[Nausea and vomiting after gynecologic laparoscopies]

Abstract

Objective: To investigate the occurrence of postoperative nausea and vomiting (PONV) in relation to the menstrual cycle in patients anaesthetised with isoflurane and propofol.

Methods: 150 patients were randomly allocated to two groups (n = 75). All patients received antiemetic treatment with 20 micrograms/kg droperidol i.v. before induction of anaesthesia. In the isoflurane group, patients were anaesthetised with thiopental, fentanyl, vecuronium, and isoflurane; in the propofol group, with propofol, fentanyl, and vecuronium. Patients were ventilated with nitrous oxide/oxygen in both groups.

Results: Under isoflurane-based anaesthesia PONV occurred in 22 (29%) patients, under propofol-based anaesthesia in 4 (5%) patients (p < 0.05). 41 study participants underwent laparoscopy during the first 8 days of the menstrual cycle. 12 (29%) of these patients developed PONV (p < 0.05 vs second and third phase of the menstrual cycle). 10 of these 12 study participants were in the isoflurane group. Postoperative shivering occurred in 38 (51%) patients anaesthetised with isoflurane and in 12 (16%) patients of the propofol group (p < 0.05).

Conclusions: The incidence of PONV is significantly higher when patients undergo laparoscopy during the first 8 days of the menstrual cycle. When compared to isoflurane, propofol results in a significantly lower incidence of PONV and postoperative shivering and a lower occurrence of postoperative pain.