Postoperative nausea and vomiting (PONV) in outpatient repair of inguinal hernia


COD: 01_2018_12_2768 Categorie: ,

Piergaspare Palumbo, Sofia Usai, Chiara Amatucci, Valentina Taurisano Pulli,
Giulio Illuminati, Francesco Vietri, Guglielmo Tellan

Ann. Ital. Chir., 2018 89, 1: 75-80

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PURPOSE: Nausea and vomiting are among the most frequent complications following anesthesia and surgery. Due to
anesthesia seems to be primarily responsible for post operative nausea and vomiting (PONV) in Day Surgery facilities,
the aim of the study is to evaluate how different methods of anesthesia could modify the onset of postoperative nausea
and vomiting in a population of patients undergoing inguinal hernia repair.
METHODS: Ninehundredten patients, aged between 18 and 87 years, underwent open inguinal hernia repair. The PONV
risk has been assessed according to Apfel Score. Local anesthetic infiltration, performed by the surgeon in any cases, has
been supported by and analgo-sedation with Remifentanil in 740 patients; Fentanyl was used in 96 cases and the last
74 underwent deep sedation with Propofol .
RESULTS: Among the 910 patients who underwent inguinal hernia repair, PONV occurred in 68 patients (7.5%). Among
patients presenting PONV, 29 received Remifentanil, whereas 39 received Fentanyl. In the group of patients receiving
Propofol, no one presented PONV. This difference is statistically significant (p < .01). Moreover, only 50 patients of the total sample received antiemetic prophylaxis, and amongst these, PONV occurred in 3 subjects. CONCLUSIONS: Compared to Remifentanil, Fentanyl has a major influence in causing PONV. Nonetheless, an appropriate antiemetic prophylaxis can significantly reduce this undesirable complication.