Menstruation Increases the Risk of Nausea and Vomiting after Laparoscopy

Beattie, W. Scott; Lindblad, Thomas; Buckley, D. Norman; Forrest, James B.

doi:10.1097/00000542-199302000-00010

Cited by 105 publications

(48 citation statements)

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“…Although the exact mechanism of an increase in the incidence of PONV during menstruation remains unclear, Beattie et al postulated that changing concentrations of follicle-stimulating hormone (FSH) and/or oestrogen may sensitize the chemoreceptor trigger zone and/or the vomiting centre. 2,3 Granisetron has been shown to be an effective treatment of vomiting in patients receiving cytotoxic drugs. 4 Our studies have recently demonstrated that it is effective in the prevention of PONV following gynaecological surgery, s-7 The results of this study showed that incidence of PONV in patients with and without menstruation who had received granisetron was less than in those who had received placebo.…”

Section: Discussionmentioning

confidence: 99%

Granisetron reduces postoperative nausea and vomiting throughout menstrual cycle

1997

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Granisetron reduces postoperative nausea and vomiting throughout menstrual cyclePurpose: The incidence of postoperative nausea and vomiting (PONV) is influenced by menstruation. This study was undertaken to assess the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for preventing PONV in patients during two different phases of menstrual cycle. Methods: One hundred twenty female patients undergoing general anaesthesia for major gynaecological surgery were divided according to the phase of menstrual cycle into two groups: day one to eight (menstrual) and day nine to end of the cycle (non-menstrual) groups. In a randomized, double-blind manner, the patients received placebo (saline) or 40/./g.kg -I granisetron iv immediately before the induction of anaesthesia. All patients received a standardized general and epidural anaesthesia and epidural morphine plus bupivacaine for postoperative analgesia. The incidence of PONV and other adverse events was recorded dunng the first 24 hr after anaesthesia.Results: The treatment groups were similar with respect to patient demographics, types of surgery, anaesthetics administered and analgesics used postoperatively. The incidence of PONV was 72% and 32% in patients during menstruation receiving placebo or granisetron (P < 0.05), and was 46% and 2096 in those during non-menstruation, respectively (P < 0.05). No differences in the incidence of other adverse events were observed among the groups.Conclusion: Granisetron was effective in reducing the incidence of PONV in both phases of the menstrual cycle studied. Objectif: Les menstruations influencent I'incidence des nausEes et des vomissements postop&atoires (NVPO).Cette Etude visait ~ Evaluer I'efficacitE du granisetron, un antagoniste du r&epteur de la 5-hydroxytryptamine de type 3, administrE pour la prevention des NVPO pendant [es diffErentes phases du cycle menstruel.M&hodes : Cent vingt patientes programmEes pour une chirurgie gynEcologique majeure sous anesth&ie gEn&ale ont EtE rEparties en deux groupes dEterminEs par la phase de leur cycle menstruel: du premier au huiti~me jour (,~menstruel~) et du neuvi~me jour ~ la fin du cycle (anon menstruel~). En double aveugle et alEatoirement, les patientes ont re~u un placebo (du sol. phys.) ou 40/ag'kg -t de granisetron iv immEdiatement avant I'induction de I'anesth&ie. Toutes les patientes ont re~:u une anesthEsie gEn&ale ou Epidurale standard et de la morphine Epidurale avec ajout de bupivaca'ine pour ranalgEsie postol~ratoire. ILincidence des NVPO et des autres incidents a ErE enregistrEe pendant 24 h aprEs I'anesthEsie.REsultats : Les deux groupes Etaient identiques sur le plan de la d~mographie, du type de chirurgie, de I'anesth~sie et des analg&iques administrEs en postop&atoire. ILincidence des NVPO a ErE respectivement de 72% et de 32% darts le groupe menstruel recevant le placebo et le granisetron (P < 0,05) et de 46% et de 20~ darts le groupe non menstruel (P < 0,05). Eincidence des complications a ErE la mEme dans les deux groupes.C...

