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  • Acta Anaesthesiol Scand · Oct 1998

    Randomized Controlled Trial Clinical Trial

    Surgeon's experience as a factor for emetic sequelae after middle ear surgery.

    • P Honkavaara and I Pyykkö.
    • Department of Anaesthesia, Helsinki University Central Hospital, Finland.
    • Acta Anaesthesiol Scand. 1998 Oct 1; 42 (9): 1033-7.

    PurposeTo test the hypothesis that an experienced surgeon is associated with less postoperative nausea and vomiting (PONV).MethodsA post hoc analysis was done on the data of 167 patients from 3 randomized studies on the prevention of PONV, with transdermal scopolamine, ondansetron and propofol, in middle ear surgery under general anaesthesia.ResultsThe patients in the residents' group suffered more from PONV (69% vs. 42%, P < 0.01) and from retching or vomiting (52% vs. 23%, P < 0.001) than those in the specialists' group. The proportion of patients needing droperidol was also higher in the residents' group (66% vs. 27%, P < 0.001). The durations of anaesthesia and surgery seemed to correlate positively with PONV. In matched-pair analysis, residentship was confirmed as a risk factor for emetic symptoms. In the residents' group, prophylaxis of PONV resulted in a decrease in retching and vomiting from 71% to 29% (P < 0.01), and in patients needing droperidol from 87% to 46% (P < 0.01).ConclusionThe patients operated by residents need more aggressive prophylaxis for PONV than those operated by specialists in middle ear surgery.

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