Address of Corresponding Author

Gynecol Obstet Invest 2005;59:49-53 (DOI: 10.1159/000081222)

  Key Words

• Gynecologic laparoscopy
• Menstrual cycle
• Nausea and vomiting
• Pain and agitation in laparoscopy
• Agitation in laparoscopy

  Abstract

Background: Several studies have suggested that the menstrual cycle has an impact on postoperative nausea and vomiting (PONV). No previous study has evaluated the effect of the menstrual cycle on the incidence of postoperative agitation and analgesic/antiemetic requirements. Methods: On the basis of the phase of the menstrual cycle [pre±menstrual (Pd 25-6), early follicular phase (Pd 8-12), ovulatory phase (Pd 13-15), and luteal phase (Pd 20-24)], 67 patients enrolled in this blinded, prospective study. Anesthesia was standardized. Fentanyl was given to the patients who had severe pain in the recovery room. The patients who had agitation were given midazolam. When pain intensity was >5 on the Visual Analog Scale, metamizol was administered in the Gynecology Department. A blinded anesthesiologist recorded episodes of PONV in the recovery room, and 2 and 24 h postoperatively. Results: The opioid requirement and the frequency of agitation were similar in each group. Metamizol consumption was highest in the luteal phase (p < 0.05). The follicular and luteal phases were predictors for vomiting at recovery (p < 0.05 and p < 0.001, respectively). At the postoperative 2nd hour, nausea was higher in the follicular phase than in the other phases (p < 0.05) and the luteal phase was a predictor for retching (p < 0.001). At the postoperative 24th hour, nausea was the common symptom in the luteal phase (p < 0.05). The need for ondansetron was highest in the luteal phase (p < 0.01). Conclusions: In conclusion, we suggest that the scheduling of all surgical procedures according to the menstrual phase may serve to reduce the incidence of PONV and metamizol/ondansetron consumption and hospital costs.

Copyright © 2005 S. Karger AG, Basel

  Author Contacts

Elif Bengi Sener, MD, Assistant Professor in Anesthesia
Ondokuz Mayis University, Faculty of Medicine
Department of Anesthesiology, TR-55139 Samsun (Turkey)
Tel. +90 362 4576000/3350, Fax +90 362 4576041
E-Mail bengimd@hotmail.com

  Article Information

This study was presented at the 13th World Congress of Anesthesiologists (WCA), Paris 2004.

Received: February 10, 2004
Accepted after revision: August 19, 2004
Published online: September 30, 2004
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 2, Number of References : 19