The effects of amounts of intraoperative intravenous fluid administration on postoperative nausea and vomiting during gynecological surgery

Background: Perioperative fluid deficits is known to induce the intestinal ischemia and release the emetogenic factors like serotonin. Many studies have reported that there is a close association between the amount of perioperative fluid administration and the incidence of postoperative nausea and vomiting (PONV). In this study, we examined whether amounts of intraoperative intravenous fluid administration would be related with the incidence of PONV in patients scheduled for gynecological surgery. Methods: One hundred twenty gynecological patients with ASA I-II were randomized to receive either large (18 ml/kg/hr) or small (6 ml/kg/hr) volume infusion of lactated Ringer’s solution intraoperatively. The incidence of PONV, severity of pain, and need for supplemental antiemetic and analgesic therapy were assessed by a blinded investigator at 0−2, 2−6, and 6−24 h postoperatively. Results: There were no significant differences between the two groups in the severity of pain and amounts of rescue antiemetics and rescue analgesics administration at any given time. There were no differences between the two groups regarding the incidence of PONV at 0−2, 2−6, and 6−24 h, postoperatively. Conclusions: Intraoperative large volume infusion of lactated Ringer’s solution was ineffective in reducing the incidence of PONV in patients scheduled for gynecological surgery during the postoperative period. (Korean J Anesthesiol 2008; 55: 166∼70)