Influence of the menstrual cycle on the incidence of nausea and vomiting after laparoscopic gynecological surgery: a pilot study.

Abstract

STUDY OBJECTIVE:

To investigate whether the phase of menstrual cycle influences the incidence of postoperative nausea and vomiting (PONV) in women undergoing general anesthesia for elective laparoscopic gynecological surgery.

DESIGN:

Prospective, observational, blinded study.

SETTING:

General hospital, Postanesthesia Care Unit, and gynecologic floor room.

PATIENTS:

111 ASA physical status 1 and 2 women, aged 18 to 53 years.

INTERVENTIONS:

Patients were classified into three groups according to the phase of menstrual cycle at the time of anesthesia: Group F1: follicular phase (menstrual days 1-8; n = 34); Group O2: ovulatory phase (days 9-15; n = 40); and Group L3: luteal phase (days 16 to end of cycle; n = 37). Anesthetic, postoperative pain management, and antiemetic regimens were standardized.

MEASUREMENTS:

Frequency of nausea, vomiting, or both were assessed for early (0-2 hrs). Late PONV (2-24 hrs) along with the use of rescue antiemetic, severity of nausea, and pain.

MAIN RESULTS:

In the follicular (n = 34), ovulatory (n = 40) and luteal phase (n = 37) groups, the frequencies of PONV over 24 hours were 35%, 38%, and 14% (P = 0.04), respectively. This was due to differences in the early postoperative period where the frequencies were 21%, 25%, and 3% (P = 0.02), respectively, as frequencies were similar in the late period (15%, 20% and 14%, P = 0.71), respectively. Nausea scores, rescue antiemetic usage, pain scores, and opioid consumption were similar in the groups.

CONCLUSION:

Patients in the luteal phase of their menstrual cycle may have a decreased risk of PONV after laparoscopic gynecological surgery in the early postoperative period.

• Authors: Tatjana Šimurina, Boris Mraovic, Neven Skitarelić, Tatjana Andabaka, Zdenko Sonicki
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 24 Issue 3 Pg. 185-92 (May 2012) ISSN: 1873-4529 [Electronic] United States
• PMID: 22459340 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Antiemetics

Topics

• Adolescent
• Adult
• Anesthesia, General (methods)
• Antiemetics (therapeutic use)
• Elective Surgical Procedures (methods)
• Female
• Follicular Phase (physiology)
• Gynecologic Surgical Procedures (methods)
• Hospitals, General
• Humans
• Incidence
• Laparoscopy (methods)
• Luteal Phase (physiology)
• Middle Aged
• Ovulation (physiology)
• Pain, Postoperative (epidemiology)
• Pilot Projects
• Postoperative Nausea and Vomiting (epidemiology)
• Prospective Studies
• Risk
• Severity of Illness Index
• Single-Blind Method
• Young Adult