ABSTRACT
ABSTRACT: Objective: To asses the rate of nausea & vomiting and pain in strabismic patients anesthetized by propofol Materials & methods: Prospective, non comparative, nonrandomized clinical trial performed on 49 consecutive strabismus surgery. Propofol used for induction and maintenance of anesthesia in all patients. Nausea & vomiting and pain was graded by standard visual analog scale (VAS) in 6 and 24 hours after operation. Other variables was age & sex of patients, duration of operation and recovery, number of muscles operated on and total dose of propofol. The results analyzed by SPSS 10.1. Results: 49 patients [27 (55.1%) female, 22(44.9%) male with mean age of 13.76 years old] included in this study. Mean number of operated muscles in each patient was 2.71 muscles, mean operation time was 46.73 minutes and mean recovery time was 12.08 min. Mean vomiting grade in 6 hrs. after surgery was 2.03 & in 24 hrs. after surgery was 1.31. Statistical correlation was not found between pain & nousea and age, sex, number of muscles operated on , total dose of propofol and duration of anesthesia. Conclusion: It seems that change in anesthesia drug and technique during strabismus surgery (using propofol as main drug) is more safer than use of antiemetic drugs before and after operation
1 INTRODUCTION
Strabismus surgery is mostly carried out as daycase surgery. One study reports postoperative nausea and vomiting (PONV) leading to overnight admission in more than one-third of ambulatory patients1. The incidence of postoperative vomiting or emesis is high, 88%, and up to 50% of the children have severe pain after strabismus surgery2,3. The postoperative pain itself has been considered to be a major cause of the postoperative nausea4. Many factors are known to influence the incidence of vomiting and pain after paediatric strabismus surgery such as the anaesthetic technique, administration of anti-emetics, induction agents such as propofol and use of analgesia intraoperatively and postoperatively2,5-7. Patients find postoperative nausea and vomiting (PONV) most distressing and it is often the worst memory of their hospital stay. The consequences of prolonged PONV range from unexpected admission of day patients, with its economic implications, to physical, metabolic and psychological effects on the patient which slow their recovery and reduce their confidence in future surgery and anaesthesia. The incidence and severity of PONV has been decreasing over the last 10 years, due to the identification of precipitating factors, the use of better anaesthetics and perioperative medications, and improvement in operative techniques8. Despite these changes, there is still an unacceptable frequency of PONV.
