Comparison of the effects of the low and high flow anesthesia on nausea-vomiting and shivering in laparoscopic cholecystectomy

The aim of this study is to compare the effects of high and low flow anesthesia in which desfluran is used during laparoscopic surgery, on postoperative nausea and vomiting and shivering.60 patients at ASA I-II group included during the study. Anesthetic induction was achieved by using propofol, fentanyl and vecuronium after preoxigenation. After the intubation, denitrogenation was achieved by using 100% oxygen at 6-10 L/min and adequate anesthetic depth was acquired. The patients were divided into two grups randomly and fresh gas flow was reduced. The fresh gas flow at Group D (low flow) was 1 L/min( oxygen 0.5 L/min, air 0.5 L/min plus desfluran); 4L/min (oxygen 2 L/min, air 2 L/min plus desfluran) at Group Y (high flow).The input and postintubation evaluation of the hemodynamic (ETCO2, SpO2, FiO2, HR, MAP and body temperature) parameters of the patients were obtained at 5, 10, 15, 20, 25, 30, 45, 60 minutes. After the operation, nausea, vomiting and VAS values were recorded during the first 24 hours at 0-30 minutes, 30-60 minutes, 2-4 hours, 6-12 hours and 12-24 hours. Postoperative shivering and body temperatures were recorded at 0-30 minutes, 30-45 minutes and 45-60 minutes.There was no significance between the groups from the aspect of the demographic parameters. Postoperative nausea of 0-30 minutes was significantly higher at Group Y than Group D. Postoperative body temperatures of Goup D at 0-30 minutes were significantly higher than Group Y. Postoperative shivering was significantly lower at Group D than Group Y at 0-30 minutes.As a result, we concluded that low flow anesthesia reduces the POBK at the early postoperative period. This situation may be connected to decreased respiratory heat loss because of low flow anesthesia. It supports our thesis that in the low flow anesthesia group shivering and hypothermia were less than other group. However, further studies are needed to make any definite conclusions.KEYWORDS: Desfluran, Low Flow Anesthesia, Postoperative Nausea, Vomiting and Shivering.IV. ABSTRACTCOMPARISON OF THE EFFECTS OF THE LOW AND HIGH FLOW ANESTHESIA ON NAUSEA-VOMITING AND SHİVERİNG IN LAPAROSCOPIC SURGERYÖnder ÖZEN, MDResidency Thesis; Department of Anesthesiology and ReanimationSupervisor: Assistant Prof. Dr. Rauf GÜL2011, 61 pagesThe aim of this study is to compare the effects of high and low flow anesthesia in which desfluran is used during laparoscopic surgery, on postoperative nausea and vomiting and shivering.60 patients at ASA I-II group included during the study. Anesthetic induction was achieved by using propofol, fentanyl and vecuronium after preoxigenation. After the intubation, denitrogenation was achieved by using 100% oxygen at 6-10 L/min and adequate anesthetic depth was acquired. The patients were divided into two grups randomly and fresh gas flow was reduced. The fresh gas flow at Group D (low flow) was 1 L/min( oxygen 0.5 L/min, air 0.5 L/min plus desfluran); 4L/min (oxygen 2 L/min, air 2 L/min plus desfluran) at Group Y (high flow).The input and postintubation evaluation of the hemodynamic (ETCO2, SpO2, FiO2, HR, MAP and body temperature) parameters of the patients were obtained at 5, 10, 15, 20, 25, 30, 45, 60 minutes. After the operation, nausea, vomiting and VAS values were recorded during the first 24 hours at 0-30 minutes, 30-60 minutes, 2-4 hours, 6-12 hours and 12-24 hours. Postoperative shivering and body temperatures were recorded at 0-30 minutes, 30-45 minutes and 45-60 minutes.There was no significance between the groups from the aspect of the demographic parameters. Postoperative nausea of 0-30 minutes was significantly higher at Group Y than Group D. Postoperative body temperatures of Goup D at 0-30 minutes were significantly higher than Group Y. Postoperative shivering was significantly lower at Group D than Group Y at 0-30 minutes.As a result, we concluded that low flow anesthesia reduces the POBK at the early postoperative period. This situation may be connected to decreased respiratory heat loss because of low flow anesthesia. It supports our thesis that in the low flow anesthesia group shivering and hypothermia were less than other group. However, further studies are needed to make any definite conclusions.KEYWORDS: Desfluran, Low Flow Anesthesia, Postoperative Nausea, Vomiting and Shivering.IV. ABSTRACTCOMPARISON OF THE EFFECTS OF THE LOW AND HIGH FLOW ANESTHESIA ON NAUSEA-VOMITING AND SHİVERİNG IN LAPAROSCOPIC SURGERYÖnder ÖZEN, MDResidency Thesis; Department of Anesthesiology and ReanimationSupervisor: Assistant Prof. Dr. Rauf GÜL2011, 61 pagesThe aim of this study is to compare the effects of high and low flow anesthesia in which desfluran is used during laparoscopic surgery, on postoperative nausea and vomiting and shivering.60 patients at ASA I-II group included during the study. Anesthetic induction was achieved by using propofol, fentanyl and vecuronium after preoxigenation. After the intubation, denitrogenation was achieved by using 100% oxygen at 6-10 L/min and adequate anesthetic depth was acquired. The patients were divided into two grups randomly and fresh gas flow was reduced. The fresh gas flow at Group D (low flow) was 1 L/min( oxygen 0.5 L/min, air 0.5 L/min plus desfluran); 4L/min (oxygen 2 L/min, air 2 L/min plus desfluran) at Group Y (high flow).The input and postintubation evaluation of the hemodynamic (ETCO2, SpO2, FiO2, HR, MAP and body temperature) parameters of the patients were obtained at 5, 10, 15, 20, 25, 30, 45, 60 minutes. After the operation, nausea, vomiting and VAS values were recorded during the first 24 hours at 0-30 minutes, 30-60 minutes, 2-4 hours, 6-12 hours and 12-24 hours. Postoperative shivering and body temperatures were recorded at 0-30 minutes, 30-45 minutes and 45-60 minutes.There was no significance between the groups from the aspect of the demographic parameters. Postoperative nausea of 0-30 minutes was significantly higher at Group Y than Group D. Postoperative body temperatures of Goup D at 0-30 minutes were significantly higher than Group Y. Postoperative shivering was significantly lower at Group D than Group Y at 0-30 minutes.As a result, we concluded that low flow anesthesia reduces the POBK at the early postoperative period. This situation may be connected to decreased respiratory heat loss because of low flow anesthesia. It supports our thesis that in the low flow anesthesia group shivering and hypothermia were less than other group. However, further studies are needed to make any definite conclusions.KEYWORDS: Desfluran, Low Flow Anesthesia, Postoperative Nausea, Vomiting and Shivering.