The Effect of Ethanol Inhalation on Postoperative Nausea in Patients using Patient Controlled Analgesia

에탄올 비강흡입이 수술 후 자가통증조절기 사용 환자의 오심에 미치는 효과

  • Received : 2009.05.18
  • Accepted : 2009.08.03
  • Published : 2009.08.31

Abstract

Purpose: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). Methods: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. Results: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). Conclusion: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.

Keywords

References

  1. Anderson, L. A., & Gross, J. B. (2004). Aromatherapy with peppermint, ISO, or placebo is equally effective in relieving postoperative nausea. Journal of Perianesthsia Nursing, 19(1), 29-35. https://doi.org/10.1016/j.jopan.2003.11.001
  2. Apfel, C. C., & Roewer, N. (2003). Risk assessment of postoperative nausea and vomiting. International Anesthesiology Clinics, 41(4), 13-32. https://doi.org/10.1097/00004311-200341040-00004
  3. Boogaerts, J. G., Vanacker, E., Seidel, L., Albert, A., & Bardiau, M. (2000). Assessment of postoperative nausea using a visual analogue scale. Acta Anaesthesiologica Scandinavica, 44(4), 470-474. https://doi.org/10.1034/j.1399-6576.2000.440420.x
  4. Choi, D. H., Cha, S. H., & Kim, E. J. (2005). Effects of prophylactic antiemetic combination of dexamethasone and ondansetron on postoperative nausea and vomiting in high-risk patients. Korean Journal of Anesthesiology, 49(6), 751-756. https://doi.org/10.4097/kjae.2005.49.6.751
  5. Cohen, J. (1988). Statistical power analysis for behavioral science. New York: Academic Press.
  6. Glass, P. S. A., Estrok, P., Ginsberg, B., Goldberg, J. S., & Sladen, R. N. (1992). Use of patient-controlled analgesia to compare the efficacy of epidural to intravenous fentanyl administration. Anesthesia and Analgesia, 74(3), 345-351.
  7. Golembiewski, J. A., & O'Brien, D. (2002). A systematic approach to the management of postoperative nausea and vomiting. Journal of Perianesthsia Nursing, 17(6), 364-376. https://doi.org/10.1053/jpan.2002.36596
  8. Grizeil-Stojcic, E., Rasic, Z., Cala, Z., Mrsic, V., & Smiljanic, A. (2007). Comparison of dexamethasone, metoclopramide, and their combination in the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Surgical Endoscopy, 21(4), 607-612. https://doi.org/10.1007/s00464-006-9122-7
  9. Hogan, C. M. (1990). Advances in management of nausea and vomiting. The Nursing Clinics of North America, 25(2), 475-497.
  10. Junger, A., Hartmann, B., Schindler, E., Dietrich, G., & Jost, A. (2001). The use of an anesthesia information management system for prediction of antiemetic rescue treatment at the postanesthesia care unit. Anesthesia and Analgesia, 92(5), 1203-1209. https://doi.org/10.1097/00000539-200105000-00023
  11. Kaufmann, M. A., Roscow, C., & Schneiper, M., & Schneider, M. (1994). Prophylactic antiemetic therapy with patientcontrolled analgesia: A double blind, placebo controlled comparison of droperidol, metoclopromide and tropisetron. Anesthesia and Analgesia, 8(5), 988-994.
  12. Kenny, G. N. (1994). Risk factors for postoperative nausea and vomiting. Anesthesia, 49, Suppl: 6-10. https://doi.org/10.1111/j.1365-2044.1994.tb03576.x
  13. Kim, E. J., Ahn, H, J., Park, S. H., Bang, S. R., & Choi, D. H. (2005). Risk factors of postoperative nausea and vomiting: development of Korean risk model. Korean Journal of Anesthesiology, 48(4), 380-386. https://doi.org/10.4097/kjae.2005.48.4.380
  14. Kim, M. K., Bai, S. J., Han, J. M., Lee, Y. K., Kim, J. S., & Shin, Y. S. (2004). The incidence of nausea and vomiting in immediate postanesthetic period. Korean Journal of Anesthesiology, 47(4), 472-476. https://doi.org/10.4097/kjae.2004.47.4.472
