Korean J Anesthesiol.  2015 Dec;68(6):581-585. 10.4097/kjae.2015.68.6.581.

Postoperative pain, nausea and vomiting among pre- and postmenopausal women undergoing cystocele and rectocele repair surgery

• Vahabi S
• Abaszadeh
• Yari F
• Yousefi N

• KMID: 2237309
• DOI: http://doi.org/10.4097/kjae.2015.68.6.581

Abstract

BACKGROUND
Postoperative nausea and vomiting (PONV) and postoperative pain are among the most common side-effects of surgery. Many factors, such as a change in the level of sex hormones, are reported to affect these complications. This study aimed to evaluate the probable effects of the menopause on PONV and postoperative pain.
METHODS
Prospective study, in which a total number of 144 female patients undergoing cystocele or rectocele repair surgery under standardized spinal anesthesia were included. Patients were divided into two equally sized sample groups of pre- and postmenopausal women (n = 72). The occurrence of PONV, the severity of pain as assessed by visual analog scale (VAS) pain score, and the quantity of morphine and metoclopramide required were recorded at 2, 4, 6, 12, 18 and 24 h after surgery.
RESULTS
The mean VAS pain score and the mean quantity of morphine required was higher among premenopausal women (P = 0.006). Moreover, these patients required more morphine for their pain management during the first 24 h after surgery compared to postmenopausal women (P < 0.0001). No difference was observed between the two groups regarding the incidence of PONV (P = 0.09 and P = 1.00 for nausea and vomiting, respectively) and the mean amount of metoclopramide required (P = 0.38).
CONCLUSIONS
Premenopausal women are more likely to suffer from postoperative pain after cystocele and rectocele repair surgery. Further studies regarding the measurement of hormonal changes among surgical patients in both pre- and postmenopausal women are recommended to evaluate the effects on PONV and postoperative pain.

Keyword

Menopause; Postoperative nausea and vomiting; Postoperative pain

MeSH Terms

Anesthesia, Spinal
Cystocele*
Female
Gonadal Steroid Hormones
Humans
Incidence
Menopause
Metoclopramide
Morphine
Nausea*
Pain Management
Pain, Postoperative*
Postoperative Nausea and Vomiting
Prospective Studies
Rectocele*
Visual Analog Scale
Vomiting*
Gonadal Steroid Hormones
Metoclopramide
Morphine