scores, and analgesic requirements were similar between the 2 groups. Prevalence of vomiting was more frequent in the control group (24%) than in the NG tube group (10%, p = 0.007), and was more frequent in patients who underwent valve and redo procedures.


CONCLUSIONS
Use of an NG tube during cardiac surgery may reduce the incidence of postoperative vomiting.
Lavi
Ronit
R
Department of Anesthesia, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Katznelson
Rita
R
Cheng
Davy
D
Minkovich
Leonid
L
Klein
Andy
A
Carroll
Jo
J
Karski
Jacek
J
Djaiani
George
G
D000368:Aged; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003422:Critical Care; D017548:Echocardiography, Transesophageal; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D011229:Preanesthetic Medication; D015742:Propofol
D018686:Anesthetics, Intravenous; D000932:Antiemetics; D015742:Propofol