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Surgeon's experience as a factor for emetic sequelae after middle ear surgery
Author(s) -
Honkavaara P.,
Pyykkö I.
Publication year - 1998
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1998.tb05372.x
Subject(s) - medicine , retching , droperidol , postoperative nausea and vomiting , anesthesia , vomiting , ondansetron , propofol , surgery , general anaesthesia , nausea , tonsillectomy , antiemetic
Purpose: To test the hypothesis that an experienced surgeon is associated with less postoperative nausea and vomiting (PONV). Methods: A post hoc analysis was done on the data of 167 patients from 3 randomized studies on the prevention of PONV, with transdermal scopolamine, ondansetron and propofol, in middle ear surgery under general anaesthesia. Results: The patients in the residents' group suffered more from PONV (69% vs. 42%, P <0.01) and from retching or vomiting (52% vs. 23%, P <0.001) than those in the specialists' group. The proportion of patients needing droperidol was also higher in the residents' group (66% vs. 27%, P <0.001). The durations of anaesthesia and surgery seemed to correlate positively with PONV. In matched‐pair analysis, residentship was confirmed as a risk factor for emetic symptoms. In the residents' group, prophylaxis of PONV resulted in a decrease in retching and vomiting from 71% to 29% ( P <0.01), and in patients needing droperidol from 87% to 46% ( P <0.01). Conclusion: The patients operated by residents need more aggressive prophylaxis for PONV than those operated by specialists in middle ear surgery.