Previous chemotherapy can cause PONV

Abstract

Background. Although the treatment and mechanisms of postoperative nausea and vomiting (PONV) and chemotherapy-induced nausea and vomiting (CINV) are similar, the interactions between these 2 morbidities require more research. Objectives. In our prospective observational study, we investigated whether previous chemotherapy has an effect on PONV in breast cancer surgery. Materials and methods. One hundred and forty-eight female patients with the American Society of Anesthesiologists (ASA) physical status I or II, aged 18–65 years and with a scheduled breast cancer surgery were recruited into the study. After they completed preoperative follow-up questionnaires, anesthesia was induced with propofol (2 mg/kg), remifentanil (1.0 μg/kg) and rocuronium (0.6 mg/kg), and maintained with sevoflurane (1.5–2.0%), 45% oxygen/air mixture and infusion of remifentanil (0.1–0.2 μg/kg/min). After extubation, the intensity of PONV was assessed during the first 2 h and at 2–24 h after surgery. The symptoms of PONV were classified as mild (mild nausea, vomiting once, and nausea caused by an external stimulant (eating, drinking or motion)), moderate (vomiting twice, mild nausea without an external stimulant, and antiemetic medication required once) and severe (vomiting more than twice, severe nausea, antiemetic medication required more than once) by a different researcher. Preoperative interview forms, perioperative anesthetic follow-up forms and postoperative assessment forms were recorded and evaluated by different members of this research group. Results. Data of 143 patients were analyzed. In the group of patients who received chemotherapy, the prevalence of nausea and vomiting within the postoperative period of 2–24 h significantly increased (p < 0.05). Conclusions. Previous chemotherapy may be a risk factor for the presence of PONV.