Postoperative Nausea and Vomiting and Pain After Robotic-Assisted Mitral Valve Repair.
J Cardiothorac Vasc Anesth
; 34(12): 3225-3230, 2020 Dec.
Article
en En
| MEDLINE
| ID: mdl-32732099
ABSTRACT
OBJECTIVE:
To determine the rate and clinical factors associated with postoperative nausea and vomiting (PONV) and severe pain after robotic-assisted mitral valve repair.DESIGN:
Retrospective chart review.SETTING:
Major quaternary academic medical center.PARTICIPANTS:
Adult patients undergoing robotic-assisted mitral valve repair from May 5, 2018 through September 13, 2019.INTERVENTIONS:
Participant electronic medical records were abstracted for clinical characteristics, PONV within the first 72 postoperative hours, episodes of severe pain (defined as pain score ≥7 using an 11-point numerical pain rating scale), and opioid use within the first 24 postoperative hours. Multivariate analyses were performed. MEASUREMENTS AND MAINRESULTS:
Of 124 participants, PONV was noted in 83 (67%; 95% confidence interval [CI] 58%-75%) patients and severe pain in 96 (77%, 95% CI 69%-84%) patients. The median (interquartile range) time to PONV was 6.1 (3.7-14.7) hours. After adjusting for age, sex, and duration of surgery, pre-incisional use of methadone was associated with reduced risk for severe pain (odds ratio 0.40 [95% CI 0.16-0.99]; pâ¯=â¯0.048) and a lower 24-postoperative hour opioid requirement (estimate -29.0 mg intravenous morphine equivalents [95% CI -46.7 to -11.3]; pâ¯=â¯0.006). However, methadone was not associated with a reduction of the cumulative opioid dose (intraoperative and 24-hour postoperative opioid dose; pâ¯=â¯0.248). Both severe pain and PONV were associated with longer hospital stay.CONCLUSION:
PONV and severe pain are common after robotic-assisted mitral valve repair. Peri-incisional methadone is associated with a modest decrease in the severe pain rate but without a reduction in opioid dose or hospital stay.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_sistemas_informacao_saude
Asunto principal:
Náusea y Vómito Posoperatorios
/
Procedimientos Quirúrgicos Robotizados
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Asunto de la revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Mongolia