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In this study, it was aimed to investigate the relationship between postoperative nausea and vomiting, anxiety levels and pain scores in the postoperative period according to dosing and choosing of intravenous fluid type that the patients received in the preoperative period.
Fluid management is an integral and important part of perioperative treatment. In order to prevent organ damage, a key components of assuring adequate organ perfusion is to provide adequate volume and appropriate fluid. Types of the fluids, amount of the fluid given and timing of the administration are the main topics that determine the fluid management strategy. Colloids (e.g. albumin or fresh frozen plasma (FFP)) and crystalloids (e.g. ringer lactate, isotonic, 5% dextrose) are types of intravenous fluids that are used for fluid replacement apart from blood transfusion . Crystalloids are low-cost salt solutions with small molecules, which can move around easily when injected into the body.
There are studies reporting that fluid therapy applied in the preoperative period reduces gastric acid secretion and reduces stomach movements and nausea and vomiting. In addition, there are studies reporting that fluids given in the preoperative period have a positive effect on anxiety levels by reducing the feeling of hunger and thirst in patients. There are studies reporting that fluid therapy reduces ATP destruction and oxidative stress, which contributes to the reduction of pain levels.
90 ASA I-II patients who will undergo laparoscopic cholecystectomy surgery will be included in the study and will be divided into three equal groups. Patients in Group 1 were administered 400 ml 0.9% saline infusion within 30 minutes, 2 hours before surgery. Patients in Group 2 were infused with 400 ml 5% Dextrose at the same infusion rate. In groups 1 and 2, 10 ml/kg/h 0.9% saline infusion was applied during the intraoperative period. Patients in Group 3 were administered 200 ml dextrose infusion in the preoperative period and 200 ml dextrose infusion in the intraoperative period. 0.9% saline infusion was applied so that the total intraoperative fluid volume was the same as in the other groups.
Postoperative nausea and vomiting (PONV) , within 24 hours was compared between groups by PONV score. Other outcomes were the antiemetic drugs needed, The NRS Score, The State-Trait Anxiety Inventory , additional analgesic drug requirement.
In this study, it was aimed to investigate the relationship between postoperative nausea and vomiting, anxiety levels and pain scores in the postoperative period according to dosing and choosing of intravenous fluid type that the patients received in the preoperative period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Group receiving preoperative and intraoperative saline infusion. |
| |
| Group 2 | The group receiving preoperative dextrose and intraoperative saline infusion. |
| |
| Group 3 | The group receiving preoperative and intraoperative dextrose infusion. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| preoperative IV 0.9% saline 400 ml | Other | Group 1 will be infused with IV 0.9% saline 400 mL. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| PONV Score | Postoperative nausea and vomitting recording in patients undergone laparoscopic cholocystectomy.
| 0 hours postoperatively |
| PONV Score | Postoperative nausea and vomitting recording in patients undergone laparoscopic cholocystectomy.
| 2 hours postoperatively |
| PONV Score | Postoperative nausea and vomitting recording in patients undergone laparoscopic cholocystectomy.
| 4 hours postoperatively |
| PONV Score | Postoperative nausea and vomitting recording in patients undergone laparoscopic cholocystectomy.
