The menstrual cycle and nausea or vomiting after wisdom teeth extraction

Area of Science:

• Anesthesiology
• Obstetrics & Gynecology

Background:

• Postoperative nausea or vomiting (PONV) is a common complication following surgical procedures.
• The menstrual cycle's influence on PONV incidence remains an area requiring further investigation.

Purpose of the Study:

• To determine if the day of the menstrual cycle affects PONV incidence in pre-menopausal women undergoing third molar extractions.
• To assess the impact of oral contraceptive pill (OCP) use on this relationship.

Main Methods:

• A prospective study involving 195 pre-menopausal women undergoing third molar extractions.
• Patients were categorized based on OCP use (95 users, 100 non-users).
• PONV incidence was analyzed in relation to specific phases of the menstrual cycle.

Main Results:

• Women taking OCPs exhibited a significantly higher incidence of PONV on cycle days 9-15 compared to other phases (P < 0.05).
• No significant increase in PONV was observed during days 9-15 for women not taking OCPs.
• A history of PONV was the most potent predictor of experiencing PONV post-surgery (P < 0.005).
• Motion sickness tendency did not correlate with increased PONV incidence.

Conclusions:

• The day of the menstrual cycle, particularly days 9-15, is a significant factor influencing PONV in pre-menopausal women using oral contraceptives.
• Previous PONV episodes are a critical risk factor, outweighing factors like motion sickness.
• These findings suggest tailored anesthetic management strategies may be beneficial based on OCP use and patient history.