Supplemental oxygen for prevention of nausea and vomiting after breast surgery

Abstract

The incidence of vomiting decreased during the short postoperative administration of supplemental oxygen 50%. However, perioperative oxygen 50% administration did not prevent PONV over the 24-h follow-up period in patients undergoing breast surgery performed under general anaesthesia.

Supplemental oxygen does not prevent postoperative nausea and vomiting after gynecological laparoscopy

“…These later studies may be limited by sub-therapeutic levels of supplemental oxygen. 5 Our study adds further to this evidence and clearly demonstrates that supplemental intraoperative 80% oxygen, compared with routine intraoperative 30% oxygen, does not reduce the incidence of PONV during the initial 24-hr period among women undergoing laparoscopic gynecological surgery. No benefit was observed in any ''subgroup'' time periods, including immediately following surgery in the PACU (pre-discharge), time after discharge from hospital (post-discharge), early PONV (0-6 hr), or late PONV ([6-24 hr).…”

“…4 Later studies in subjects undergoing breast surgery, ambulatory gynecologic laparoscopy, thyroidectomy, laparoscopic cholecystectomy strabismus, or dental surgery failed to demonstrate any benefit from supplemental intraoperative oxygen on PONV. [5][6][7][8][9][10][11] A recent meta-analysis of 1729 patients from ten studies has been published (since the conduct of this trial but prior to this current study publication) synthesizing the data from the aforementioned studies. Regardless of the type of surgery, the meta-analysis did not demonstrate any overall effect from supplemental intraoperative oxygen on PONV.…”

“…[5][6][7][8][9][10][11] The relevance of these findings with respect to gynecological laparoscopic procedures is unclear, since only one of these subsequent studies involved subjects undergoing gynecological laparoscopic procedures 6 where the beneficial effects of supplemental oxygen had been previously observed. 4 To help elucidate the potential benefit of supplemental intraoperative oxygen in this high-risk population, we hypothesized that administering intraoperative supplemental 80% oxygen, compared with administering 30% oxygen, would reduce the incidence of postoperative nausea and/or reduce vomiting by 50% among women for up to 24 hr following ambulatory laparoscopic gynecological surgery of short (less than 1 hr) duration.…”

Effects of high intraoperative inspired oxygen on postoperative nausea and vomiting in gynecologic laparoscopic surgery

“…Purhonen's group [8] investigated influence of FIO 2 of 0.5 in breast surgery and did not find the difference in PONV compared with FIO 2 of 0.3, 89% vs. 82%, at 24 hours, but the incidence of POV at 2 hours was significantly different, 0% vs. 12%, respectively. In the current study only FIO 2 of 0.8 decreased the incidence of early POV compared with FIO 2 of 0.3 ( Table 3).…”

“…FIO 2 of 0.5 is more commonly used in anesthesia practice when higher FIO 2 is desirable. One study found no effect of FIO 2 of 0.5 on PONV in patients undergoing breast surgery but suggested beneficial effect on early postoperative vomiting [8].…”