medigraphic.com
ISSN 1995-9494 (Electronic)
Revista del Hospital Clínico Quirúrgico "Arnaldo Milián Castro"

2022, Number 1

<< Back Next >>

Acta Med Cent 2022; 16 (1)

Incidencia de náuseas y vómitos postoperatorios en anestesia espinal para cirugía electiva

Nieto MCG, Pérez CD, Santiago PA, Cruz GO, Álvarez HLM, Barreto FEE

Language: Spanish
References: 29
Page: 58-68
PDF size: 444.86 Kb.


ABSTRACT

Introduction: postoperative nausea and vomiting is a troublesome side effect after spinal anesthesia, increases the need for perioperative care and is associated with more postoperative morbidity.
Objective: to determine the incidence of postoperative nausea and vomiting in patients undergoing spinal anesthesia in elective surgery.
Methods: an observational, descriptive, cross-sectional, descriptive study was performed in 502 patients from January 2017 to December 2018. The variables sex, age, smoking, history of motion sickness and nausea (or both) and postoperative vomiting, anesthetic agents used, use of postoperative opioids, type of surgery according to diagnosis, hospital stay and approach to the surgical site, surgical time and occurrence of nausea and vomiting in the first 24 hours postoperatively were evaluated.
Results: the incidence of postoperative nausea and vomiting was 10.16% with a predominance in the female sex, non-smokers, those with a history of postoperative nausea and vomiting and motion sickness (or both), in gynecological surgery, in patients with surgical time equal to or greater than one hour and when postoperative opioids were used. Age, anesthetic agents used for spinal anesthesia, approach to the surgical site, and hospital stay were not associated with an increased incidence of postoperative nausea and vomiting.
Conclusions: the incidence of postoperative nausea and vomiting was low and the higher number of risk factors was associated with higher occurrence of nausea and vomiting.


REFERENCES

  1. Frelich M, Divák J, Vodička, V, Masárová M, Jor O, Gál R. Dexamethasone reduces the incidence of postoperative nausea and vomiting in children undergoing endoscopic adenoidectomy under general anesthesia without increasing the risk of postoperative hemorrhage. Med Sci Monit [Internet]. 2018 [citado 02/12/2019];24:8430-8438. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263352/. https://dx.doi.org/10.12659/MSM.911231

  2. Nazar C, Bastidas J, Coloma R, Zamora M, Fuentes R. Prevención y tratamiento de pacientes con nauseas y vómitos postoperatorios. Rev Chil Cir [Internet]. 2017 [citado 02/12/2019];69(5):421-28. Disponible en: https://www.elsevier.es/es-revista-revista-chilena-cirugia-266-articulo-prevencion-tratamiento-pacientes-con-nauseas-S0379389317300388. https://dx.doi.org/10.1016/j.rchic.2017.02.009

  3. Meyer MJ, George EE. La unidad de cuidados postanestésicos. En: Pino RM, editor. Manual de procedimientos de anestesia clínica del Massachusetts General Hospital. 9a ed. Philadelphia: Wolters Kluwer; 2016. p. 594-613.

  4. Robles-Espinosa GD, Martínez-Ramírez JS, Torres-Alarcón CG. Prevalencia de nausea y vómito postoperatorio en colecistectomía laparoscópica en un tercer nivel de atención. Rev Mex Anestesiol [Internet]. 2019 [citado 02/12/2019];42(1):19-27. Disponible en: https://www.medigraphic.com/pdfs/rma/cma-2019/cma191c.pdf

  5. Pérez Caballero D, Nieto Monteagudo CG. Nauseas y vómitos postoperatorios en anestesia general para intervencion quirúrgica electiva. Acta Méd Centro [Internet]. 2017 [citado 02/12/2019];11(3):39-48. Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/845/1050

  6. Apfel CC, Heidrich FM, Jukar-Rao S, Jalota L, Hornuss C, Whelan RP, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth [Internet]. 2012 [citado 02/12/2019];109(5):742-53. Disponible en: https://pubmed.ncbi.nlm.nih.gov/23035051/. https://doi.org/10.1093/bja/aes276

  7. Apfel CC. Nauseas y vómitos postoperatorios. En: Miller RD, editor. Miller Anestesia. 8a ed. Barcelona: Elseivier; 2015. p. 864-914.

