Effects of Fluid Infusion on Postoperative Vomiting in Pediatric Patients Undergoing Otorhinolaryngological Surgery
Condition: Postoperative Nausea and Vomiting
MeSH terms: Vomiting; Postoperative Nausea and Vomiting
Study type: Interventional

Summary: 
      Otorhinolaryngological surgery is one of the commonly applied procedures surgical treatments
      of children in the world. Postoperative vomiting (POV) is an important part of the management
      of pediatric anesthesia in this surgery that is also related with these surgical procedures.
      Postoperative vomiting is one of the most common complication of this surgery and may cause
      patients to receiving anesthesia again and stay longer in the hospital.The use of effective
      fluid therapy might be a safe way to reduce POV. There are many studies of fluid therapy
      adult patients on the other hands the number of children studies are limited.

      The aim of this study was to evaluate the POV effect of intraoperative hydration with 0.9
      NaCl solution in children undergoing otorhinolaryngological surgery.
    

Detailed description: 
      After institutional ethics committee approval and written informed parental consent, ASA
      physical status I or II, aged 2-14 year, who were undergoing elective day case
      otorhinolaryngological surgery under general anaesthesia, were screened for eligibility for
      enrollment in this prospective, randomized, double blind, placebo controlled study.

      In the operating room, after routine monitoring, general anaesthesia was induced with %8
      sevoflurane in 100% oxygen by a face mask with spontaneous ventilation.

      Patients were randomly assigned to one of the two groups. Randomization was carried out using
      a computer-generated random numbers.

      The control group (Group I) received ≤10 ml kg-1 h-1 and the high volüme group ( Group II)
      received >30 ml kg-1h-1 of intravenous %0.9 NaCl solution.Before tracheal intubation, all
      subjects received propofol 2:5mg kg-1, fentanyl 1µg kg-1 and rocuronium 0.6 mg kg-1.

      After tracheal intubation, anaesthesia was maintained with 40% mixture of oxygen/nitrous
      oxide and 2% sevoflurane. The solution appears to be covered via an infusion pump was used.
      During anaesthesia, all patients received intravenous paracetamol 10 mg kg-1 for
      postoperative pain .

      Following extubation, until the transfer of the patient from the time of the PACU nausea,
      vomiting or both were recorded..

      Retching efforts in the PACU were recorded as nausea evaluated. Both nausea and vomiting were
      assessed on a four point scale: 0=no nausea/vomit, 1=mild nausea/vomit, patient not
      requesting metoclopramide, 2=nausea/vomit, patient requesting metoclopramide and
      3=nausea/vomit resistant to treatment At the first episode of severely nause and vomiting, or
      both, a rescue antiemetic consisting of intravenous ondansetron was administered.

      Intensity of pain was evaluated using Children's Hospital East Ontario Pain Scale (CHEOPS).

      Knowledge collection for posoperative pain to PACU arrival and departure was performed by a
      postanesthesia care unit (PACU) nurses who blinded to the procedure the amount of fluid
      therapy.
    

Intervention name(s): %0.9 NaCl 10ml/kg; %0.9 NaCl 20ml/kg
Intervention type(s): Drug; Drug
Intervention description(s): Fluid administration; Fluid administration
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: fluid infusion; vomiting; otorhinolaringology