Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942009000500004
Brazilian Journal of Anesthesiology
Scientific Article

Oxigênio suplementar e incidência de náuseas e vômitos perioperatórios no parto cesariano sob anestesia subaracnoidea

Supplemental oxygen and the incidence of perioperative nausea and vomiting in cesarean sections under subarachnoid block

Fernanda Salomão Turazzi Pécora; Luiz Marcelo Sá Malbouisson; Marcelo Luis Abramides Torres

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Resumo

JUSTIFICATIVA E OBJETIVOS: Oxigênio suplementar pode reduzir a incidência de náuseas e vômitos pós-operatórios em pacientes submetidos à anestesia geral. O objetivo deste estudo foi testar a eficácia do oxigênio suplementar durante a cesariana eletiva sob anestesia subaracnoidea em diminuir a incidência de náuseas e vômitos perioperatórios. MÉTODO: Após indução de anestesia subaracnoidea padronizada, noventa e quatro parturientes submetidas ao parto operatório foram distribuídas de forma aleatória para receberem, através de cateter nasal tipo óculos, 4 L.min-1 de oxigênio (Grupo O) ou ar comprimido (Grupo S) até o final do procedimento. As pacientes foram inquiridas acerca da ocorrência de náuseas e vômitos durante a operação e nas primeiras seis e 24 horas de pós-parto. RESULTADOS: Os dois grupos mostraram-se comparáveis quanto às variáveis demográficas, perioperatórias e quanto aos dados do recém-nascido. No Grupo O, a incidência de náusea durante a operação nas primeiras 6 horas de pós-operatório e entre 6 e 24 horas de pós-operatório foi de 35%, 20% e 13%, respectivamente, enquanto no Grupo S foi de 35%, 30% e 19%, respectivamente. A incidência de vômito no Grupo O foi de 9%, 11% e 6% nos períodos correspondentes e no Grupo S 21%, 7% e 7%, respectivamente. Essas diferenças não foram significativas. CONCLUSÕES: Na população estudada, a oxigenoterapia suplementar desde a indução da anestesia até o término da operação não reduziu a incidência de náuseas ou vômitos intraoperatórios e pós-operatórios em mulheres submetidas ao parto cesariano sob anestesia subaracnoidea.

Palavras-chave

CIRURGIA, Obstétrica, COMPLICAÇÕES, TÉCNICAS ANESTÉSICAS, Regional

Abstract

BACKGROUND AND OBJECTIVES: Supplemental oxygen can reduce the incidence of postoperative nausea and vomiting in patients under general anesthesia. The objective of the present study was to determine the efficacy of supplemental oxygen to reduce the incidence of perioperative nausea and vomiting in elective cesareans under subarachnoid block. METHODS: After induction of standardized subarachnoid block, 94 parturients undergoing surgical delivery were randomly divided to receive 4 L.min-1 of oxygen (Group O) or medical air (Group S) under nasal cannula throughout the procedure. Patients were questioned on the development of nausea and vomiting during the surgery and in the first six and 24 hours after the procedure. RESULTS: Demographic and perioperative parameters, as well as the data on the newborn, were comparable in both groups. In Group O, the incidence of nausea during the surgery, in the first 6 hours afterwards, and between 6 and 24 hours was 35%, 30%, and 19%, respectively, while in Group S, it was 35%, 30%, and 19%, respectively. In Group O, the incidence of vomiting was 9%, 11% and 6% in the corresponding periods, and in Group S, 21%, 7% and 7%, respectively. Those differences were not statistically significant. CONCLUSIONS: The administration of supplemental oxygen from anesthetic induction until the end of the surgery did not reduce the incidence of intra- and postoperative nausea or vomiting in women undergoing cesarean section under subarachnoid block.

Keywords

ANESTHETIC TECHNIQUES, Regional, COMPLICATIONS, SURGERY, Obstetric

References

Abouleish E, Rawal N, Fallon K. Combined intrathecal morphine and bupivacaine for Cesarean section. Anesth Analg. 1988;67:370-374.

Abouleish E, Rawal N, Rashad MN. The addition of 0.2 mg subarachnoid morphine to hyperbaric bupivacaine for cesarean delivery: a prospective study of 856 cases. Reg Anesth. 1991;16:137-140.

Dahl JB, Jeppesen IS, Jorgensen H. Intraoperative and postoperative analgesic efficacy and adverse effects of intrathecal opioids in patients undergoing Cesarean section with spinal anesthesia: a qualitative and quantitative systematic review of randomized, controlled trials. Anesthesiology. 1999;91:1919-1927.

