This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Pusch, F. Articles by Krafft, P. Search for Related Content PubMed PubMed Citation Articles by Pusch, F. Articles by Krafft, P. Related Collections Cardiovascular Postanesthetic Care Unit Pharmacology

---

GENERAL ARTICLES

The Effects of Systolic Arterial Blood Pressure Variations on Postoperative Nausea and Vomiting

Franz Pusch^*, Alexander Berger^*, Eckart Wildling, Werner Tiefenthaler^*, and Peter Krafft^*

*Department of Anesthesiology and General Intensive Care, University of Vienna; and Department of Anesthesiology and General Intensive Care, Hospital of Korneuburg, Austria, Vienna

Address correspondence to Franz Pusch, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Address e-mail to franz.pusch{at}univie.ac.at

In this clinical study, we tested the hypothesis that a marked systolic blood pressure decrease >35% (SBP >35%) from preanesthetic baseline during the induction and maintenance of anesthesia is associated with more postoperative nausea and vomiting (PONV). In 300 ASA physical status I and II women undergoing elective gynecological surgery with general anesthesia, the maximum SBP during the induction as well as maintenance of general anesthesia were calculated. Observers blinded to hemodynamic variables assessed the incidence of PONV. The overall incidence of nausea (visual analog scale >4) and vomiting within the immediate observation period (0–2 h) was 39% and 25%, respectively. Frequency of nausea and vomiting in the late observation period was 21% and 9%, respectively. Women with a SBP >35% during the induction of anesthesia suffered from a more frequent incidence of PONV within the immediate (57% versus 35% and 41% versus 22%, respectively; P < 0.01) and within the late observation period (33% versus 18% and 19% versus 7%, respectively; P 0.01). In women with a SBP >35% during maintenance of anesthesia, a more frequent incidence of nausea within the immediate observation period (53% versus 36%; P < 0.05) was found. We conclude that a maximum SBP >35% during the anesthetic induction is associated with an increased incidence of PONV after gynecological surgery during general anesthesia.

IMPLICATIONS: A prospective clinical investigation revealed that a marked systolic blood pressure decrease >35% (SBP >35%) during the induction of general anesthesia is associated with an increased incidence of postoperative nausea and vomiting (PONV). The association between a SBP >35% during maintenance of general anesthesia and PONV is less pronounced.

This article has been cited by other articles:

				L. L. Haentjens, D. Ghoundiwal, K. Touhiri, M. Renard, E. Engelman, V. Anaf, P. Simon, L. Barvais, and B. E. Ickx Does Infusion of Colloid Influence the Occurrence of Postoperative Nausea and Vomiting After Elective Surgery in Women? Anesth. Analg., June 1, 2009; 108(6): 1788 - 1793. [Abstract] [Full Text] [PDF]

				C. L. Burlacu, D. Healy, D. J. Buggy, C. Twomey, D. Veerasingam, A. Tierney, and D. C. Moriarty Continuous Gastric Decompression for Postoperative Nausea and Vomiting After Coronary Revascularization Surgery Anesth. Analg., February 1, 2005; 100(2): 321 - 326. [Abstract] [Full Text] [PDF]

				J. J. Magner, C. McCaul, E. Carton, J. Gardiner, and D. Buggy Effect of intraoperative intravenous crystalloid infusion on postoperative nausea and vomiting after gynaecological laparoscopy: comparison of 30 and 10 ml kg-1 Br. J. Anaesth., September 1, 2004; 93(3): 381 - 385. [Abstract] [Full Text] [PDF]

				G. Verheecke and C. C. Apfel Early postoperative vomiting and volatile anaesthetics or nitrous oxide Br. J. Anaesth., January 1, 2003; 90(1): 109 - 110. [Full Text] [PDF]

				P. Kranke, N. Roewer, D. Rusch, S. N. Piper, F. Pusch, and E. Wildling Arterial Hypotension During Induction of Anesthesia May Not Be a Risk Factor for Postoperative Nausea and Vomiting * Response Anesth. Analg., January 1, 2003; 96(1): 302 - 303. [Full Text] [PDF]