Parameters Affecting Nausea and Vomiting After Thoracoscopic Wedge Resection in Patients With Pneumothorax

Abstract

Background: Postoperative nausea and vomiting (PONV) is one of the complications that can occur frequently in the first 24 hours postoperatively. We aimed to investigate the parameters that could predict PONV in patients who underwent thoracoscopic wedge resection for pneumothorax.Materials and Methods: After obtaining the approval of the ethics committee (ID: 2012-KEAK-15/2358, Date: 14.09.2021), the records of patients who underwent elective video-assisted thoracic surgery (VATS) between January 2018 and June 2021 were analyzed retrospectively. The patients who underwent elective thoracoscopic wedge resection for pneumothorax, who were between the ages of 18-65, American Society of Anesthesiologists (ASA) I-III, and whose body mass index (BMI) was between 18-30 kg/m 2 were included in the study. However, patients who received a blood transfusion or used antiemetics, anticholinergic drugs, and analgesics continuously were not included. In addition, patients with a history of chronic pain were not included in the study. The patients were divided into two groups, the PONV group (Group 1) and the control group (Group 2). The PONV incidence, visual analog scale (VAS) scores, 24-hour morphine consumption, additional analgesic requirement, neutrophil/lymphocyte ratios (NLR), and platelet/lymphocyte ratios (PLR) were evaluated.Results: The groups were similar in terms of demographic data (p > 0.05). Additional analgesic requirement and 24-hour morphine consumption were significantly higher in the PONV group (p: 0.005, p < 0.001, respectively). Preoperative NLR (p < 0.001), postoperative NLR (p < 0.001), preoperative PLR (p < 0.022), the VAS scores of the first hour (p: 0.004), and 24 th hour (p < 0.001) were statistically significantly higher in the PONV group compared to the control group.Conclusions: NLR parameters can be effective with high sensitivity and specificity in predicting PONV during the preoperative and postoperative period. Besides, preoperative PLR may also be effective in predicting PONV. A treatment that can be planned according to these parameters may play a key role in preventing PONV. In addition, efficient perioperative analgesia management may be effective in reducing PONV by limiting the emetogenic analgesics.

Stripping Massage and Literature Review in Post-Thoracoscopic Chest Pain Management

“…The visual analog scale (VAS) is a widely recognized and practical assessment tool for evaluating chest pain, commonly used in both clinical practice and research studies. [7][8][9] The study's main objective was to measure the reduction in VAS scores as the primary outcome, while reduced opioid consumption was the secondary outcome. Additionally, a literature review was conducted on the PubMed and Cochrane Library databases, focusing on various postthoracoscopic surgery chest pain treatments.…”

Comparison of Patient-Controlled Analgesia With Tramadol or Morphine After Video-Assisted Thoracoscopic Surgery in Geriatric Patients

“…VATS is applied as a reliable procedure in many thoracic surgeries [1][2][3][4][5]. Although it is a less invasive technique than thoracotomy, patients often experience postoperative pain [6]. If adequate postoperative analgesia is not administered, undesirable consequences such as atelectasis, decreased patient comfort, increased postoperative morbidity, prolonged hospital stay, and chronic pain may be encountered [6,7].…”

“…Although it is a less invasive technique than thoracotomy, patients often experience postoperative pain [6]. If adequate postoperative analgesia is not administered, undesirable consequences such as atelectasis, decreased patient comfort, increased postoperative morbidity, prolonged hospital stay, and chronic pain may be encountered [6,7]. Peripheral nerve blocks are often preferred to prevent postoperative pain due to their low side effects [8].…”