Abboud TK, Dror A, Mosaad P. Mini-dose intrathecal morphine for the relief of post-cesarean section pain: safety, efficacy, and ventilatory responses to carbon dioxide. Anesth Analg. 1988;67:137-143.

Swart M, Sewell J, Thomas D. Intrathecal morphine for caesarean section: an assessment of pain relief, satisfaction and side-effects. Anaesthesia. 1997;52:373-377.

Fujii Y, Tanaka H, Toyooka H. Prevention of nausea and vomiting with granisetron, droperidol and metoclopramide during and after spinal anaesthesia for caesarean section: a randomized, double-blind, placebo-controlled trial. Acta Anaesthesiol Scand. 1998;42:921-925.

Abouleish EI, Rashid S, Haque S. Ondansetron versus placebo for the control of nausea and vomiting during Caesarean section under spinal anaesthesia. Anaesthesia. 1999;54:479-482.

Chaney MA. Side effects of intrathecal and epidural opioids. Can J Anaesth. 1995;42:891-903.

Watcha MF, White PF. postoperative nausea and vomiting: its etiology, treatment and prevention. Anesthesiology. 1992;77:162-184.

Habib AS, Itchon-Ramos N, Phillips-Bute BG. Transcutaneous acupoint electrical stimulation with the ReliefBand for the prevention of nausea and vomiting during and after cesarean delivery under spinal anesthesia. Anesth Analg. 2006;102:581-584.

Rowbotham DJ. Recent advances in the non-pharmacological management of postoperative nausea and vomiting. Br J Anaesth. 2005;95:77-81.

Jordan MJ, Hill D. Women undergoing caesarean section under regional anaesthesia should routinely receive supplementary oxygen. Int J Obst Anesth. 2002;11:282-288.

Backe SK, Lyons G. Oxygen and elective Caesarean section. Br J Anaesth. 2002;88:4-5.

Greif R, Laciny S, Rapf B. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology. 1999;91:1246-1252.

Goll V, Akca O, Greif R. Ondansetron is no more effective than supplemental intraoperative oxygen for prevention of postoperative nausea and vomiting. Anesth Analg. 2001;92:112-117.

Joris JL, Poth NJ, Djamadar AM. Supplemental oxygen does not reduce postoperative nausea and vomiting after thyroidectomy. Br J Anaesth. 2003;91:857-861.

Purhonen S, Turunen M, Ruohoaho UM. Supplemental oxygen does not reduce the incidence of postoperative nausea and vomiting after ambulatory gynecologic laparoscopy. Anesth Analg. 2003;96:91-96.

Purhonen S, Niskanen M, Wustefeld M. Supplemental oxygen for prevention of nausea and vomiting after breast surgery. Br J Anaesth. 2003;91:284-287.

Purhonen S, Niskanen M, Wustefeld M. Supplemental 80% oxygen does not attenuate postoperative nausea and vomiting after breast surgery. Acta Anaesthesiol Scand. 2006;50:26-31.

Donaldson AB. The effect of supplemental oxygen on postoperative nausea and vomiting in children undergoing dental work. Anaesth Intensive Care. 2005;33:744-748.

Treschan TA, Zimmer C, Nass C. Inspired oxygen fraction of 0.8 does not attenuate postoperative nausea and vomiting after strabismus surgery. Anesthesiology. 2005;103:6-10.

Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006;102:1884-1898.

Phillips TW Jr, Broussard DM, Sumrall WD 3rd. Intraoperative oxygen administration does not reduce the incidence or severity nausea or vomiting associated with neuraxial anesthesia for cesarean delivery. Anesth Analg. 2007;105:1113-1117.

Nortcliffe SA, Shah J, Buggy DJ. Prevention of postoperative nausea and vomiting after spinal morphine for Caesarean section: comparison of cyclizine, dexamethasone and placebo. Br J Anaesth. 2003;90:665-670.

Borgeat A, Ekatodramis G, Schenker CA. postoperative nausea and vomiting in regional anesthesia: a review. Anesthesiology. 2003;98:530-547.

Balki M, Carvalho JC. Intraoperative nausea and vomiting during cesarean section under regional anesthesia. Int J Obstet Anesth. 2005;14:230-241.

Ghods AA, Soleimani M, Narimani M. Effect of postoperative supplemental oxygen on nausea and vomiting after cesarean birth. J PeriAnesth Nurs. 2005;20:200-205.

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