• Gynecol. Obstet. Invest. · Jan 2005

    Effects of menstrual cycle on postoperative analgesic requirements, agitation, incidence of nausea and vomiting after gynecological laparoscopy.

    • Elif Bengi Sener, Serhat Kocamanoglu, Mehmet Bilge Cetinkaya, Emre Ustun, Emine Bildik, and Ayla Tur.
    • Ondokuzmayis University, Faculty of Medicine, Samsun, Turkey. bengimd@hotmail.com
    • Gynecol. Obstet. Invest. 2005 Jan 1;59(1):49-53.

    BackgroundSeveral studies have suggested that the menstrual cycle has an impact on postoperative nausea and vomiting (PONV). No previous study has evaluated the effect of the menstrual cycle on the incidence of postoperative agitation and analgesic/antiemetic requirements.MethodsOn the basis of the phase of the menstrual cycle [pre+/-menstrual (Pd 25-6), early follicular phase (Pd 8-12), ovulatory phase (Pd 13-15), and luteal phase (Pd 20-24)], 67 patients enrolled in this blinded, prospective study. Anesthesia was standardized. Fentanyl was given to the patients who had severe pain in the recovery room. The patients who had agitation were given midazolam. When pain intensity was >5 on the Visual Analog Scale, metamizol was administered in the Gynecology Department. A blinded anesthesiologist recorded episodes of PONV in the recovery room, and 2 and 24 h postoperatively.ResultsThe opioid requirement and the frequency of agitation were similar in each group. Metamizol consumption was highest in the luteal phase (p < 0.05). The follicular and luteal phases were predictors for vomiting at recovery (p < 0.05 and p < 0.001, respectively). At the postoperative 2nd hour, nausea was higher in the follicular phase than in the other phases (p < 0.05) and the luteal phase was a predictor for retching (p < 0.001). At the postoperative 24th hour, nausea was the common symptom in the luteal phase (p < 0.05). The need for ondansetron was highest in the luteal phase (p < 0.01).ConclusionsIn conclusion, we suggest that the scheduling of all surgical procedures according to the menstrual phase may serve to reduce the incidence of PONV and metamizol/ondansetron consumption and hospital costs.Copyright 2005 S. Karger AG, Basel.

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