|
| Measure | Description | Time Frame |
|---|---|---|
| Pain on the Numeric Rating Scale (NRS) | Participants recorded pain rated on the numeric rating scale (NRS) at 6 time points. NRS range was from 0-10 with 0 being no pain and 10 the worst pain possible. | 0 hours postoperatively |
| Pain on the Numeric Rating Scale (NRS) |
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Inclusion Criteria:
Exclusion Criteria:
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90 ASA I-II patients who will undergo laparoscopic cholecystectomy surgery will be included in the study and will be divided into three equal groups.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Etlik City Hospital | Ankara | Varlık Mahallesi, Halil Sezai Erkut Caddesi Yenimahalle | 06170 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27900717 | Result | Hoorn EJ. Intravenous fluids: balancing solutions. J Nephrol. 2017 Aug;30(4):485-492. doi: 10.1007/s40620-016-0363-9. Epub 2016 Nov 29. | |
| 16288616 | Result | Agarwal A, Dhiraaj S, Tandon M, Singh PK, Singh U, Pawar S. Evaluation of capsaicin ointment at the Korean hand acupressure point K-D2 for prevention of postoperative nausea and vomiting. Anaesthesia. 2005 Dec;60(12):1185-8. doi: 10.1111/j.1365-2044.2005.04402.x. |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D020250 | Postoperative Nausea and Vomiting |
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
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| preoperative dextrose 5% 400 ml |
| Other |
Group 2 will be infused with dextrose 5% Dekstroz 400 ml. |
|
| preoperative and intraoperative dextrose 5% 400 ml | Other | Group 3 will be infused with dextrose preoperative 200 ml and intraoperative 200 ml 5% dextrose infusion. |
|
| 8 hours postoperatively |
| PONV Score | Postoperative nausea and vomitting recording in patients undergone laparoscopic cholocystectomy.
| 12 hours postoperatively |
| PONV Score | Postoperative nausea and vomitting recording in patients undergone laparoscopic cholocystectomy.
| 24 hours postoperatively |
Participants recorded pain rated on the numeric rating scale (NRS) at 6 time points. NRS range was from 0-10 with 0 being no pain and 10 the worst pain possible. |
| 2 hours postoperatively |
| Pain on the Numeric Rating Scale (NRS) | Participants recorded pain rated on the numeric rating scale (NRS) at 6 time points. NRS range was from 0-10 with 0 being no pain and 10 the worst pain possible. | 4 hours postoperatively |
| Pain on the Numeric Rating Scale (NRS) | Participants recorded pain rated on the numeric rating scale (NRS) at 6 time points. NRS range was from 0-10 with 0 being no pain and 10 the worst pain possible. | 8 hours postoperatively |
| Pain on the Numeric Rating Scale (NRS) | Participants recorded pain rated on the numeric rating scale (NRS) at 6 time points. NRS range was from 0-10 with 0 being no pain and 10 the worst pain possible. | 12 hours postoperatively |
| Pain on the Numeric Rating Scale (NRS) | Participants recorded pain rated on the numeric rating scale (NRS) at 6 time points. NRS range was from 0-10 with 0 being no pain and 10 the worst pain possible. | 24 hours postoperatively |
| State-Trait Anxiety Inventory ( The STAI ) | The State-Trait Anxiety Inventory (STAI) is a commonly used measure of trait and state anxiety. It has 20 items for assessing trait anxiety and 20 for state anxiety. All items are rated on a 4-point scale (e.g., from "Almost Never" to "Almost Always"). Higher scores indicate greater anxiety. | 2 hours before induction of anesthesia |
| State-Trait Anxiety Inventory ( The STAI ) | The State-Trait Anxiety Inventory (STAI) is a commonly used measure of trait and state anxiety. It has 20 items for assessing trait anxiety and 20 for state anxiety. All items are rated on a 4-point scale (e.g., from "Almost Never" to "Almost Always"). Higher scores indicate greater anxiety. | 0 hours postoperatively |
| 11682427 | Result | Hausel J, Nygren J, Lagerkranser M, Hellstrom PM, Hammarqvist F, Almstrom C, Lindh A, Thorell A, Ljungqvist O. A carbohydrate-rich drink reduces preoperative discomfort in elective surgery patients. Anesth Analg. 2001 Nov;93(5):1344-50. doi: 10.1097/00000539-200111000-00063. |
| 30188590 | Result | Kristoffersen L, Malahleha M, Duze Z, Tegnander E, Kapongo N, Stoen R, Follestad T, Eik-Nes SH, Bergseng H. Randomised controlled trial showed that neonates received better pain relief from a higher dose of sucrose during venepuncture. Acta Paediatr. 2018 Dec;107(12):2071-2078. doi: 10.1111/apa.14567. Epub 2018 Oct 2. |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D009325 | Nausea |
| D012817 | Signs and Symptoms, Digestive |
| D014839 | Vomiting |
| D001523 | Mental Disorders |
| D017670 |
| Sodium Compounds |