  8. Koivuranta M, Läärä E, Snåre L, Alahuhta S. A survey of postoperative nausea and vomiting. Anaesthesia [Internet]. 1997 [citado 02/12/2019];52(5):443-449. Disponible en: https://pubmed.ncbi.nlm.nih.gov/9165963/. https://doi.org/10.1111/j.1365-2044.1997.117-az0113.x

  9. Brull R, Mc Farlane AJ, Chan VW. Anestesia intradural, epidural y caudal. En: Miller RD, editor. Miller Anestesia. 8a ed. Barcelona: Elseivier; 2015. p. 1684-1720.

  10. Haro-Haro B, Zamora SA, Almonte de León H. Control de nausea y vómito postoperatorio en pacientes con colecistectomia laparoscópica. Anest Méx [Internet] 2016 [citado 02/12/2019];28(3):38-46. Disponible en: http://www.scielo.org.mx/pdf/am/v28n3/2448-8771-am-28-03-00038.pdf

  11. De la O Ríos E. Náuseas y vómitos postoperatorios. Rev Med Costa Rica Centroam [Internet]. 2016 [citado 02/12/2019];73(620):565-70. Disponible en: https://www.medigraphic.com/pdfs/revmedcoscen/rmc-2016/rmc163ab.pdf

  12. Jelting Y, Klein C, Harlander T, Eberhart L, Roewer N, Kranke P. Preventing nausea and vomiting in women undergoing regional anesthesia for cesarean section: challenges and solutions. Local Reg Anesth [Internet]. 2017 [citado 02/12/2019];10:83-90. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558589/. https://dx.doi.org/10.2147/LRA.S111459

  13. Oliveira Campos G, Martins MJ, Nascimento Jesús G, Rios de Oliveira PR, Nogueira Lessa C, Macêdo Fernandes de Oliveira JC, et al. Palonosetron versus ondansetron for prevention of nausea and vomiting after total abdominal hysterectomy under spinal anesthesia with intrathecal morphine: a double-blind, randomizaed controlled trial. BMC Anesthesiol [Internet]. 2019 [citado 02/12/2019];19(1):159. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698358/. https://dx.doi.org/10.1186/s12871-019-0830-7

  14. Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg [Internet]. 2020 [citado 02/12/2019];131(2):411-448. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32467512/. https://doi.org/10.1213/ane.0000000000004833

  15. Sansonnens J, Taffé P, Burnaud B. Higher ocurrence of nausea and vomiting after total hip arthroplasty using general versus spinal anesthesia: an observational study. BMC Anesthesiol [Internet]. 2016 [citado 02/12/2019];16(1):44. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962505/. https://dx.doi.org/10.1186/s12871-016-0207-0

  16. Veiga Gil L, Pueyo J, López Olaondo L. Náuseas y vómitos postoperatorios: fisiopatología, factores de riesgo, profilaxis y tratamiento. Rev Esp Anestesiol Reanim [Internet]. 2017 [citado 02/12/2019];64(4):223-232. Disponible en: https://medes.com/publication/119392. https://dx.doi.org/10.1016/j.redar.2016.10.001

  17. Gempeler Rueda FE, Miranda Pineda N, Garrido Hartmann A, Echeverry Lombana MP, Tobos González LM, Acosta Fernández CF. Incidencia de náusea y vómito postoperatorio y factores asociados en el Hospital Universitario de San Ignacio. Univ Med [Internet]. 2016 [citado 02/12/2019];57(1):11-21. Disponible en: https://revistas.javeriana.edu.co/index.php/vnimedica/article/view/16525/13245. https://doi.org/10.11144/Javeriana.umed57-1.invp

