effect of preoperative fluid therapy on post operative nausea and vomiting [comparison of colloids vs. crystalloids]

ABSTRACT

The objectives of this study were To compare the incidence of postoperative nausea and vomiting in both groups. To compare the degree of postoparative pain relief in both groups. The study was done at HDU and Gynae ward II, Nishtar Hospital Multan. It was completed in 5 months period from 2nd jan 2005-2nd June 200511 was a prospective, double blind randomized controlled trial done on 70 patients, belonging to ASA I and II who were admitted for transabdominal hysterectomy. All the patients were randomly allocated to receive 5ml/kg Haes Steril 6% [group I] or 15ml/kg Hartmann's solution [group H] intravenouly shortly, before induction of anaesthesia. During the operation, fluid management was identical in both groups. Postoperatively they were kept in HDU for 12 hours. The severity of nausea, episodes of vomiting, degree of pain, and the need for supplemental antiemetic and analgesics drugs, were assessed by staff at HDU, at 0-1 hr 1-12 hr, for PONV and at 0,6,12 hrs. [for pain. Where as later on at 12-24 hrs postoperatively, these were assessed by a blinded investigator at the respective wards of the patients. Patients were asked to rate their nausea on a 100-mm VAS at 15min intervals throughout recovery [0=no nausea; 100=the worst imaginable nausea]. A score of SO mm or greater was considered significant. During the first postoperative 24 h, postoperative nausea occurred in 3 patients [8.5%] in the group I, and in 4 patients [11.4%] in-group II [p=<0.05], whereas vomiting occurred in 2 patients in gp I and in 3 patients in gp II. The mean pain scores were also slightly lower in gp I than in gp II. We concluded from our study that colloid .substitutes administered in smaller volume produced same, rather slightly more beneficial effects on PONV and postoperative pain compared to the crystalloids given in larger volume and can therefore be of great benefit to patients with fluid restriction