Literature DB >> 24156010

Postoperative orthostatic intolerance and gender differences.

Sang Wook Shin1.   

Abstract

Entities:  

Year:  2013        PMID: 24156010      PMCID: PMC3800716          DOI: 10.3344/kjp.2013.26.4.406

Source DB:  PubMed          Journal:  Korean J Pain        ISSN: 2005-9159


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LETTER TO EDITORS

I read with interest the article entitled "Orthostatic intolerance ambulation in patients using patient controlled analgesia" in the recently published Korean Journal of Pain [1]. First, the phrase "orthostatic intolerance" was not familiar to me, and it also prompted me to give some attention to the postoperative patient in the ward after the postanesthesia care unit and to the patient's rehabilitation after surgery. In this article, the authors defined orthostatic intolerance (OI) as the occurrence of dizziness, nausea, vomiting, blurred vision, headache, drowsiness or syncope, and attempted to investigate the incidence of OI in gastrectomy patients during their first ambulation in their ward following surgery. The authors also tried to investigate the correlation between the incidence of OI and contributing factors. Although there are some questions relating to the settings of their study - the amount of infused opioids, pain measurements, etc. - I would like to express an opinion on the study's conclusions. The authors concluded that the incidence of OI is significantly higher in male than in female patients and that it is influenced by the opioid dose. Other studies have found that age, female gender, opioid use, or continuous infusion of fentanyl are predisposing factors for OI in some procedures [2-4]. Some of their results relating to fentanyl infusion are comparable to Park's report [3], but their findings on gender are not, as according to Park's study, the incidence of OI is higher in the male gender [1]. It is this result that I question in Park's article. The results compared the differences in patients who developed OI. Out of 105 patients who developed OI, 61 patients were male, and 44 patients were female, but their proportions out of the total male and female patients were 52.6% and 74.6%, respectively. With this result, I would perhaps conclude that the female gender is more vulnerable to OI than the male, as was shown in the other report [2].
  4 in total

1.  Orthostatic intolerance during early mobilization after fast-track hip arthroplasty.

Authors:  Ø Jans; M Bundgaard-Nielsen; S Solgaard; P I Johansson; H Kehlet
Journal:  Br J Anaesth       Date:  2011-12-15       Impact factor: 9.166

2.  Postoperative continuous intravenous infusion of fentanyl is associated with the development of orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery.

Authors:  Yoshika Iwata; Yoko Mizota; Toshiyuki Mizota; Tomohiro Koyama; Tsutomu Shichino
Journal:  J Anesth       Date:  2012-04-21       Impact factor: 2.078

3.  Orthostatic intolerance during early mobilization following video-assisted thoracic surgery.

Authors:  Toshiyuki Mizota; Yoshika Iwata; Hiroki Daijo; Tomohiro Koyama; Tomoharu Tanaka; Kazuhiko Fukuda
Journal:  J Anesth       Date:  2013-05-14       Impact factor: 2.078

4.  Orthostatic intolerance ambulation in patients using patient controlled analgesia.

Authors:  Kwang Ok Park; Yoon Young Lee
Journal:  Korean J Pain       Date:  2013-07-01
  4 in total

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