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Section: Discussionmentioning

confidence: 99%

Granisetron reduces postoperative nausea and vomiting throughout menstrual cycle

1997

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“…In the early postoperative period, the incidence of nausea but not of vomiting was decreased during the luteal phase. The results of this study were similar to studies that suggested that the early phase of the cycle increases risk of PONV [9][10][11], but differed with those that determined that the luteal phase was a predictor of PONV [12,13] and likewise to those studies that found no influence of the cycle on PONV [14,16,17]. Small, single-center studies may not have enough power to answer the question, but a subsequent metaanalysis may be helpful.…”

Section: Discussionsupporting

confidence: 65%

“…While the follicular phase of the menstrual cycle increased the risk for PONV in some studies [9][10][11], the luteal phase increased the risk in another [12]. Moreover both phases, follicular and luteal increased the risk in one study [13] but not in a multicentre study [14] or a factorial trial of six interventions for the prevention of PONV (IMPACT study) [8] (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Influence of the menstrual cycle on the incidence of nausea and vomiting after laparoscopic gynecological surgery: a pilot study

Šimurina

Mraović

Skitarelić

et al. 2012

Journal of Clinical Anesthesia

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“…2 Similarly, the results of studies investigating the relationship of PONV to the stage of the menstrual cycle were inconsistent. While some studies reported an increased susceptibility to PONV during the first seven days of the menstrual cycle, 19,20 this was not confirmed in other studies. 21 Recently, a systematic review of the results of all available studies suggested that the phase of the menstrual cycle had no impact on the occurrence of PONV (IIA).…”

mentioning

confidence: 68%

“…The recommended dose for dimenhydrinate is 1 to 2 mg·kg -1 in adults and 0.5 mg·kg -1 in children (IIA). 30 The NNT (95% CI) to stay completely free from nausea was 8 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) during the first six hours postoperatively and 6 (3-33) for the period from zero to 48 hr. For vomiting, the NNT (95% CI) was 7 (4-50) and 5 (3)(4)(5)(6)(7)(8) for the early and the 48-hr period respectively.…”

Section: Other Older Generation Antiemeticsmentioning

confidence: 99%

Evidence-based management of postoperative nausea and vomiting: a review

Habib

Gan

2004

Can J Anesth/J Can Anesth

196

106

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P Pu ur rp po os se e: : To provide evidence-based guidelines for the prophylaxis and treatment of postoperative nausea and vomiting (PONV).S So ou ur rc ce e: : Literature from randomized controlled trials, systematic reviews, logistic regression analyses and expert opinion in the management of PONV.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The etiology of PONV is multifactorial. Patient, anesthesia, and surgery related risk factors have been identified. Universal PONV prophylaxis is not cost-effective. Identification of patients at high-risk of PONV allows targeting prophylaxis to those who will benefit most from it. No prophylaxis is needed for patients at low risk for PONV. For patients at moderate risk for PONV, prophylaxis using a single antiemetic or a combination of two agents should be considered. Double and triple antiemetic combinations should be considered for patients at high risk for PONV. Furthermore, a multimodal approach should be adopted incorporating steps to keep the baseline risk of PONV low. The optimum cost-effective approach to the management of PONV will differ between an ambulatory centre and an inpatient hospital setting. For the treatment of established PONV in patients who failed prophylaxis, patients should not receive a repeat dose of the prophylactic antiemetic. Rather, a drug acting at a different receptor should be used. Beyond six hours after surgery, patients can be treated with any of the agents used for prophylaxis, except dexamethasone and transdermal scopolamine.C Co on nc cl lu us si io on n: : PONV are common after anesthesia and surgery. We provided evidence-based guidelines for the management of this problem based on the available literature. Objectif : Énoncer des lignes de conduite fondées sur des données probantes pour la prévention et le traitement des nausées et des vomissements postopératoires (NVPO). Source : Les publications d'essais contrôlés et randomisés, les études méthodiques, les analyses de régression logistique et l'opinion d'experts sur le traitement des NVPO. Constatations principales : L'origine des NVPO est multifactorielle. Les facteurs de risque reliés au patient, à l'anesthésie et au type de chirurgie sont connus. La prévention universelle des NVPO n'est pas rentable. L'identification des patients à haut risque de NVPO permet

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Menstruation Increases the Risk of Nausea and Vomiting after Laparoscopy

Cited by 105 publications

References 0 publications

Granisetron reduces postoperative nausea and vomiting throughout menstrual cycle

Granisetron reduces postoperative nausea and vomiting throughout menstrual cycle

Influence of the menstrual cycle on the incidence of nausea and vomiting after laparoscopic gynecological surgery: a pilot study

Evidence-based management of postoperative nausea and vomiting: a review

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