Hepatopankreatobiliyer Cerrahi Hastalarında Ameliyat Sonrası Bulantı-Kusma ve Risk Faktörlerinin İncelenmesi

Yıl 2024, Cilt: 3 Sayı: 3, 59 - 69, 05.12.2024

Eda Ayten Kankaya , Kübra Yasak , Özlem Bilik

Öz

Bu araştırmada hepatopankreatobiliyer cerrahi hastalarının ameliyat sonrası bulantı kusma ve seçilmiş risk faktörleri arasındaki ilişkinin incelenmesi amaçlanmıştır.
Tanımlayıcı, kesitsel ve ilişki arayıcı türde olan araştırma bir üniversitenin genel cerrahi kliniğinde 156 hasta ile gerçekleştirilmiştir. Verilerin toplanmasında sosyodemografik klinik özellikler formu ve Apfel skoru kullanılmıştır.
Hepatopankreatobiliyer cerrahisi hastalarının %30.1'i ameliyat sonrası bulantı yaşarken, %16'sı kusma yaşamıştır. Ameliyat sonrası bulantı yaşadığını söyleyen hastaların oranı %30.1 (n:47)’dir. Bulantı yaşayan hastaların %21.8’i (n:34); kusma yaşadığını söyleyen hastaların %13.5’i hareket etme, yürüme, yemek yeme gibi günlük yaşam aktivitelerinin etkilendiğini belirtmiştir. Kadın cinsiyet, ameliyat sonrası opioid kullanımı ve oral alıma geç başlamanın bulantı ve kusmada etkili olduğu saptanmıştır.
Hepatopankreatobiliyer cerrahisi hastalarında, Apfel skoru, ameliyat sonrası bulantı-kusma riskini tahmin etmekte etkili bir araç olarak kullanılabilmekle birlikte, skorun içeriğindeki parametrelerin her birinin ameliyat sonrası bulantı-kusmayı açıklamada eşit derecede etkili olmadığı düşünülmektedir. Ameliyat sonrası bulantı-kusma riskini azaltmak için, cerrahi türü ve hasta özellikleri göz önünde bulundurularak kişiselleştirilmiş ameliyat sonrası yönetim stratejileri geliştirilmelidir.

Anahtar Kelimeler

Cerrahi, Bulantı, Hepatobiliyer, Kusma, Pankreas, Risk

Investigation of Postoperative Nausea-Vomiting and Risk Factors in Hepatopancreatobiliary Surgery Patients

Öz

This study aimed to investigate the relationship between postoperative nausea and vomiting and selected risk factors in hepatopancreatobiliary surgery patients. The descriptive, cross-sectional, and correlational study was conducted with 156 patients in a university general surgery clinic. The sociodemographic clinical characteristics form and Apfel score were used to collect data.30.1% of hepatopancreatobiliary surgery patients experienced postoperative nausea, while 16% experienced vomiting. The rate of patients who reported postoperative nausea was 30.1% (n: 47). 21.8% (n: 34) of patients who experienced nausea and 13.5% of patients who reported vomiting stated that their daily life activities such as movement, walking, and eating were affected. It was determined that female gender, postoperative opioid use, and late initiation of oral intake were effective in nausea and vomiting. The Apfel score serves as an effective tool for predicting the risk of postoperative nausea and vomiting in hepatopancreatobiliary surgery patients, although its effectiveness in explaining postoperative nausea and vomiting varies among its parameters. In order to reduce the risk of postoperative nausea and vomiting, personalized postoperative management strategies should be developed considering the type of surgery and patient characteristics.

