Postoperative Nausea and Vomiting in Paediatric Anaesthesia

Urits, Ivan; Orhurhu, Vwaire; Jones, Mark R.; Adamian, Leena; Borchart, Matthew; Galasso, Annemarie; Viswanath, Omar

doi:10.5152/tjar.2019.67503

Cited by 18 publications

(11 citation statements)

References 48 publications

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“…For example, a prospective study that aimed to examine predictors of PONV reported a higher frequency of PONV among patients experiencing excessive POP [ 25 ]. A significant association between reported pain and PONV was also seen in several other studies [ 26 , 37 , 38 ]. A study conducted in Uganda found that surgical patients who reported feeling pain were twice as likely to experience PONV than patients who did not [ 22 ].…”

Section: Discussionsupporting

confidence: 79%

Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

et al. 2021

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Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.

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Section: Discussionsupporting

confidence: 79%

Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

et al. 2021

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“…According to one study, a reduction in PONV also resulted in agitation reduction [33]. Although this study also considered the possibility of administering ondansetron to decrease PONV, it was not used in this study due to concerns about the burden of additional cost and side effects such as Q-T interval prolongation, headache, and dizziness [34]. Lidocaine has been reported to reduce PONV, although the mechanism of action is unknown [35].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Agitation-Reducing Effects of Esmolol and Lidocaine in Pediatric Strabismus Surgery: A Double-Blind, Randomized Clinical Study

Ji,

Kang,

Seo

et al. 2023

Soonchunhyang Med Sci

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Objective: Agitation is a common symptom in children undergoing surgery, especially when surgeries are performed under sevoflurane and when patients undergo strabismus surgery. Because agitation can increase the risk of falls and lacerations on surgical sites and can delay discharge from the recovery room, adopting measures to reduce the incidence of agitation is essential. This study aimed to compare the agitation-reducing effects of lidocaine and esmolol administered individually or as a combination.Methods: We included 80 patients scheduled to undergo strabismus surgery. Thiopental and sevoflurane were administered to induce general anesthesia. Group EL received lidocaine (2 mg/kg) right after the end of surgery and esmolol (0.5 mg/kg) immediately after recovery from anesthesia after turning the anesthetic gas off; group L received lidocaine at 2 mg/kg right after the end of surgery and did not receive esmolol, group E did not receive lidocaine at the end of the surgery but received esmolol at 0.5 mg/kg right after recovery from anesthesia, and group C received neither esmolol nor lidocaine. Agitation severity was assessed using the objective pain score, Pediatric Anesthesia Emergence Delirium Scale immediately after recovery from anesthesia and until discharge from the recovery room.Results: Groups L and EL showed significantly lower agitation than groups E and C right after recovery from anesthesia, right after arrival to the recovery room, and 10 minutes after arrival to the recovery room (P < 0.05). Groups L and EL showed no differences in the reduction of the severity of agitation (P > 0.05).Conclusion: Compared to the groups without lidocaine administration, groups L and EL, which received 2 mg/kg lidocaine, showed a higher level of reduction in agitation immediately after recovery from anesthesia and right after arrival to the recovery room (P < 0.05).

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“…22 Another theory centers around the anti-inflammatory properties of dexamethasone, which may help reduce inflammatory reaction's leading parasympathetically driven stimulation of the chemoreceptor trigger zone. 23,24 MPV is another marker of an inflammatory response, but it is a weak marker. 25,26 In our study, we also did not find any correlation between nausea and vomiting and MPV values.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging under Sedation in Pediatric Patients: A Single-Institution Experience

Aycan

Taseli

Temel

et al. 2021

Journal of Child Science

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Magnetic resonance imaging (MRI) scans for children are a challenge for anesthesiologists since the child must be sedated enough to stand still. But anesthetic drugs used for sedation might have serious side effects and monitorization resources and accessibility to the patient during MRI scan is limited. We retrospectively examined 977 pediatric patients' files who had MRI scans in our hospital. We observed that children received one of the four combinations of anesthetic drugs: group 1 received midazolam, propofol, and ketamine; group 2 received midazolam and ketamine; group 3 received midazolam and thiopental; and group 4 received midazolam and propofol combination for sedation. The patients in group 1 had significantly higher vomiting rates than the patients in group 4 (p = 0.005). We observed bronchospasm in patients in group 1 (p = 0.006) and group 3 (p = 0.001), more than in patients in group 4. Nausea and vomiting ratios were lower in group 4. In patients with nausea and vomiting within a week after the procedure, statistically significant lower neutrophil–lymphocyte ratio values (p = 0.012) were observed. All four anesthetic combinations used in the trial provided safe anesthesia for the children, during the MRI scan. The anesthetic choice must be made according to the procedure time and patient's comorbidities. In this trial, we observed minimum side effects with midazolam and propofol combination.

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Postoperative Nausea and Vomiting in Paediatric Anaesthesia

Cited by 18 publications

References 48 publications

Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

Comparison of the Agitation-Reducing Effects of Esmolol and Lidocaine in Pediatric Strabismus Surgery: A Double-Blind, Randomized Clinical Study

Magnetic Resonance Imaging under Sedation in Pediatric Patients: A Single-Institution Experience

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