The Effect of Morphine on the Incidence of Postoperative Nausea and Vomiting after Strabismus Surgery with Propofol
,
Abstract
Background: Corrective strabismus surgery is associated with moderate pain and a very high incidence of postoperative nausea and vomiting (PONV). In our treatment centers Morphine is used a lot and it’s associated with high incidence of PONV and we have few alternative analgesics. The aim of this study was to compare the incidence of postoperative emesis with intravenous morphine in patients undergoing corrective strabismus surgery with propofol anesthesia with the control group.
Methods: In a prospective, double-blind, randomized study, 126 patients who were candidates for strabismus surgery (either sex or any age) were randomly assigned to receive morphine or placebo. None of the patients received any premedication and a standardized anesthesia technique was used for all the patients. The incidence of PONV in patients within 24 hours after the surgery was compared.
Results: During 24 hours after strabismus surgery, 29 (46%) patients in the morphine group and 27 (42.9%) in the control group had nausea. The frequency of vomiting was 11 (17.5%) patients in morphine group and 9 (14.3%) in the control group. There was no significant difference between the two groups regarding nausea episodes (P=0.85) and vomiting episodes (P= 0.8).
Conclusion: According to the results of this study, morphine does not increase PONV after strabismus surgery
.
Gunton KB, Wasserman BN, DeBenedictis C. Strabismus. Prim Care. 2015;42(3):393-407.
Kushner BJ. The benefits, risks, and efficacy of strabismus surgery in adults. Optom Vis Sci 2014;91(5):e102-9.
Wan MJ, Hunter DG. Complications of strabismus surgery: incidence and risk factors. Semin Ophthalmol 2014;29(5-6):421-8.
Coppens M, Versichelen L, Mortier E. Treatment of postoperative pain after ophthalmic surgery. Bull Soc Belge Ophtalmol 2002;(285):27-32.
Lesin M, Sundov ZD, Jukic M, Puljak L. Postoperative pain in complex ophthalmic surgical procedures: comparing practice with guidelines. Pain Med 2014;15(6):1036-426.
Kaufman S, Martin-Sheridan D. Postoperative nausea and vomiting after strabismus surgery: mechanisms, treatment, and implications for practice. CRNA 1996;7(3):139-43.
Tramèr M, Moore A, McQuay H. Prevention of vomiting after paediatric strabismus surgery: a systematic review using the numbers-needed-to-treat method. Br J Anaesth 1995;75(5):556-61..
Wolf R, Morinello E, Kestler G, et al. PONV after strabismus surgery: Risk adapted prophylaxis?. Anaesthesist 2016;65(7):507-13.
Williams N, Strunin A, Heriot W. Pain and vomiting after vitreoretinal surgery: a potential role for local anaesthesia. Anaesth Intensive Care 1995;23(4):444-8.
Allen LE, Sudesh S, Sandramouli S, Cooper G, McFarlane D, Willshaw HE. The association between the oculocardiac reflex and post-operative vomiting in children undergoing strabismus surgery. Eye (Lond). 1998;12 ( Pt 2):193-6.
Rose J, Watcha M. Postoperative nausea and vomiting in paediatric patients. British journal ofanaesthesia.1999;83(1):104-17.
Weir PM, Munro HM, Reynolds PI, Lewis IH, Wilton N. Propofol infusion and the incidence of emesis in pediatric outpatient strabismus surgery. Anesthesia and analgesia. 1993;76(4):760-4.
Trang T, Al-Hasani R, Salvemini D, Salter MW, Gutstein H, Cahill CM. Pain and Poppies: The Good, the Bad, and the Ugly of Opioid Analgesics. J Neurosci 2015;35(41):13879-88.
Munro H, Riegger L, Reynolds P, Wilton N, Lewis I. Comparison of the analgesic and emetic properties of ketorolac and morphine for paediatric outpatient strabismus surgery. Br J Anaesth 1994;72(6):624-8.
Rauh KH, Andersen RS, Rosenberg J. Visual analogue scale for measuring post-operative pain. Ugeskr Laeger 2013;175(24):1712-6.
Meek R, Kelly AM, Hu XF. Use of the visual analog scale to rate and monitor severity of nausea in the emergency department. Acad Emerg Med 2009;16(12):1304-1310.
Wennström B, Reinsfelt B. Rectally administered diclofenac (Voltaren) reduces vomiting compared with opioid (morphine) after strabismus surgery in children. Acta Anaesthesiol Scand 2002;46(4):430-4.
Moradi Farsani D, Alikiaei B, Hoseinzadeh F. Comparison of Ondansetrone, Metoclopramide and Midazolam for Preventing PONV Prophylaxis after Strabismus Surgery. J Arak Uni Med Sci 2017;20(2): 67-77.
| Files | ||
| Issue | Vol 5, No 3-4 (Winter 2017) | |
| Section | Original Article(s) | |
| Keywords | ||
| Morphine Postoperative nausea and vomiting Strabismus | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
