Daniela Ionescu1, Cristina Badescu, Iurie Acalovschi. 1. Department of Anesthesia and Intensive Care, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Japoca, Romania. dionescuati@yahoo.com
Abstract
BACKGROUND AND OBJECTIVE: It has been demonstrated that smoking significantly reduces postoperative nausea and vomiting (PONV). However, there are approximately 4000 substances in cigarette smoke that can be responsible for this effect. To demonstrate whether nicotine is the substance with antiemetic effects we applied a nicotine patch in patients undergoing laparoscopic cholecystectomy under general anaesthesia. METHODS:Seventy-five patients classified as ASA (American Society of Anesthesiologists' classification) I/II were divided in three groups: group 1 (n = 25), which comprised non-smokers; group 2 (n = 25), which comprised patients who had given up smoking for the last 5 years and received perioperatively a nicotine patch that contained 16.6mg nicotine/patch; and group 3 (n = 25), which comprised actual smokers. Postoperatively, the incidence of PONV and the need for antiemetic rescue medication were monitored every 6 hours. RESULTS: We found a significant reduction in the incidence of PONV in group 2 (5/25 [20%], p = 0.0001 vs group 1) and group 3 (8/25 [32%], p = 0.002 vs group 1) compared with group 1 (18/25 [76%]). The difference in incidence of PONV between group 2 and group 3 was not significant (p > 0.05). CONCLUSIONS:Nicotine significantly reduced the incidence of PONV after laparoscopic cholecystectomy.
RCT Entities:
BACKGROUND AND OBJECTIVE: It has been demonstrated that smoking significantly reduces postoperative nausea and vomiting (PONV). However, there are approximately 4000 substances in cigarette smoke that can be responsible for this effect. To demonstrate whether nicotine is the substance with antiemetic effects we applied a nicotine patch in patients undergoing laparoscopic cholecystectomy under general anaesthesia. METHODS: Seventy-five patients classified as ASA (American Society of Anesthesiologists' classification) I/II were divided in three groups: group 1 (n = 25), which comprised non-smokers; group 2 (n = 25), which comprised patients who had given up smoking for the last 5 years and received perioperatively a nicotine patch that contained 16.6mg nicotine/patch; and group 3 (n = 25), which comprised actual smokers. Postoperatively, the incidence of PONV and the need for antiemetic rescue medication were monitored every 6 hours. RESULTS: We found a significant reduction in the incidence of PONV in group 2 (5/25 [20%], p = 0.0001 vs group 1) and group 3 (8/25 [32%], p = 0.002 vs group 1) compared with group 1 (18/25 [76%]). The difference in incidence of PONV between group 2 and group 3 was not significant (p > 0.05). CONCLUSIONS:Nicotine significantly reduced the incidence of PONV after laparoscopic cholecystectomy.
Authors: Christoph Czarnetzki; Eduardo Schiffer; Christopher Lysakowski; Guy Haller; Daniel Bertrand; Martin R Tramèr Journal: Br J Clin Pharmacol Date: 2011-03 Impact factor: 4.335
Authors: Canhua Xiao; Alexandra Hanlon; Qiang Zhang; Benjamin Movsas; Kian Ang; David I Rosenthal; P Félix Nguyen-Tan; Harold Kim; Quynh Le; Deborah Watkins Bruner Journal: Cancer Date: 2013-12-11 Impact factor: 6.860