  15. Kim, S. I. (2005). Current management of postoperative nausea and vomiting. Korean Journal of Anesthesiology, 48(1), 1-9. https://doi.org/10.4097/kjae.2005.48.1.1
  16. Kim, S. I., Lee, S. C., Ok, S. Y., & Kim, S. J. (2005). Ondansetron reduces postoperative nausea and vomiting after a laparoscopic cholecystectomy. Korean Journal of Anesthesiology, 49(3), 365-369. https://doi.org/10.4097/kjae.2005.49.3.365
  17. Korea Occupational Safety & Health Agency. Retrieved June, 23, 2009, from the Korea occupational safety & health agency Web site: http://www.kosha.net/shdb/msds/msdsSearchView.jsp?rootNodeId=807&selectedNodeId=5325&contentId=192120&query='2-프로판올'z_synonym&gotoPage=2
  18. Korea Occupational Safety & Health Agency. Retrieved June, 23, 2009, from the Korea occupational safety & health agency Web site: http://www.kosha.net/shdb/msds/msdsSearchView.jsp?rootNodeId=807&selectedNodeId=5325&contentId=209740&query='에탄올'z_materialName&gotoPage=2
  19. Lee, Y. Y. (2006). Prediction model on causing factors for the postoperative nausea and vomiting in patients using patient controlled analgesia. Doctoral dissertation, Chung-Ang University, Seoul.
  20. Lim, S. M., Kim, J. Y., Kang, H., Baek, C. H., Park, J. W., Jung, Y. H., Woo, Y. C., Koo, G. H., & Park, S. G. (2008). The effects of continuous infusion of postoperative nausea and vomiting in patients receiving IV-patient controlled analgesia following gynecological surgery. Korean Journal of Anesthesiology, 55(2), 176-181. https://doi.org/10.4097/kjae.2008.55.2.176
  21. Mamaril, M. E., Windle, P. E., & Burkard, J. F. (2006). Prevention and management of postoperative nausea and vomiting: a look at complementary techniques. Journal of PeriAnesthesia Nursing, 21(6), 404-410. https://doi.org/10.1016/j.jopan.2006.09.007
  22. Merritt, B. A., Okyere, C. P., & Jasinski, D. M. (2002). Isopropyl alcohol inhalation: Alternative treatment of postoperative nausea and vomiting. Nursing Research, 51(2), 125-128. https://doi.org/10.1097/00006199-200203000-00009
  23. Negus, B., & Markocic, S. (2003). A surgical antiemetic protocol-mplememtation and evaluation. Acute pain, 5(2), 63-68. https://doi.org/10.1016/j.acpain.2003.08.002
  24. Smiler, B., & Srock, M. (1998). Isopropyl alcohol for transport related nausea(letter). Anesthesia and Analgesia, 87(5), 1214.
  25. Stadler, M., Bardiau, F., Seidel, L., Albert, A., & Boogaerts, J. G. (2003). Difference in risk factors for postoperative nausea and vomiting. Anesthesiology, 98(1), 46-52. https://doi.org/10.1097/00000542-200301000-00011
  26. Suh, J. H., Kang, M. H., Ryu, J. H., Park, K. S., & Do, S. H. (2007). Comparison of ramosetron and ondansetron for preventing nausea and vomiting after gynecologic surgery. Korean Journal of Anesthesiology, 52(5), 561-565. https://doi.org/10.4097/kjae.2007.52.5.561
  27. Wang, S. M., Hofstadter, M. B., & Kain, Z. N. (1999). An alternative method to alleviate postoperative nausea and vomiting in children. Journal of Clinical Anesthesia, 11(3), 231-234. https://doi.org/10.1016/S0952-8180(99)00035-5
  28. White, P. F. (1997). Are nonpharmacological techniques useful alternatives to antiemetic drugs for the prevention of nausea and vomiting? Anesthesia and Analgesia, 84(4), 712-714. https://doi.org/10.1097/00000539-199704000-00002
  29. Winston, A. W., Rinehart, R. S., Riley, G. P., Vacchiano, C. A., & Pellegrini, J. E. (2003). Comparison of inhaled isopropyl alcohol and intravenous ondansetron for treatment of postoperative nausea. AANA Journal, 71(2), 127-132.
  30. Yang, H. S., Lee, C., & Kim, W. T. (1997). Do metoclopramide with dexamethasone act synergistically in control of postoperative nausea and vomiting? Korean Journal of Anesthesiology, 33(6), 1170-1175. https://doi.org/10.4097/kjae.1997.33.6.1170