POSTOPERATIVNA MUČNINA I POVRAĆANJE – FAKTORI RIZIKA I PREVENCIJA
DOI:
https://doi.org/10.46793/PP190319004BKljučne reči:
anestezija, mučnina, povraćanje, rizik, prevencija, deteApstrakt
Postoperativna mučnina i povraćanje (PONV) često se javljaju kod dece i zahtevaju profilaktičke i terapijske mere. PONV se može smanjiti izbegavanjem primene inhalacionih anestetika i smanjenjem postoperativno datih opioida. Deksametazon i 5-HT3 antagonisti smatraju se osnovnim profilaktičkim lekovima. Hirurška intervencija koja duže traje, vrsta hirurškog zahvata (npr. strabizam i određeni otorinolaringološki zahvati) i PONV u anamnezi takođe se smatraju faktorima rizika koji povećavaju incidencu PONV, dok se kratke procedure i ambulantna hirurgija smatraju faktorom niskog rizika. Na osnovu procene niskog, srednjeg ili visokog rizika određuje se jednostruka, dvostruka ili trostruka (dva leka i totalna intravenska anestezija) profilaksa. Droperidol i metoklopramid mogu se preporučiti jedino kao dopunska terapija.
Reference
Höhne C.Postoperative nausea and vomiting in pediatric anesthesia. Curr Opin Anaesthesiol. 2014;27(3):303-8. doi: 10.1097/ACO.0000000000000073.
Eberhart LH, Geldner G, Kranke P, Morin AM, Schäuffelen A, Treiber H et al.The development and validation of a risk score to predict the probability of postoperative vomiting in pediatric patients. Anesth Analg. 2004;99(6):1630-7.
Kranke P, Eberhart LH, Toker H, Roewer N, Wulf H, Kiefer P. A prospective evaluation of the POVOC score for the prediction of postoperative vomiting in children. Anesth Analg 2007; 105:1592–1597.
Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006; 102(6):1884-98.
Train AT, Cairo SB, Meyers HA, Harmon CM, Rothstein DH. The impact of obesity on 30-day complications in pediatric surgery. Pediatr Surg Int. 2017; 33(11):1167-1175.doi: 10.1007/s00383-017-4131-2.
Klisić A, Kavarić N. Oksidativni stres kod gojazne dece-kako ga sprečiti ili smanjiti? Prev Ped. 2017; 3(1-2):16-20.
Bjelakovic B. Cardiovascular risk prediction in children - with focus on obesity. Prev Ped. 2015; 1:24-28.
Budic I, Marjanovic V, Petrovic Z, Novakovic D, Simic D. Preventing the most common anesthesia related complications in children. Prev Ped. 2015; 1:20-23.
Efune PN, Minhajuddin A, Szmuk P. Incidence and factors contributing to postdischarge nausea and vomiting in pediatric ambulatory surgical cases. Paediatr Anaesth. 2018; 28(3):257-263.doi: 10.1111/pan.13333.
Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for management of postoperative nausea and vomiting. Anesth Analg 2014; 118:85–113.
Hermans V, De Pooter F, De Groote F, et al. Effect of dexamethasone on nausea, vomiting, and pain in paediatric tonsillectomy. Br J Anesth 2012; 109:427–431.doi: 10.1093/bja/aes249.
