• Pirjo H Manninen and Tong Khee Tan.
• Department of Anesthesia, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8. Pirjo.Manninen@uhn.on.ca
• J Clin Anesth. 2002 Jun 1;14(4):279-83.

Study ObjectiveTo assess the frequency of postoperative nausea and vomiting (PONV) in patients following an awake craniotomy compared to general anesthesia for tumor surgery.DesignProspective observational and chart review of all patients having a craniotomy for tumor during one year.SettingPostanesthesia care unit (PACU) and intensive care unit (ICU) of a university hospital.Patients187 patients were reviewed. 107 patients who had a craniotomy for supratentorial tumor that was less than six hours in duration were analyzed and compared (50 awake craniotomy vs. 57 general anesthesia).InterventionsMedical records were reviewed for events after the first four hours until discharge. The occurrence and the time of any nausea, vomiting; the administration of antiemetics and analgesic drugs; and complications were documented.MeasurementsFrequency of nausea, vomiting, administration of antiemetics and analgesia, and outcome between the two groups were compared using Chi-square and Student's t-test.Main ResultsThe frequency of nausea (4% vs. 23%; p = 0.012) and vomiting (0% vs. 11%; p = 0.052) were less in patients having an awake craniotomy compared to general anesthesia, but only during the first four hours. The administration of postoperative analgesia was not different between the two groups and did not influence the frequency of PONV.ConclusionThe frequency of PONV during the initial recovery phase was less in patients having an awake craniotomy for tumor surgery than in patients having a similar procedure with general anesthesia.

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