Effects of high intraoperative inspired oxygen on postoperative nausea and vomiting in gynecologic laparoscopic surgery.
OBJECTIVE
To assess the efficacy of intraoperative inspired oxygen fractions (FIO(2)) of 0.8 and 0.5 when compared with standard FIO(2) of 0.3 in the prevention of postoperative nausea and vomiting (PONV).


METHODS
Prospective, randomized, double-blinded, controlled study.


METHODS
General hospital, postanesthesia care unit (PACU), and gynecology floor room.


METHODS
120 ASA physical status I and II women, aged 21 to 76 years, undergoing elective gynecologic laparoscopic surgery.


METHODS
Patients were randomized to receive a gas mixture of 30% oxygen in air (FIO(2) = 0.3, Group G30), 50% oxygen in air (FIO(2) = 0.5, Group G50), or 80% oxygen in air (FIO(2) = 0.8, Group G80); there were 36 patients in each group. A standardized sevoflurane general anesthesia, postoperative pain management, and antiemetic regimen were used.


METHODS
Frequency of nausea, vomiting, and both was assessed for early (0 to two hrs) and late PONV (two to 24 hrs), along with use of rescue antiemetic, degree of nausea, and severity of pain.


RESULTS
There was no overall difference in the frequency of PONV at the early and late assessment periods among the three groups. G80 patients had significantly less vomiting than Group G30 at two hours, 3% (1/36) vs. 22% (8/36), respectively, P = 0.028. Nausea scores, rescue antiemetic use, pain scores, and opioid consumption did not differ among the groups.


CONCLUSIONS
High intraoperative FIO(2) of 0.8 and FIO(2) of 0.5 do not prevent PONV in patients without antiemetic prophylaxis. An intraoperative FIO(2) of 0.8 has a beneficial effect on early vomiting only.
Department of Anesthesiology and Intensive Care Unit, General Hospital, Zadar 23,000, Croatia. tatjana_simurina@yahoo.com
Tatjana
T
Šimurina
Boris
B
Mraović
Simon
S
Mikulandra
Zdenko
Z
Sonicki
Nina
N
Sulen
Branko
B
Dukić
Tong J
TJ
Gan
D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006769:Hospitals, General; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008738:Methyl Ethers / Q000627:therapeutic use; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D010149:Postoperative Pain / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D012720:Severity of Illness Index; D000077149:Sevoflurane; D013997:Time Factors; D055815:Young Adult
D018685:Anesthetics, Inhalation; D000932:Antiemetics; D008738:Methyl Ethers; D000077149:Sevoflurane; D010100:Oxygen