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The Effect of Intraoperative Body Temperature on Postoperative Nausea and Vomiting in Pediatric Patients
Ismail Sümer1, Harun Uysal1, Serdar Yeşiltaş1
1Department of Anesthesiology, Bezmialem Vakıf University, Istanbul, Turkey.
Insights
Lowering intraoperative body temperature below 36°C in pediatric patients increases the risk of postoperative nausea. Longer operation times also contribute to postoperative nausea and vomiting (PONV) in children.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Patient Safety
Background:
- Pediatric patients face heightened risks of perioperative hypothermia and postoperative nausea and vomiting (PONV).
- Understanding factors influencing PONV in children is crucial for improving anesthetic care and patient outcomes.
Purpose of the Study:
- To determine the relationship between intraoperative body temperature and PONV in pediatric surgical patients.
- To explore associations between PONV and intraoperative fentanyl use, patient age, and operation duration.
Main Methods:
- A prospective cohort study involving 80 children undergoing lower abdominal surgery.
- Continuous monitoring of body temperature and postoperative assessment of nausea, vomiting, and analgesic/antiemetic use.
Main Results:
- A mean body temperature below 36°C was significantly associated with increased postoperative nausea incidence at 6 hours (P=0.044).
- Longer mean surgical duration was significantly linked to a higher incidence of PONV (P=0.001).
- No significant difference in mean body temperature was found between children with and without vomiting (P>0.05).
Conclusions:
- Maintaining intraoperative body temperature above 36°C may reduce postoperative nausea in children.
- Extended surgical times are a significant risk factor for PONV in pediatric patients.
- Intraoperative fentanyl use showed a trend towards increased PONV, though not statistically significant.
Purpose:
Pediatric patients are at greater risk for both perioperative hypothermia and postoperative nausea and vomiting (PONV). The primary aim of this study was to investigate whether there is a relationship between intraoperative body temperature and PONV in children undergoing anesthesia. The secondary aim was to investigate the relationship between PONV and intraoperative fentanyl use, age and duration of operation.
Design:
A prospective cohort study METHODS: The study included 80 children who were undergoing lower abdominal surgery. Body temperature was monitored after routine preoperative preparation and standard induction. Analgesic and antiemetic requirements and the presence of nausea and vomiting were assessed postoperatively on the 30th minute and the 6th, 12th and 24th hour.
Findings:
The children with or without PONV were compared. At the postoperative 6th hour, the incidence of nausea was statistically significant in the children with a mean body temperature below 36°C (P = 0.044; P < 0.05). The mean duration of the surgery was statistically significant longer in the children with PONV (P = 0.001; P = 0.004; P <0.05). Mean body temperature was not statistically significant when comparing children with and without vomiting(P > 0.05).
Conclusion:
While a body temperature below 36°C increases the incidence of postoperative nausea, it does not cause an increase in the incidence of vomiting. A long operation time in pediatric patients causes an increase in the incidence of PONV. Although not statistically significant, PONV is encountered more than twice as much in patients receiving intraoperative fentanyl administration.
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