Incidence of Nausea and Vomiting After Fast-Track Anaesthesia for Heart Surgery

Abstract

ObjectiveThe aim of this study was to evaluate the incidence of postoperative nausea and vomiting (PONV) after fast-track cardiac anesthesia (FTCA) in the first 24-48 hours in the cardiac intensive care unit (CICU) after open-heart surgery, risk factors for PONV and its influence on CICU length of stay.MethodsA prospective observational study from January 1, 2013 to the end of December 2015 was performed in the CICU of a university hospital in the north of Jordan and Queen Alia Heart Institute, Amman, Jordan. Three hundred consecutive patients undergoing fast-track cardiac anesthesia in elective cardiac surgery were enrolled in the study. Nausea and vomiting were assessed after tracheal extubation, which was performed within 6-10 hours after surgery and during the first 24-48 hours in the CICU. Metoclopramide 10 mg intravenously was used as the initial antiemetic drug, but ondansetron 4 mg intravenously was also used as second line of management.ResultsNausea was reported in 46 (15.3%) patients, and vomiting in 31 (10.3%). Among females, 38 (33.9%) patients developed nausea and 20 (17.9%) developed vomiting. Among males, 8 (4.3%) patients developed nausea and 11 (5.9%) developed vomiting.ConclusionPONV are relatively low after FTCA and the prophylactic administration of antiemetic drug before anesthesia or after extubation is not necessary.

Effects of fast‑track anesthesia on miR‑1 and neuropeptides in serum of patients undergoing cardiac surgery

“…FTA anesthesia technology developed in recent years, achieves a strong controllability of the depth of anesthesia and postoperative recovery through the use of controllable anesthesia drugs, so as to reduce the stress response of patients ( 12 ). As a new anesthesia technique, it has been widely used in cardiac surgery in recent years, and has been proved to have high safety ( 13 ). When implementing FTA technology, we used sufentanil to replace fentanyl, because sufentanil not only has stronger analgesic effects than fentanyl, but also can reduce vascular resistance and relax vascular smooth muscle ( 14 , 15 ).…”

Role of Prophylactic Dimenhydrinate Versus Ondansetron as an Adjunct to Dexamethasone on Post-Operative Nausea and Vomiting in Laparoscopic Abdominal Procedures

“…Factors that may play a role in development of PONV include sex, age, previous history of PONV, motion sickness and migraines, smoking status, type of surgery, duration of surgery, type of anesthesia, use of opioid analgesics and hydration during surgery. 22,23 These factors can be broadly categorized to "patient factors" which includes females, people who do not smoke, past history of PONV/motion sickness, "Anesthetic Factors" like volatile anesthetic gases, nitrous oxide and use of perioperative opioid analgesics and lastly "Surgical Factors" that include type of surgery and duration of surgery. 10 The optimal control of PONV is based on three steps.…”

Putting patient value first: Using a modified nominal group technique for the implementation of enhanced recovery after cardiac surgery recommendations

“…In addition, a "diet and bowel regimen and postoperative nausea and vomiting (PONV)" recommendation was also included in the voting list based on its frequent occurrence in postoperative cardiac surgery patients as well as the emerging ERAS-CS literature. 7,19,20 Thus, participants voted on a total of 15 recommendations, organized into 3 time points: 6 preoperative, 2 intraoperative, and 7 postoperative (Table 1). Prior to data collection, participants received a document that provided an overview of the recommendations to be ranked.…”