Effect of preoperative hydration on postoperative nausea and vomiting

ABSTRACT

Postoperative nausea and vomiting [PONV] remains one of the most common postoperative complications, causing discomfort, patient dissatisfaction, delayed discharge and increased costs. Our aim: Was to determine whether preoperative IV rehydration with a balanced salt solution would decrease the incidence of PONV in patients at increased risk for these symptoms. Sixty female patients [physical status ASA class I and II] presenting for laparoscopic cholecystectomy were included in the study and were instructed to fast from the previous midnight. Patients were randomly assigned to either a control group [group 1] or a high infusion group [group 2] according to the volume of fluid infused preoperatively. Patients of control group [group 1] didn't receive pre-operative fluid bolus, whereas patients of the high infusion group [group 2] received pre-operative fluid bolus of Ringer's solution in a volume of 1.5 mL kg[-1] h[-1] of fasting time. This volume was completely administered in group 2 before induction of anesthesia, over approximately 30 min, in the preoperative holding area. The incidence of PONV, was assessed by a blinded investigator during the stay in post anesthesia care unite [PACU], and at 6, 12 and after 24 hrs postoperatively. Post-operative adverse effects [thirst, pain and drowsiness], and the need for supplemental antiemetic and analgesic therapy were also recorded during stay in PACU and for 24 hrs. The incidence of PONV and the need for anti-emetics were significantly reduced in the high volume infusion group at all time intervals. The high volume infusion group also had decreased postoperative thirst, drowsiness, and pain scores and required less supplemental analgesia. Preoperative hydration effectively reduces the incidence of PONV, antiemetic and analgesic requirements in patients with increased risk of PONV