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Association of intraocular pressure and postoperative nausea and vomiting after microvascular decompression - a
Yuantao Hou1, Hansheng Liang1, Cungang Fan2
1Department of Anesthesiology, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, China.
Background:
Postoperative nausea and vomiting is common in patients receiving microvascular decompression. In the current study, we examined whether postoperative nausea and vomiting is associated with reduced intraocular pressure (IOP) after microvascular decompression, a measure that reflects intracranial pressure.
Methods:
This is a prospective cohort study. Adult patients scheduled for microvascular decompression surgery for hemifacial spasm between January 2020 and August 2020 were eligible. IOP was measured immediately before anesthesia induction and 30 min after patients regained complete consciousness using non-contact tonometry. IOP reduction was defined by at least 1 mmHg decrease vs. preoperative baseline. The primary outcome was vomiting on postoperative day 1.
Results:
A total of 103 subjects were enrolled. IOP was reduced in 56 (54.4%) subjects. A significantly greater proportion of patients with IOP reduction had vomiting on postoperative day 1 (51.8% (29/56) vs. 23.4% (11/47) in those without IOP reduction; p = 0.003). In the multivariate regression analysis, vomiting on postoperative day 1 was associated with female sex [odds ratio = 7.87, 95% CI: 2.35-26.32, p = 0.001] and IOP reduction [odds ratio = 2.93, 95% CI: 1.13-7.58, p = 0.027].
Conclusions:
In patients undergoing microvascular decompression surgery, postoperative IOP reduction is associated with postoperative vomiting.
Trial Registration:
Chinese Clinical Trial Registry: ChiCTR2000029083 . Registered 13 January 2020.
Insights
Postoperative nausea and vomiting after microvascular decompression is linked to reduced intraocular pressure (IOP). This IOP reduction, a sign of intracranial pressure changes, predicts a higher risk of vomiting post-surgery.
Area of Science:
- Neurosurgery
- Anesthesiology
- Ophthalmology
Background:
- Postoperative nausea and vomiting (PONV) is a frequent complication following microvascular decompression (MVD).
- Intraocular pressure (IOP) changes may reflect intracranial pressure alterations after MVD.
- The association between IOP reduction and PONV after MVD requires further investigation.
Purpose of the Study:
- To investigate the relationship between reduced intraocular pressure (IOP) and the incidence of postoperative nausea and vomiting (PONV) in patients undergoing microvascular decompression (MVD).
Main Methods:
- A prospective cohort study included adult patients undergoing MVD for hemifacial spasm.
- Intraocular pressure (IOP) was measured pre-anesthesia and post-consciousness recovery.
- Vomiting on postoperative day 1 was the primary outcome, with IOP reduction defined as a decrease of at least 1 mmHg.
Main Results:
- Of 103 enrolled subjects, 56% experienced IOP reduction.
- Patients with IOP reduction showed a significantly higher incidence of postoperative day 1 vomiting (51.8%) compared to those without (23.4%).
- Multivariate analysis identified female sex and IOP reduction as significant predictors of postoperative vomiting.
Conclusions:
- Postoperative intraocular pressure reduction is significantly associated with an increased risk of postoperative vomiting in patients undergoing microvascular decompression.
- Monitoring IOP may offer insights into predicting PONV risk after MVD surgery.
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