Effects of end tidal CO2 and venous CO2 levels on postoperative nausea and vomiting in paediatric patients

N. Altay, S. Yalçın, H. Aydoğan, A. Küçük, H.H. Yüce

Department of Anesthesiology and Reanimation, Harran University School of Medicine, Sanliurfa, Turkey. nurayaltay@ymail.com

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• Anesthesiology

OBJECTIVE: Postoperative nausea and vomiting (PONV) is a common complaint of paediatric surgical patients. The aim of this prospective study was to compare the effects of end tidal CO₂ (PeCO₂) and venous CO₂ (PvCO₂) in laryngeal mask (LMA) and face mask (FM) ventilation on the occurrence of PONV in paediatric patients with surgical interventions in the inguinal region. To date, no data regarding these parameters on PONV are available.

PATIENTS AND METHODS: Ninety children were randomized using the sealed-envelope method. Group 1 consisted of 45 patients whose airway was managed with LMA; Group 2 consisted of 45 patients whose airway was managed with FM. Induction of anaesthesia was performed via administration of 8% sevoflurane in a mixture of air/oxygen in all patients. In both groups, manually controlled ventilation was applied. Five (t1) and fifteen (t2) min after the start of surgery, venous blood samples were obtained and PeCO₂ was determined.

RESULTS: PeCO₂ (t2) and PvCO₂ (t2) levels and the occurrence of PONV were significantly increased in Group 2 compared to Group 1 (p < 0.005 for all). In both groups, the occurrence of PONV was positively correlated with BMI, PeCO₂ (t2), and PvCO₂ (t2) levels (p < 0.05 for all), whereas it was inversely correlated with SpO₂ levels (p < 0.05 for all) in a bivariate analysis. We found that the PeCO₂ (t2) and PvCO₂ (t2) levels were independently associated with the occurrence of PONV in both groups.

CONCLUSIONS: Our results showed that elevated levels of PeCO₂ (t2) and PvCO₂ (t2) are independent risk factors for PONV, and these parameters may be used as adjunctive tools to assess the occurrence of PONV.

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