Anahtar Kelimeler

Hepatobiliary, Nausea, Pancreas, Risk, Surgery, Vomiting

Kaynakça

• Allene, M. D., & Demsie, D. G. (2020). Incidence and factors associated with postoperative nausea and vomiting at Debre Berhan referral hospital, NorthShewa, Ethiopia: Across-sectional study. International Journal of Surgery Open, 25, 29-34.
• Apfel, C. C., Heidrich, F. M., Jukar-Rao, S., Jalota, L., Hornuss, C., Whelan, R. P., Zhang, K., & Cakmakkaya, O. S. (2012). Evidence-based analysis of risk factors for postoperative nausea and vomiting. British journal of anaesthesia, 109(5), 742–753. https://doi.org/10.1093/bja/aes276
• Apfel, C. C., Läärä, E., Koivuranta, M., Greim, C. A., & Roewer, N. (1999). A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology, 91(3), 693–700. https://doi.org/10.1097/00000542-199909000-00022
• Apfel, C. C., Philip, B. K., Cakmakkaya, O. S., Shilling, A., Shi, Y. Y., Leslie, J. B., Allard, M., Turan, A., Windle, P., Odom-Forren, J., Hooper, V. D., Radke, O. C., Ruiz, J., & Kovac, A. (2012). Who is at risk for postdischarge nausea and vomiting after ambulatory surgery?. Anesthesiology, 117(3), 475–486. https://doi.org/10.1097/ALN.0b013e318267ef31
• Çelebi, E., & İlçe, A. (2023). Cerrahi kliniklerde çalışan hemşirelerin eras protokolleri hakkındaki bilgi düzeylerinin belirlenmesi. Sağlık Bakım Ve Rehabilitasyon Dergisi, 1(1), 12-24.
• Elvir-Lazo, O. L., White, P. F., Yumul, R., & Cruz Eng, H. (2020). Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Research, 9, F1000 Faculty Rev-983. https://doi.org/10.12688/f1000research.21832.1
• European Association For The Study Of The Liver, European Organisation For Research And Treatment Of CancerEuropean Organisation For Research And Treatment Of Cancer (2012). EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J. Hepatol. 56, 908–943. doi:10.1016/j.jhep.2011.12.001
• Gecit, S., & Ozbayir, T. (2020). Evaluation of Preoperative Risk Assessment and Postoperative Nausea and Vomiting: Importance for Nurses. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses, 35(6), 625–629. https://doi.org/10.1016/j.jopan.2020.04.006
• Herbert, G., Perry, R., Andersen, H. K., Atkinson, C., Penfold, C., Lewis, S. J., Ness, A. R., & Thomas, S. (2018). Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications. The Cochrane database of systematic reviews, 10(10), CD004080. https://doi.org/10.1002/14651858.CD004080.pub3
• López-Torres López, J., Piedracoba Cadahía, D., Alcántara Noalles, M. J., Simó Cortés, T., & Argente Navarro, P. (2019). Perioperative factors that contribute to postoperative pain and/or nausea and vomiting in ambulatory laparoscopic surgery. Factores perioperatorios que contribuyen a la aparición de dolor o náuseas y vómitos postoperatorios en cirugía laparoscópica ambulatoria. Revista espanola de anestesiologia y reanimacion, 66(4), 189–198. https://doi.org/10.1016/j.redar.2018.11.007
• Melloul, E., Hübner, M., Scott, M., Snowden, C., Prentis, J., Dejong, C. H., Garden, O. J., Farges, O., Kokudo, N., Vauthey, J. N., Clavien, P. A., & Demartines, N. (2016). Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World journal of surgery, 40(10), 2425–2440. https://doi.org/10.1007/s00268-016-3700-1
• Nitta, H., Baba, H., Sugimori, K., Furuse, J., Ohkawa, S., Yamamoto, K., Minami, H., Shimokawa, M., Wakabayashi, G., & Aiba, K. (2016). Chemotherapy-induced Nausea and Vomiting in Patients with Hepatobiliary and Pancreatic Cancer Treated with Chemotherapy: A Prospective Observational Study by the CINV Study Group of Japan. Anticancer research, 36 4, 1929-35 .
• Parra-Sanchez, I., Abdallah, R., You, J., Fu, A. Z., Grady, M., Cummings, K., 3rd, Apfel, C., & Sessler, D. I. (2012). A time-motion economic analysis of postoperative nausea and vomiting in ambulatory surgery. Canadian journal of anaesthesia = Journal canadien d'anesthesie, 59(4), 366–375. https://doi.org/10.1007/s12630-011-9660-x
• Pierre, S., & Whelan, R. (2013). Nausea and vomiting after surgery. Continuing Education in Anaesthesia, Critical Care & Pain, 13(1), 28-32.
