Korean J Anesthesiol.  2004 Oct;47(4):477-481. 10.4097/kjae.2004.47.4.477.

Analysis of Postoperative Nausea and Vomiting after Pediatric Strabismus Surgery with Sevoflurane-N2O/O2 Anesthesia

• Yi CW
• Chang YJ
• Jee DL

• KMID: 2299281
• DOI: http://doi.org/10.4097/kjae.2004.47.4.477

Abstract

BACKGROUND: Children undergoing strabismus surgery have a high incidence of postoperative nausea and vomiting (PONV). Previous reports have proposed PONV risk factors with conflicting results. We reevaluated the risk factors following pediatric strabismus surgery.
METHODS
After obtaining informed consent, we conducted a prospective study of 58 ASA I children (aged 3-15 years) who had undergone elective strabismus surgery performed by the same ophthalmologist to investigate PONV risk factors. Anesthesia was induced with thiopental and rocuronium and maintained by inhalation anesthesia with 2 vol.% sevoflurane in 50% N2O/O2. Premedicants, anticholinergics, analgesics, or subtenon lidocaine injection were not used perioperatively. PONV was recorded by patients' parents during the first 24 hours after surgery. We analyzed the influence on PONV of age, sex, preoperative anxiety, oculocardiac reflex (OCR), and procedure duration.
RESULTS
The incidence of PONV was 25.9%. Age was found to be associated with PONV (P < 0.05). PONV occurred in 13.3% of preschoolers aged 7 years or less, but in 39.3% of school children aged 8 years or more (the odds ratio for age > or = 8 year of age, 4.2, with 95% Cl 1.2-15.4). Sex, OCR, preoperative anxiety, and procedure duration did not affect PONV.
CONCLUSIONS
We found that only age is associated with PONV, and that the incidence of PONV is higher in school children than in preschoolers after pediatric strabismus surgery. These results suggest that much more attention should be paid to preventing PONV during strabismus surgery in school children.

Keyword

general anesthesia; postoperative nausea and vomiting; strabismus surgery

MeSH Terms

Analgesics
Anesthesia*
Anesthesia, General
Anesthesia, Inhalation
Anxiety
Child
Cholinergic Antagonists
Humans
Incidence
Informed Consent
Lidocaine
Odds Ratio
Parents
Postoperative Nausea and Vomiting*
Prospective Studies
Reflex, Oculocardiac
Risk Factors
Strabismus*
Thiopental
Analgesics
Cholinergic Antagonists
Lidocaine
Thiopental