Laparoskopi̇k kolesi̇stektomi̇ yapilan hastalarda hi̇perventi̇lasyonun postoperati̇f bulanti-kusma üzeri̇ne etki̇si̇

Aim: In patients undergoing laparoscopic cholecystectomy, high incidences of PONV have been reported (46-72 %). The aim of this study was to evaluate the effects of low ETCO₂ in prevention of nausea and vomiting after laparoscopic cholecystectomy. Methods: 60 ASA I-II patients undergoing laparoscopic cholecystectomy were randomly allocated to Group Y (ETCO ₂ 35-45 mmHg) or Group D (ETCO₂ 25-30 mmHg). Anaesthesia induction was performed with thiopental and rocuronium, anaesthesia was further maintained with isoflurane in O₂-N₂O inhalation. Ventilatory settings were done in both groups to achieve the targeted ETCO ₂ levels. Hemodynamic variables, blood pressure, heart rate and peripheral oxygen saturation and ETCO₂ levels were noted during the intraoperative period. The incidence of nausea and vomiting were assessed at 5, 15, 30, 45 and 60^th minutes and 2, 6, 12 and 24^th hours after surgery. Total antiemetic consumption (ondansetron 4 mg) was noted at 24 hours after surgery. Mann Whitney U and Chi-Square tests were used and p<0.05 was considered as significant. Results: Patient demographics, operation times and hemodynamic variables were comparable among groups. The area under ETCO ₂ versus time curve was higher in Group Y (p<0.001). The total ondansetron consumption in postoperative period was higher in Group Y compared to Group D (4mg, 0-8, 0mg, 0-4mg) (p=0.006). The number of patient demonstrating nausea postoperatively was higher in Group Y (n=20 vs n=10) (p=0.01). Number of nausea attacks per patient was higher in Group Y (2, 0-5) compared to Group L (0, 0-1) (p=0.002). Conclusion: The results of this study reveal that, intraoperative low ETCO₂ levels may reduce the incidence of nausea and the consumption of antiemetic drugs in laparoscopic cholecystectomy cases.