[Using two different drug regimens to compare and evaluate the prevalence of postoperative nausea and vomiting [PONV] after abdominal hysterectomy using general anesthesia]

ABSTRACT

Postoperative nausea and vomiting [PONV] is a major unpleasant symptom in the postoperative period that has many causes, including the choice of anaesthetic drugs and induction. The prevention of PONV is considered as equally important as the prevention of postoperative pain. Thus, this study was performed to evaluate and compare the prevalence of PONV after abdominal hysterectomy using general anesthesia. To this end, the roles of two different drugs regimens, Propofol and Tiopental Sodium, were studied. This single-blinded clinical research study was carried out in Ariya Hospital during the years of 1387 and 1388 [H.S.]. For this study, 104 ASA class I or II women, aged 30-60 years, were scheduled for abdominal hysterectomy by the same surgeon. The operation lasted about 25 to 30 minutes. The samples of the study were randomized into one of two groups Group P [n=52] who received the induction of 2 mg/kg Propofol with the maintenance of 5 mg/kg/hr of Propofol. On the other hand, group T [n=52] were given the induction of 5 mg/kg Tiopental Sodium with the maintenance of 0.5 MAC Halothane. All the patients received 4 micro g/kg Fentanyl, 0.6 mg/kg Atracurium and the ventilation was controlled at O2/N2O 50/50. The number of patients suffering from nausea and/or vomiting at the recovery room was recorded within 6 and 24 hours after the operation. The data were then statistically analyzed using Chi-square and Fisher's exact test. After the operations, the number of patients experiencing nausea at the recovery room was%5.8 [n=3] for group P and%59.6 [n=31] for group T [P=0.001].%5.8 [n=3] of the patients in group P were vomiting while 28.8% [n=15] in group T [P=0.003] had that experience. The number of patients experiencing nausea within 6 hours after the operation was%55.8 [n=29] for group P and%67.3 [n=35] for group T [P=0.314]. In terms of vomiting in 6 hours of postoperation,%21.2 [n=11] of the patients in group P and%38.5 [n=20] in group T were having the experience [P=0.085]. Also, the results indicate that the number of patients experiencing nausea within 24 hours of postoperation was%3.8 [n=2] for group P and%32.7 [n=17] for group T [P=0.001]. However,%1.9 [n=1] of the patients in group P and%5.8 [n=3] in group T [P=0.618] were suffering from vomiting at the recovery room were significantly lower in group P than in group T, but the difference in 6 hours after operation was insignificant. Also, the prevalence of nausea in 24 hours after operation was significantly lower in group P than in group T, but the difference in terms of vomiting within the same period was insignificant. For women undergoing abdominal hysterectomy, the choice of induction and maintenance of general anesthesia with Propofol provides a better prophylaxis against PONV than the induction with Thiopental Sodium with the maintenance of Halothane