  18. Ferretiz López G. Actualidades en el tratamiento farmacológico para la profilaxis y tratamiento de las náuseas y vómitos postoperatorios en paciente oncológico sometido a cirugía. Rev Mex Anestesiol [Internet]. 2018 [citado 02/12/2019];41(Supl 1):S144-S149. Disponible en: https://www.medigraphic.com/pdfs/rma/cma-2018/cmas181ax.pdf

  19. Wang XX, Zhou Q, Pan DB, Deng HW, Zhou AG, Huang FR, et al. Dexamethasone versus ondansetron in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a meta analysis of randomized controlled trials. BMC Anesthesiol [Internet]. 2015 [citado 02/12/2019];15:118. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536735/. https://dx.doi.org/10.1186/s12871-015-0100-2

  20. Guerra-Gómez CA, Gil-Ascencio M, Loretto-Guerra CI, Morgado-Pérez J. Comparasión de la eficacia de difenidol vs dexametasona para disminuir la náusea y el vómito postoperatorios en pacientes sometidos a timpanoplastia, mastoidectomía o ambas. An Orl Mex [Internet]. 2015 [citado 02/12/2019];60(1):1-5. Disponible en: https://www.medigraphic.com/pdfs/anaotomex/aom-2015/aom151a.pdf

  21. Tobi KU, Imarengiaye CO, Amadasun FE. The effects of dexamethasone and metoclopramide on early and late postoperative nausea and vomiting in woman undergoing myomectomy under spinal anaesthesia. Niger J Clin Pract [Internet]. 2014 [citado 02/12/2019];17(4):449-55. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24909468/. https://doi.org/10.4103/1119-3077.134036

  22. Grant M, Kim J, Hobson D, Wick E, Wu C. The effect of intravenous midazolam on postoperative nausea and vomiting: A meta-analysis. Anesth Analg [Internet]. 2016 [citado 02/12/2019];122(3):656-63. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26332858/. https://doi.org/10.1213/ane.0000000000000941

  23. Alcantara Muñóz MR, Alarcón Rodríguez JJ, Hernández Cortés C. Palonosetrón comparado con ondansetrón en terapia combinada con dexametasona para la prevencion de náusea y vómito postoperatorio en pacientes con alto riesgo sometidos a funduplicatura por laparoscopia. Acta Méd Grupo Ángeles [Internet]. 2015 [citado 02/12/2019];13(1):5-8. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=56740

  24. Therneau IW, Martin EE, Sprung J, Kellogg TA, Schroeder DR, Weingarten TN. The role of aprepitant in prevention of postoperative nausea and vomiting after bariatric surgery [Internet]. 2018 [citado 02/12/2019];28(1):37-43. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28674839/. https://doi.org/10.1007/s11695-017-2797-0

  25. González Castilla R. Dexametasona en la profilaxis de náuseas y vómitos postoperatorios. Rev Cuba Anestesiol Reanim [Internet]. 2016 [citado 02/12/2019];15(1):1-6. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726-67182016000100004

  26. Veitía Wilson EC, Martínez Leyva L, Amable Díaz T, Martínez Romero M, Morales Martínez I. Terapia combinada en la profilaxis de las náuseas y vómitos postoperatorios en cirugía laparoscópica. Rev Cub Med Mil [Internet]. 2019 [citado 02/12/2019];48(4):855-874. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572019000400013

  27. Fukuda K. Analgésicos opiodes. En: Miller RD, editor. Miller Anestesia. 8a ed. Barcelona: Elseivier; 2015. p. 864-914

  28. Koju RB, Gurung BS, Dongol Y. Prophilactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section. BMC Anesthesiol [Internet]. 2015 [citado 02/12/2019];15:18. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429329. https://dx.doi.org/10.1186/1471-2253-15-18

  29. Lee J, Solt K. Anestésicos intravenosos e inhalados. En: Pino RM, editor. Manual de procedimientos de anestesia clínica del Massachusetts General Hospital. 9a ed. Philadelphia: Wolters Kluwer; 2016. p. 162-176.




2020     |     www.medigraphic.com