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[Blocking nociceptive afferents by retrobulbar bupivacaine does not decrease nausea and vomiting after

D Müller1, W Armbruster, W Unkel

  • 1Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen.

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|November 6, 2003
PubMed
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Prophylactic neural blockade did not reduce postoperative nausea and vomiting (PONV) in ocular surgery patients. Droperidol was the only effective antiemetic, significantly decreasing PONV incidence.

Area of Science:

  • Anesthesiology
  • Ophthalmology
  • Pharmacology

Background:

  • Postoperative nausea and vomiting (PONV) is a common complication after anesthesia.
  • Ocular surgery presents unique challenges for managing PONV due to the sensitive nature of the eye.
  • Evaluating prophylactic interventions is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine if prophylactic neural blockade of nociceptive afferents or antiemetics can reduce PONV.
  • To assess the efficacy of retrobulbar anesthesia and various antiemetics in patients undergoing ocular surgery.
  • To compare the effectiveness of droperidol and serotonin receptor antagonists in preventing PONV.

Main Methods:

  • A randomized, prospective, double-blind study involving 102 patients undergoing ocular surgery.

Related Experiment Videos

  • Patients received either retrobulbar injections (mepivacaine/bupivacaine or saline) or intravenous antiemetics (dolasetron, ondansetron, droperidol, or placebo).
  • PONV incidence, ocular pain, and overall postoperative complaints were assessed using standardized questionnaires.

    • Main Results:

    • Retrobulbar anesthesia significantly reduced ocular pain and total postoperative complaints but did not decrease PONV incidence.
    • Droperidol was the only antiemetic that significantly reduced PONV (p = 0.001).
    • Serotonin receptor antagonists used in the study did not show a significant effect on PONV.

    Conclusions:

    • Prophylactic retrobulbar anesthesia is ineffective in preventing PONV after ocular surgery under propofol-remifentanil anesthesia.
    • Droperidol demonstrates superior efficacy in preventing PONV compared to the tested serotonin receptor antagonists in this patient population.
    • Targeting nociceptive afferents via retrobulbar blockade is not a viable strategy for PONV prevention in this context.