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Vomiting after alfentanil anesthesia: effect of dosing method
G S Okum1, P Colonna-Romano, J C Horrow
1Department of Anesthesiology, Hahnemann University, Philadelphia, PA 19102-1192.
Anesthesia and Analgesia
|October 1, 1992
Summary
Alfentanil infusion increases the risk of nausea and vomiting compared to bolus doses, especially during laparoscopic surgery. Laparoscopy independently elevates this risk, with combined infusion and laparoscopy posing the highest incidence.
Area of Science:
- Anesthesiology
- Pharmacology
- Surgical Outcomes
Background:
- Postoperative nausea and vomiting (PONV) are common complications following anesthesia.
- The method of alfentanil administration may influence the incidence of PONV.
Purpose of the Study:
- To investigate the association between alfentanil administration methods (bolus vs. infusion) and the incidence of nausea and vomiting.
- To assess the independent and combined effects of alfentanil administration and surgical procedure type (laparoscopic vs. incisional) on PONV.
Main Methods:
- A double-blind study involving 40 women undergoing gynecologic or laparoscopic surgery.
- Two groups received intravenous alfentanil: one via bolus doses, the other via continuous infusion.
- Incidence of nausea and vomiting was recorded and compared between groups and surgical types.
Main Results:
- The alfentanil infusion group reported significantly higher rates of nausea and vomiting (50%) compared to the bolus dose group (30%).
- Laparoscopic surgery independently increased the incidence of nausea and vomiting (75%) compared to incisional procedures (17%).
- A synergistic effect was observed between alfentanil infusion and laparoscopic surgery, leading to the highest PONV rates.
Conclusions:
- Continuous alfentanil infusion is associated with a higher risk of postoperative nausea and vomiting.
- Laparoscopic surgery is an independent risk factor for PONV.
- Combining alfentanil infusion with laparoscopic surgery significantly increases the risk of nausea and vomiting, suggesting a need for careful perioperative management.