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BJA Advance Access published online on June 25, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh219
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted April 24, 2004

Clinical Investigation

Effect of intraoperative intravenous crystalloid infusion on postoperative nausea and vomiting after gynaecological laparoscopy: comparison of 30 and 10 ml kg-1

J. J. Magner 1*, C. McCaul 2, E. Carton 3, J. Gardiner 3, D. Buggy 4

1 Department of Anaesthesia, Rotunda Hospital, Parnell Square, Dublin 1, Ireland; Department of Anaesthesia, St Mary's NHS Trust, Praed St, London W2 1NY, UK
2 Divisions of Anaesthesia, Intensive Care Medicine and The Lung Biology Programme, The Hospital For Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
3 Department of Anaesthesia, Rotunda Hospital, Parnell Square, Dublin 1, Ireland; Department of Anaesthesia and Intensive Care Medicine, Mater Misericordiae Hospital, Eccles St, Dublin 7, Ireland
4 Department of Anaesthesia and Intensive Care Medicine, Mater Misericordiae Hospital, Eccles St, Dublin 7, Ireland

* To whom correspondence should be addressed. E-mail: jjmagner{at}irishanaesthesia.com.


  Abstract

Background. I.V. fluid administration has been shown to reduce postoperative nausea and vomiting (PONV). The optimum dose is unknown. We tested the hypothesis that administration of i.v. crystalloid of 30 ml kg-1 would reduce the incidence of PONV compared with 10 ml kg-1 of the same fluid.

Methods. A total of 141 ASA I female patients undergoing elective gynaecological laparoscopy were randomized, in double-blind fashion, to receive either 10 ml kg-1 (n=71; CSL-10 group) or 30 ml kg-1 (n=70; CSL-30 group) of i.v. compound sodium lactate (CSL).

Results. In the first 48 h after anaesthesia, the incidence of vomiting was lower in the CSL-30 group than in the CSL-10 group (8.6% vs 25.7%, P=0.01). Anti-emetic use was less in the CSL-30 group at 0.5 h (2.9% vs 14.3%, P=0.04). The incidence of severe nausea was significantly reduced in the treatment group at awakening (2.9% vs 15.7%, P=0.02), 2 h (0.0% vs 8.6%, P=0.04) and cumulatively (5.7% vs 27.1%, P=0.001). The numbers needed to treat to prevent vomiting, severe nausea and antiemetic use in the first 48 h were 6, 5 and 6, respectively.

Conclusion. I.V. administration of CSL 30 ml kg-1 to healthy women undergoing day-case gynaecological laparoscopy reduced the incidence of vomiting, nausea and anti-emetic use when compared with CSL 10 ml kg-1.

Keywords: anaesthesia, day case; anaesthetic techniques, i.v. infusion; complications, nausea and vomiting; fluids, i.v; postoperative nausea and vomiting; surgery, laparoscopy; vomiting, nausea; vomiting, nausea, anaesthetic factors; vomiting, nausea, incidence.
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