ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
The Antiemetic Efficacy Of Prophylactic 5-hidroksitriptamin Type 3 Antagonists In Laparoscopic Gynecologic Surgery
Dr. Bahattin DURU,a Dr. Zekeriyya ALANOĞLU,a Dr. Eylem TINAZ DÖNER,a Dr. Asuman UYSALELa
aAnesteziyoloji ve Reanimasyon AD, Ankara Üniversitesi Tıp Fakültesi, ANKARA
Objective: The aim of this randomized, prospective study was to evaluate the effects of preoperatively administered different dosages of ondansetron and granisetron on nausea and vomiting incidence after gynecological laparoscopic procedures.
Material and Methods: Eighty-five patients undergoing laparoscopic gynecologic surgery were admitted to the study. In all patients sodium thiopental 4-6 mg/kg and vecuronium 0.1 mg/kg were used for anesthesia induction. After endotracheal intubation and before the initiation of surgical procedure, the patients were randomized into 4 groups via closed-envelope technique. Group G20, group G40, grup O50 and group O100 received granisetron 20 mcg/kg, granisetron 40 mcg/kg, ondansetron 50 mcg/kg and ondansetron 100 mcg/kg, respectively. A desfluran 4-6% and N2O 50% O2 50% combination was used for anesthesia management. A history of postoperative nausea and vomiting, motion sickness, as well as the phase of the menstrual cycle, were noted. Surgery and anesthesia times were noted. The patients were evaluated for presence of nausea, vomiting, head ache, dizziness, numbness and muscle pain at 30 minutes, 1, 4, 12, and 24 hours after extubation. Total number of bouts of nausea and vomiting, and total analgesic and antiemetic drug consumption were also noted at postoperative 24 hour period. Analysis of variance, Kruskal-Wallis one-way ANOVA, Mann-Whitney U tests and Chi square test were the statistical analysis techniques. A p value < 0.05 was considered as significant.
Results: Five patients were excluded from the study due to failure of intubation on the first attempt. The number of patients having nausea at the postoperative 12th hour was lower in group G40 (n= 8, 40%) when compared to group G20 (n= 13, 65%), group O50 (n= 13, 65%) and group O100 (n= 14, 70%) (p= 0.026). The number patients having vomiting at the postoperative 12th hour was lower in group G40 (n= 4, 20%) compared to group G20 (n= 10, 60%), group O50 (n= 13, 65%) and group O100 (n= 11, 45%) (p= 0.047 vs. group G20, p= 0.004 vs. group O50, p= 0.022 vs. group O100). The number of vomitings per patient (median and 25%-75% range) during the postoperative 24-hour period was lower in group G40 0 (0-2) compared to group G20 1.5 (0-4), group O50 2.5 (0-3.75) and group O100 2 (0-4) (p< 0.05).
Conclusion: The results of this study indicate that, in laparoscopic gynecologic surgery, the use of intravenous granisetron 40 mcg/kg before the initiation of surgery decreases the number of vomiting episodes when compared to granisteron 20 mcg/kg or ondansetron 50-100 mcg/kg.Keywords: Laparoscopy, postoperative nausea and vomiting,granisetron, ondansetronTurkiye Klinikleri J Med Sci 2004, 24:624-632
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