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Japanese Journal of Anesthesiology 2009-Dec

[Postoperative nausea, vomiting and pain after pediatric outpatient surgery : comparison of laparoscopic and conventional inguinal hernia repair].

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Kaoru Matsunami
Tomoaki Shimizu
Keiko Kinouchi
Kazuya Tachibana

Keywords

Abstract

BACKGROUND

The number of laparoscopic surgery is increasing in pediatric surgery. There are few studies in which the pediatric outpatient postoperative course was compared between the laparoscopic and conventional open surgery.

METHODS

Girls older than 1 year who had undergone outpatient hernia repair between August 2005 and November 2006 were retrospectively reviewed dividing into 2 groups according to the procedures. The girls in Group L underwent laparoscopic percutaneous extraperitoneal closure (LPEC) (n = 53) and girls in Group P underwent conventional Potts procedure (n = 48). In all the patients anesthesia was induced and maintained with sevoflurane and nitrous oxide in oxygen. Airway was secured either by tracheal intubation or laryngeal mask airway without the use of muscle relaxants. All the patients received ilioinguinal nerve block and the patients in group L received additional paraumbilical nerve block.

RESULTS

The operation time and anesthesia time were longer in group L. The patients in group L had a higher incidence of nausea (30.2% vs. 12.5%, P < 0.01) and vomiting (22.6% vs. 10.4%, P < 0.05) and required more analgesics (39.6% vs. 23.0%, P < 0.01) compared with those in group P. The incidence of unplanned hospital admission was not different between the groups.

CONCLUSIONS

The patients undergoing LPEC required more postoperative analgesics. The measures to lower postoperative nausea and vomiting should be adopted in these patients.

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