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Anesth Analg 2002;95:476-479
© 2002 International Anesthesia Research Society


GENERAL ARTICLES

Perioperative Gastric Emptying Is Not a Predictor of Early Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

M. Wattwil, MD PhD*{ddagger}, S.-E. Thörn, MD PhD*, A Lövqvist*, L. Wattwil*, H. Klockhoff, MD{dagger}, L.-G. Larsson, MD{dagger}, and I. Näslund, MD PhD{dagger}

Departments of *Anesthesiology and Intensive Care and {dagger}Surgery, Örebro University Hospital, Örebro; and {ddagger}Department of Medicine and Care, Faculty of Health Sciences, Linköping, Sweden

Address correspondence and reprint requests to Magnus Wattwil, MD, PhD, Department of Anesthesiology and Intensive Care, Örebro University Hospital, SE-701 85 Örebro, Sweden. Address e-mail to magnus.wattwil{at}orebroll.se

It is not known whether patients with postoperative nausea and vomiting (PONV) have delayed gastric emptying compared with patients without PONV. We compared the perioperative rate of gastric emptying in patients experiencing PONV with the rate in those without PONV immediately after laparoscopic cholecystectomy. Gastric emptying was studied by the acetaminophen method. Acetaminophen is not absorbed from the stomach but is rapidly absorbed from the small intestine, and the rate of gastric emptying therefore determines the rate of absorption of acetaminophen administered into the stomach. Forty patients (ASA physical status I and II) were included in the study. After the induction of anesthesia, a gastric tube was positioned in the stomach and 1.5 g of acetaminophen dissolved in 200 mL of water was administered. Venous blood samples for the determination of serum acetaminophen concentrations were taken before and at 15-min intervals during a period of 180 min after the administration of acetaminophen. Twenty-six patients experienced nausea during the first 4 h postoperatively. The other 14 patients had no nausea. There were no statistically significant differences in the maximal acetaminophen concentration, the time taken to reach the maximal concentration, or the area under the serum acetaminophen concentration time curves from 0 to 60, 0–120, and 0–180 min between the groups of patients with or without PONV. We did not find any relationship between postoperative gastric emptying and PONV, and therefore gastric emptying is not a predictor of PONV.

IMPLICATIONS: The incidence of postoperative nausea and vomiting is frequent after laparoscopic cholecystectomy. This study has shown that perioperative gastric emptying is not a predictor of early postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.




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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]




Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2002 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.