MENSTRUATION INCREASES THE RISK OF NAUSEA AND VOMITING AFTER LAPAROSCOPY - A PROSPECTIVE RANDOMIZED STUDY

Background. Several factors may influence the incidences of postoperative nausea and vomiting. In women, one of these factors may be the timing of their surgery in relation to their menstrual cycle. The purpose of this study was to assess the effect of menstruation and efficacy of the antiemetic droperidol on postoperative nausea and vomiting. Methods. In a prospective randomized double-blind clinical trial, 100 female patients who were scheduled for laparoscopic tubal sterilization were stratified on the basis of the date of their last menses into menstrual (days 1-8) and nonmenstrual (days 9-28) groups. Patients in both groups were then randomized to receive placebo or 10, 20, or 30 mug/kg droperidol before induction of anesthesia, and data were obtained for 24 h after completion of their surgery. Results: Nausea and vomiting were reported in 55 patients, and the risk was 2.92 times greater in the menstrual group (71.4%) than in the nonmenstrual group (46.2%; (P = .013). Droperidol (30 mug/kg) reduced the incidence of vomiting from 47.1% (placebo) to 13.3% in the nonmenstrual group (P = .045) but had no effect in the menstrual group. Five prognostic variables (menstrual stratum, droperidol, age 30 yr or younger, weight 65 kg or less, and history of nausea and vomiting) for postoperative nausea and vomiting were tested by stepwise logistic regression. Menstrual stratum was the only variable identified as a significant (P = .017) predictor, having a percent probability equal to 2.21. Conclusions: The risk of postoperative nausea and vomiting is increased in women undergoing laparoscopic tubal sterilization during the first 8 days of their menstrual cycle, and droperidol up to 30 mug/kg is not as effective in these patients.