Impact of Intraoperative End-Tidal CO₂ Variations on Postoperative Nausea, Vomiting, and Pain

Öz

Aim: Patients undergoing robotic-assisted laparoscopic procedures tend to experience a higher frequency of postoperative nausea and vomiting (PONV). This study aimed explore the influence of intraoperative end-tidal carbon dioxide (ETCO₂) levels on the occurrence of PONV in robotic surgery. Methods: This observational clinical study included patients undergoing robotic laparoscopic radical prostatectomy. Patients were divided into two groups based on intraoperative ETCO₂ levels: Group 1 (26–35 mmHg) and Group 2 (36–45 mmHg). The incidence of PONV, the use of rescue antiemetics, and pain scores were recorded at 0, 2, 4, 8, 12, and 24 hours postoperatively. Results: We found that Group 1 exhibited lower Apfel scores at both 0 (p < 0.001) and 2 (p = 0.046) hours post-surgery. Furthermore, Group 2 had a higher incidence of PONV and greater usage of rescue antiemetics within the first 24 hours following surgery. (p<0.05) Conclusion: We found that lower intraoperative ETCO₂ levels were associated with a reduced incidence of PONV in robotic laparoscopic surgery, a procedure known to carry a high risk of PONV.PONV remains a significant clinical issue that negatively affects patient comfort and recovery. we believe that future research should continue to explore the effectiveness of both pharmacological and non-pharmacological approaches for the prevention of PONV.

Anahtar Kelimeler

• End-tidal carbon dioxide
• Pain
• Postoperative nausea and vomiting
• Robotic-assisted laparoscopic radical prostatectomy

İntraoperatif End-Tidal CO₂ Değişimlerinin Postoperatif Bulantı, Kusma ve Ağrı Üzerine Etkisi

Öz

Amaç: Robotik yardımlı laparoskopik cerrahi geçiren hastalar, artmış postoperatif bulantı ve kusma (PONV) riski altındadır. Bu çalışma, robotik cerrahide intraoperatif end-tidal karbondioksit (ETCO₂) düzeylerinin PONV insidansı üzerindeki etkisini araştırmayı amaçladı. Yöntemler: Bu gözlemsel klinik çalışmaya, robotik yardımlı laparoskopik radikal prostatektomi uygulanan hastalar dahil edildi. Hastalar, intraoperatif ETCO₂ düzeylerine göre iki gruba ayrıldı: Grup 1 (26–35 mmHg) ve Grup 2 (36–45 mmHg). PONV insidansı, kurtarıcı antiemetik kullanımı ve ağrı skorları postoperatif 0, 2, 4, 8, 12 ve 24. saatlerde kaydedildi. Bulgular: Grup 1, postoperatif 0. saatte (p < 0.001) ve 2. saatte (p = 0.046) anlamlı olarak daha düşük Apfel skorlarına sahipti. Ayrıca, Grup 2'de ilk 24 saat içinde daha yüksek PONV insidansı ve artmış kurtarıcı antiemetik kullanımı gözlendi (p < 0.05). Sonuç: Düşük intraoperatif ETCO₂ düzeyleri, PONV riski yüksek olan robotik yardımlı laparoskopik cerrahilerde PONV insidansının azalmasıyla ilişkilendirildi. PONV, hasta konforunu ve iyileşmesini olumsuz etkileyen önemli bir klinik sorundur. Gelecekteki araştırmaların, PONV'nin önlenmesine yönelik farmakolojik ve farmakolojik olmayan stratejileri araştırmaya devam etmesi gerektiğine inanıyoruz.

Anahtar Kelimeler

• End-tidal karbondioksit
• Ağrı
• Postoperatif bulantı ve kusma
• Robotik yardımlı laparoskopik radikal prostatektomi

Kaynakça

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