title: Influence of the menstrual cycle on the incidence of nausea and vomiting after laparoscopic gynecological surgery: a pilot study.
abstract: OBJECTIVE
  To investigate whether the phase of menstrual cycle influences the incidence of postoperative nausea and vomiting (PONV) in women undergoing general anesthesia for elective laparoscopic gynecological surgery.
  
  
  METHODS
  Prospective, observational, blinded study.
  
  
  METHODS
  General hospital, Postanesthesia Care Unit, and gynecologic floor room.
  
  
  METHODS
  111 ASA physical status 1 and 2 women, aged 18 to 53 years.
  
  
  METHODS
  Patients were classified into three groups according to the phase of menstrual cycle at the time of anesthesia: Group F1: follicular phase (menstrual days 1-8; n = 34); Group O2: ovulatory phase (days 9-15; n = 40); and Group L3: luteal phase (days 16 to end of cycle; n = 37). Anesthetic, postoperative pain management, and antiemetic regimens were standardized.
  
  
  METHODS
  Frequency of nausea, vomiting, or both were assessed for early (0-2 hrs). Late PONV (2-24 hrs) along with the use of rescue antiemetic, severity of nausea, and pain.
  
  
  RESULTS
  In the follicular (n = 34), ovulatory (n = 40) and luteal phase (n = 37) groups, the frequencies of PONV over 24 hours were 35%, 38%, and 14% (P = 0.04), respectively. This was due to differences in the early postoperative period where the frequencies were 21%, 25%, and 3% (P = 0.02), respectively, as frequencies were similar in the late period (15%, 20% and 14%, P = 0.71), respectively. Nausea scores, rescue antiemetic usage, pain scores, and opioid consumption were similar in the groups.
  
  
  CONCLUSIONS
  Patients in the luteal phase of their menstrual cycle may have a decreased risk of PONV after laparoscopic gynecological surgery in the early postoperative period.
authors.affiliation: Department of Anesthesiology and Intensive Care Unit, Medical High School, University of Zadar, Croatia. tatjana_simurina@yahoo.com
authors.forename: Tatjana
authors.initials: T
authors.lastname: Šimurina
authors.forename: Boris
authors.initials: B
authors.lastname: Mraovic
authors.forename: Neven
authors.initials: N
authors.lastname: Skitarelić
authors.forename: Tatjana
authors.initials: T
authors.lastname: Andabaka
authors.forename: Zdenko
authors.initials: Z
authors.lastname: Sonicki
mesh_terms: D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D000932:Antiemetics / Q000627:therapeutic use; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005498:Follicular Phase / Q000502:physiology*; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006769:Hospitals, General; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods; D008183:Luteal Phase / Q000502:physiology*; D008875:Middle Aged; D010060:Ovulation / Q000502:physiology*; D010149:Postoperative Pain / Q000453:epidemiology; D010865:Pilot Projects; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D011446:Prospective Studies; D012306:Risk; D012720:Severity of Illness Index; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D000932:Antiemetics