The influence of different perioperative analgesia modes on postoperative nausea and vomiting in day-case surgery patients

The influence of perioperative analgesia modes on the prevalence of postoperative nausea and vomiting in day-case surgery patients is investigated in the article. The study involved 100 cases of unilateral phlebectomy under propofol and nitrous oxide anaesthesia, randomized by 4 groups with different perioperative analgesia modes of 25 patients each. In the first group fentanyl IV infusion was provided during surgery, in the second group it was amplified with ketoprofen 100 mg IV. In the third group sodium adenosintriphosphate IV infusion was provided for the whole surgery time, whereas the patients in the fourth group received 100 mg ketoprofen IV before it. Analgesic efficacy of all the four modes was equal, while ketoprofen administration aggravated and prolonged postoperative nausea and vomiting without influence on PONV morbidity.

Pre-operative prediction of ‘dry taps’

Objectives:The treatment of children with ‘glue ear’ often presents surgeons with the question of whether or not to insert a grommet when myringotomy reveals no fluid in the middle ear. We present a study designed to assess which factors contribute to the presence of a ‘dry tap’.Design:We prospectively gathered data from a cohort of 280 children (504 myringotomies). The cohort included two subgroups, one received halothane and nitrous oxide anaesthesia, and the other received enflurane anaesthesia.Setting:The ENT department of a district general hospital.Participants:Children (aged less than 17 years) requiring myringotomy.Main outcome measures:The presence of a ‘glue’ or dry tap at myringotomy was documented. We also recorded data on the following: pre- and post-induction tympanometry; age; season; anaesthetic type; and the delay from listing to actual operation.Results:A non type B pre-induction tympanogram and delay to operation were strong indications of finding a dry tap at surgery.Conclusions:In our study population, the proportion of dry taps at myringotomy was 18 per cent. The presence of a dry tap was rarely due to the induction of anaesthesia. Multivariate analysis revealed that the combination of factors most likely to predict a dry tap were non type B tympanogram and delay to operation.