• Qasemi, F., Aini, T., Ali, W., Dost, W., Rasully, M. Q., Anwari, M., Dost, W., Zaheer, R., Dost, R., & Talpur, A. S. (2023). The effectiveness of ondansetron and dexamethasone in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy. Cureus, 15(4), e37419. https://doi.org/10.7759/cureus.37419
• Qian, Y., Zhu, J. K., Hou, B. L., Sun, Y. E., Gu, X. P., & Ma, Z. L. (2022). Risk factors of postoperative nausea and vomiting following ambulatory surgery: A retrospective case-control study. Heliyon, 8(12), e12430. https://doi.org/10.1016/j.heliyon.2022.e12430
• Sakızcı Uyar, B., &Dönmez, A. (2018) Postoperatif bulantı ve kusma. Journal of Anesthesia – JARSS, 26 (3), 120 – 126
• Salazar-Parra, M., Guzman-Ramirez, B. G., Pintor-Belmontes, K. J., Barbosa-Camacho, F. J., Bernal-Hernández, A., Cruz-Neri, R. U., Fuentes-Orozco, C., Aguirre, L. L. R., Rodríguez-Navarro, D., Brancaccio-Pérez, I. V., Esparza-Estrada, I., Cervantes-Pérez, E., Cervantes-Guevara, G., Cervantes-Cardona, G. A., & González-Ojeda, A. (2020). Gender Differences in Postoperative Pain, Nausea and Vomiting After Elective Laparoscopic Cholecystectomy. World journal of surgery, 44(12), 4070–4076. https://doi.org/10.1007/s00268-020-05744-3
• Smith, H. S., Smith, E. J., & Smith, B. R. (2012). Postoperative nausea and vomiting. Annals of palliative medicine, 1(2), 94–102. https://doi.org/10.3978/j.issn.2224-5820.2012.07.05
• Son, J., & Yoon, H. (2018). Factors Affecting Postoperative Nausea and Vomiting in Surgical Patients. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses, 33(4), 461–470. https://doi.org/10.1016/j.jopan.2016.02.012
• Teshome, D., Hunie, M., Kibret, S., Mestofa, M., & Fenta, E. (2024). Prevalence and Factors Associated with Postoperative Nausea and Vomiting in an Ethiopian Comprehensive Specialized Hospital. Advances in Preventive Medicine, 2024(1), 6699732.
• Thapa, C., Bajracharya, G. R., Acharya, S., & Shrestha, N. (2022). Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy under General Anaesthesia in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA; journal of the Nepal Medical Association, 60(253), 789–792. https://doi.org/10.31729/jnma.7670
• Timerga, S., & Befkadu, A. (2024). Prevalence and associated factors of postoperative nausea and vomiting among adult patients undergoing elective surgery. Annals of medicine and surgery (2012), 86(3), 1304–1308. https://doi.org/10.1097/MS9.0000000000001678
• Toleska, M., Shosholcheva, M., Dimitrovski, A., Kartalov, A., Kuzmanovska, B., & Dimitrovska, N. T. (2022). Is Multimodal Anesthesia Effecting Postoperative Nausea and Vomiting in Laparoscopic Cholecystectomy?. Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki), 43(2), 51–58. https://doi.org/10.2478/prilozi-2022-0018
• Unalp-Arida, A., & Ruhl, C. E. (2024). Burden of gallstone disease in the United States population: Prepandemic rates and trends. World journal of gastrointestinal surgery, 16(4), 1130–1148. https://doi.org/10.4240/wjgs.v16.i4.1130
• Van Giersbergen, M. Y., & Uslu, Y. (2021). Cerrahi Hastalarda Bulantı ve Kusma Yönetiminde Kanıta Dayalı Uygulamalar. Türkiye Klinikleri Surgical Nursing-Special Topics, 7(3), 33-42.
• Willcutts, K. F., Chung, M. C., Erenberg, C. L., Finn, K. L., Schirmer, B. D., & Byham-Gray, L. D. (2016). Early Oral Feeding as Compared With Traditional Timing of Oral Feeding After Upper Gastrointestinal Surgery: A Systematic Review and Meta-analysis. Annals of surgery, 264(1), 54–63. https://doi.org/10.1097/SLA.0000000000001644
• Yayla, A., Eskici İlgin, V., Kılınç, T., Karaman Özlü, Z., & Ejder Apay, S. (2022). Nausea and Vomiting After Laparoscopic Cholecystectomy: Analysis of Predictive Factors. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses, 37(6), 834–841. https://doi.org/10.1016/j.jopan.2022.01.002
• Zhao, B., Zhao, T., Yang, H., & Fu, X. (2024). The Efficacy of Acupressure for Nausea and Vomiting After Laparoscopic Cholecystectomy: A Meta-analysis Study. Surgical laparoscopy, endoscopy & percutaneous techniques, 34(1), 87–93. https://doi.org/10.1097/SLE.0000000000001196