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Relation between middle ear pressure changes and postoperative nausea and vomiting in pediatric strabismus surgery
Kazim Karaaslan1, Hasan Kocoglu, Fahrettin Yilmaz
1Department of Anesthesiology, Izzet Baysal Medical Faculty, Abant Izzet Baysal University, Bolu 14280, Turkey. drkaraaslan@hotmail.com
Insights
Tympanometric changes, including middle ear pressure and compliance, were not linked to postoperative nausea and vomiting (PONV) in children after strabismus surgery. This study found no correlation between these factors.
Area of Science:
- Anesthesiology
- Otolaryngology
- Pediatric Surgery
Background:
- Postoperative nausea and vomiting (PONV) is a common complication in pediatric surgery.
- Tympanometry measures middle ear function, and its potential influence on PONV is not well understood.
Purpose of the Study:
- To investigate the relationship between tympanometric changes and the incidence of PONV in children undergoing strabismus surgery.
- To determine if alterations in middle ear pressure, compliance, or volume correlate with PONV.
Main Methods:
- Prospective, observational study involving 49 children undergoing elective strabismus surgery.
- Tympanometry performed before anesthesia induction and after recovery.
- PONV assessed using a 4-point scale at 0-2, 2-6, and 6-24 hours postoperatively.
Main Results:
- Fourteen patients (28.6%) experienced nausea, and 10 (20.4%) vomited.
- Significant increases in tympanic gradient, compliance, and pressure were observed postoperatively (P < 0.05).
- No statistically significant correlation was found between tympanometric variables (pressure, volume, compliance, gradient) and the occurrence of PONV (P > 0.05).
Conclusions:
- Changes in middle ear pressure, volume, compliance, and gradient are not associated with PONV frequency after strabismus surgery.
- Tympanometric findings do not appear to be a predictive factor for PONV in this pediatric surgical population.
Study Objective:
To investigate the effects of tympanometric changes on the frequency of postoperative nausea and vomiting (PONV).
Design:
Prospective, observational study.
Setting:
University hospital.
Patients:
49 ASA physical status I, nonpremedicated children undergoing elective strabismus surgery.
Interventions:
Frequency of PONV was assessed at various time intervals (0-2, 2-6, and 6-24 hours) with a 4-point scale (0, no nausea; 1, nausea but no vomiting; 2, one episode of vomiting; 3, two or more episodes of vomiting), and correlation with tympanometric data was investigated.
Measurements:
Tympanogram was obtained before induction of standardized anesthesia and after full recovery. Fourteen (28.6%) patients had nausea, and 10 (20.4%) patients vomited. The tympanic gradient, compliance, and pressure values were found to be significantly higher in postoperative measurements than their preoperative counterparts (P < 0.05). The volumes of both ears increased postoperatively, but these differences were not statistically significant (P > 0.05). Changes in middle ear pressure, volume, compliance, and gradient did not correlate with PONV (P > 0.05).
Conclusions:
Gradient, compliance, volume, and pressure changes in middle ears were not found to be related to the frequency of nausea and vomiting after strabismus surgery.
