الفهرس 
Introduction and Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Aim of the work
To compare the efficacy of crystalloid infusion versus ephedrine injection in prevention of postoperative nausea and vomiting in patients undergoing diagnostic gynecological laparoscopy for infertility under general anesthesia.
Results
This study included 60 patients who were divided randomly into three groups. Group I included 20 patients who received 10 ml / kg Ringer lactate as a control group. Group II included20 patients who received 30 ml/ kg Ringer lactate. Group III included 20 patients who received 0.5 mg / kg ephedrine I.M.
I)Demographic and operative data:
The three groups were comparable as regard mean age, weight, ASA type and anesthetic duration (table 1).
II)Hemodynamic parameters and oxygen saturation :
There was a state of hemodynamic stability throughout the study period in all groups. There was insignificant change as regard the mean heart rate (table 2, figure 1) ,the mean arterial blood pressure (table 3, figure 2) and the mean oxygen saturation (table 4, figure 3) in the three groups.
III)Recovery
As regard recovery from anesthesia there was insignificant difference between the three groups. The mean time to reach Aldrete recovery score 9 was 7 min in group I , 8 min in group II and 6.5 minutes in group III(table 5 , figure 4).
IV)Post operative Nausea and Vomiting:
1) Postoperative nausea in the three groups (table 6, figure 5)
A significant decrease in the incidence of postoperative nausea was observed at the first 30 minutes and 2.5 hours postoperatively in group II (30 ml /kg Ringer lactate) and group III (ephedrine 0.5 mg /kg ) when compared to control group.
Significant statistical difference was found when comparing the incidence of nausea between the three groups.
Our results showed significant statistical difference when comparing the incidence of postoperative nausea In group II (30 ml /kg Ringer lactate) during the first 30 minutes and 2.5 hours postoperatively compared to the control group, during the first 30 minutes postoperatively it was 10 % in group II (30 ml /kg Ringer lactate) versus 40% in group I (control group) with a P value of 0.029 and during the 2.5 hours postoperatively it was 10 % in G II versus 25 % in G I with a P value of 0.036.
There was significant reduction in the incidence of postoperative nausea In group III (ephedrine 0.5 ml / kg), during the first 30 minutes and 2.5 hours postoperatively compared to the control group, during the first 30 minutes postoperatively it was 15 % in group III ephedrine versus 40% in group I with a P value of 0.031 and during the 2.5 hours postoperatively it was 5 % in G III versus 25 % in G I with a P value of 0.035.
There is no significant difference between the three groups as regard postoperative nausea during the period from 2.5 hours to 24 hours postoperatively.
We can summarize that group II (ephedrine) and group III (30 ml /kg Ringer lactate) were superior to control group in prevention of postoperative nausea.
II) Postoperative vomiting and dry retching in the three groups (table 7 figure 6):
A significant decrease in the incidence of postoperative vomiting and dry retching was observed at the first 30 minutes and 2.5 hours postoperatively in group I (30 ml/kg Ringer lactate) and group III (ephedrine 0.5 mg /kg ) when compared to control group.
Significant statistical difference was found when comparing the incidence of postoperative vomiting and dry retching between the three groups.
Our results showed significant statistical difference when comparing the incidence of postoperative vomiting and dry retching during the first 30 minutes and 2.5 hours postoperatively compared to the control group, during the first 30 minutes postoperatively it was 15 % in group II (30 ml /kg Ringer lactate) versus 45% in group I with a P value of 0.018 and during the 2.5 hours postoperatively it was 10 % in G II versus 35 % in G I with a P value of 0.041.
In group III (ephedrine 0.5 ml / kg), the incidence of postoperative vomiting and dry retching decreased significantly during the first 30 minutes and 2.5 hours postoperatively compared to the control group, during the first 30 minutes postoperatively it was 10 % in group III ephedrine versus 45% in group I with a P value of 0.005 and during the 2.5 hours postoperatively it was 5 % in G III versus 35 % in G I with a p value of 0.039.
An insignificant difference in the incidence of postoperative vomiting and dry retching during the period from 2.5 hours to 24 hours postoperatively was observed between the three groups.
We can summarize that group II (ephedrine) and group III (30 ml /kg Ringer lactate) were superior to control group in prevention of postoperative vomiting and dry retching.
All patients who suffered from PONV during the first 2.5 hours postoperatively also experienced PONV during the 2.5 – 24 hours period.
V) Drugs used
The need for rescue antiemetic was significant higher in group I(control group) compared to group II (30 ml /kg Ringer lactate) and group III (ephedrine) during the first 30 minutes and during the 2.5 hours postoperatively, with no significance during the period from 2.5-24 hours postoperatively (table 8 figure 7).
VI) Sedation
As regard sedation patients who received ephedrine had significantly lower sedation scores than patients in the other two groups (table 9, figure 8).
Complications and side effects
Table 10 figure 9 summarizes the number and incidence of patients who suffered from sore throat, thirst, dizziness and shoulder pain.
In group II (30 ml /kg Ringer lactate) (20 patients) : There were 9 (45 %) patients suffered from sore throat , 2 patients (10 %) suffered from thirst, one patient (5 %) suffered from dizziness and 3 patients (15 %) suffered from shoulder pain.
In group III (ephedrine 0.5 ml / kg) (20 patients): patients suffered from sore throat were decreased to be 2 patients (10 %), 3 patients (15 %) suffered from thirst, no patients suffered from dizziness and 2 patients suffered from shoulder pain.
In group I (10 ml /kg Ringer lactate) ( 20 patients ): patients suffered from sore throat were decreased to be 2 patients (10%) , 3 patients (15%) suffered from thirst , no patients suffered from dizziness and 4 patients suffered from shoulder pain.