Low Pressure (8 mmHg) Pneumoperitoneum does not Reduce the Incidence and Severity of Postoperative Nausea and Vomiting (PONV) following Gynecologic Laparoscopy / 대한마취과학회지

ABSTRACT

BACKGROUND: Postoperative nausea and vomiting (PONV) is distressing complication of anesthesia and surgery, with a relatively high incidence in women undergoing gynecologic laparoscopy. Therefore, this study aimed to investigate occurrence and severity of PONV of low pressure (LP [8 mmHg]) in comparison to standard pressure (SP [13 mmHg]) pneumoperitoneum. METHODS: 46 consecutive patients qualified for elective gynecologic laparoscopy were randomly allocated to either SP group (n = 23) or LP group (n = 23). All the patients were separately evaluated at three intervals of 0-2 h, 2-6 h and 6-24 h during the first postoperative 24 hours with regard to emetic symptoms. Additionally, the degree of surgical exposure in LP group was rated in 4-point scale by surgeon. RESULTS: The overall incidence of PONV during the initial 24 postoperative hours did not differ between the groups (65.2% in LP group vs 82.6% in SP group, P = 0.314). There was also no difference between the groups in regard to the incidence and severity of PONV and postoperative nausea, consumption of analgesics and the need for rescue ondansetron at any separate observation periods. However, some degrees of surgical difficulties were rated in 12 patients (52.1%) from LP group. Furthermore, mean estimated blood loss in LP group was significantly increased than in SP group (P < 0.05). CONCLUSIONS: We conclude that lowering of the insufflation pressure to 8 mmHg can not reduce the incidence and severity of PONV after gynecologic laparoscopy and even increase the noticeable surgical difficulties and risks in some cases.