Anesth Pain Med.  2020 Jan;15(1):66-72. 10.17085/apm.2020.15.1.66.

Effect of gastric decompression on postoperative vomiting in pediatric patients undergoing strabismus surgery: a randomized controlled study

• Jung KT
• Kim SH
• Kim DJ
• Kim SH
• An TH

• KMID: 2500457
• DOI: http://doi.org/10.17085/apm.2020.15.1.66

Abstract

Background
Postoperative vomiting (POV) is one of the most serious complications in pediatric patients undergoing strabismus surgery. This study was conducted to test the hypothesis that gastric decompression (GD) could prevent POV caused by gastric distension after mask ventilation.
Methods
A total of 60 pediatric patients (ASA PS I–II, aged one to 10 years) were randomly allocated to two groups; Group D (n = 30) and Group C (n = 30). Induction of anesthesia was performed with careful face mask ventilation with 100% O2 (3 L/min) and sevoflurane 3 vol% to limit airway pressure below 20 cmH2O. Endotracheal intubation was done after confirming adequate neuromuscular blockade. Then, the patients in Group D received GD, while patients in Group C did not. After the surgery, POV was assessed during the emergence from anesthesia in the operating room and postanesthetic care unit (30 min and 60 min).
Results
During the emergence, POV was significantly decreased in Group D compared to Group C (Group D 3.3% vs. Group C 30.0%, P = 0.006). The odds ratio analysis showed a lower incidence of POV in Group D (odds ratio = 0.080; 95% confidence limit: 0.009–0.685) during the emergence period. There was no significant difference in the incidence of POV in the postanesthetic care unit (Group D 6.7% vs. Group C 4.3% at 30 min, P = 1.000; 0% in both groups at 60 min).
Conclusions
GD reduced the incidence of POV in pediatric patients undergoing strabismus surgery during emergence.

Keyword

Anesthesia; Decompression; Pediatrics; Stomach; Strabismus; Vomiting

Figure

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  Fig. 1 Cohort flow chart. A total of 60 pediatric patients (American Society of Anesthesiologists physical status class I–II, aged one to 10 years) were randomly allocated into two groups. Patients in Group D (n = 30) received gastric decompression after endotracheal intubation and patients in Group C (n = 30) did not. At the end of the surgery, postoperative vomiting was assessed during anesthesia emergence (after extubation) and in the postanesthetic care unit (30 min and 60 min) by a physician who did not participate in the anesthesia.

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