Effect of Intra-Operative Intravenous Crystalloid Infusion on Post-Operative Nausea and Vomiting after Diagnostic Gynaecological Laparoscopy- Comparison of 30 mL/Kg & 15 mL/Kg.

Laparoscopic procedures have the advantages of minimal incision, early recovery, lesser post-operative pain and early ambulation. However, they are associated with an increased incidence of post-operative nausea and vomiting (PONV), which is all the more frequent in gynaecological laparoscopic surgeries. In our study, we have evaluated the effectiveness of intra-operative intravenous crystalloid infusion on post-operative nausea and vomiting after diagnostic gynaecological laparoscopy.METHODSInformed consent was obtained and patients were randomly divided into two groups. Group 1 received 30 mL/Kg intravenous crystalloid infusion intra operatively and group 2 received 15 mL/Kg intravenous crystalloid infusion. Incidence of nausea, incidence of emesis (retching or vomiting), the amount of rescue antiemetic used, and the haemodynamic parameters were noted in the postoperative period for 12 hours for both the groups.RESULTSIncidence of PONV was much more in group 2 in 0, 1, 2, 3, 4, 6 hours post operatively and rescue antiemetic use was much more in group 2 in total 12 hours post-operative period. There was no statistically significant difference in hemodynamic parameters between Group 1 and Group 2.CONCLUSIONSIntra-operative administration of 30 mL/Kg of crystalloid infusion significantly reduces the incidence of PONV and rescue antiemetic use compared to 15 mL/Kg crystalloid infusion in diagnostic gynaecological laparoscopy. So, it can be used as a non-pharmacological method for prophylaxis of PONV.

Analgesic effects of preoperative caudal injection with tramadol in patients after receiving gynaecological laparoscopy under general anesthesia / 中国微创外科杂志

Objective To observe the analgesic effects of preoperative tramadol caudal injection in patients after receiving gynaecological laparoscopy under general anesthesia. Methods A total of 60 patients scheduled for gynaecological laparoscopic operations under general anesthesia was randomly divided into two groups with 30 patients each.The Group A was given an injection of tramadol 100 mg,2% lidocaine 5 ml,ondansetron 4 mg,and normal saline 20 ml by caudal route preoperatively,while the Group B was given an intravenous drip of tramadol 100 mg and ondansetron 4 mg at 10 minutes before the end of operation.The Visual Analog Scale(VAS) pain scores and the Ramsay Sedation Scores were recorded after extubation,before the departure from operation room,and at 1,3,and 6 hours after surgery,respectively.Adverse effects of dysphoria,dizziness,drowsiness,nausea,and vomiting were recorded.Results The VAS scores were significantly lower after extubation,before the departure from operation room,and at 1 and 3 hours after surgery in the Group A than in the Group B(t=-5.961,-8.362,-4.038,-3.565;P=0.000), while the difference was not significant between the two groups at 6 hours after surgery(t=-1.403,P=0.166).The Ramsay scores were significantl higher after extubation,before the departure from operation room,and at 1 and 3 hours after surgery in the Group A than in the Group B(t=9.409,10.407,8.167,4.082;P=0.000),while the difference was not significant between the two groups at 6 hours after surgery(t=0.428,P=0.670).Significantly more patients presented dysphoria,dizziness,nausea,and vomiting in the Group B than in the Group A after extubation and before the departure from operation room.Conclusions Tramadol 100 mg caudal injection before operation can produce a better postoperative analgesic effect in patients receiving gynaecological laparoscopic operations.