The aim of this study is to investigate the effect of fresh gas flow applied during general anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing septorhinoplasty surgery. Patients who agree to participate in the study will be divided into three groups according to the fresh gas flow applied: low flow (0.5 lt/min) (Group L), medium flow (2 lt/min) (Group M) and high flow (4 lt/min) (Group H), and the postoperative nausea and vomiting data of the groups will be compared.
Preoperative demographic characteristics and Apfel score (smoking history, gender, postoperative opioid use, POB history) of the patients will be recorded. General anesthesia will be applied to all patients with standard ASA monitoring. In general anesthesia induction, 2 mg/kg propofol, 1 mcg/kg remifentanil, 0.6 mg/kg rocuronium will be used for all patients. Sevoflurane (minimum alveolar concentration of 1) will be used as a volatile agent and remifentanil (0.1 mcg-1 mcg/kg/h) will be used as an analgesic agent for anesthesia maintenance. After endotracheal intubation, fresh gas flow will be applied at 4 lt/min for 8 minutes, reduced to 0.5 lt/min in Group L, 2 lt/min in Group M, and maintained at 4 lt/min in Group H. After extubation, patients will be monitored in the recovery unit for at least 30 minutes, and at postoperative 0th minute (when first seen in the recovery room), 30th minute, 1st hour, 6th hour, 12th hour and 24th hour, the nausea score of the patients will be evaluated using the Numerical Rating Scale (NRS) with a score between 0 and 10. If vomiting is present, the number of times the patient vomited will be questioned and recorded. The patients' postoperative VAS scores, the amount of antiemetics used, the amount of opioids used intraoperatively and postoperatively will be recorded, and comparisons will be made between the groups and evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
Fresh gas flow will be set to 0.5 l/min in the low flow anesthesia group.
Fresh gas flow will be set to 2 lt/min in the medium flow anesthesia group.
Fresh gas flow will be set to 4 lt/min in the high flow anesthesia group.
Adıyaman Training and Research Hospital
Adıyaman, Merkez, Turkey (Türkiye)
postoperative nausea and vomiting
The patients' postoperative nausea and vomiting scores will be assessed when they are taken to the postoperative care room, immediately before being transferred from the postoperative care room to the ward (at the 30th minute postoperatively), at the 1st hour postoperatively, at the 6th hour postoperatively, at the 12th hour postoperatively, and at the 24th hour postoperatively. Nausea will be assessed by scoring with a numerical rating scale between 0 and 10. Vomiting will be questioned. If vomiting occurs, the number of times it occurs will be questioned. Whether postoperative antiemetics are used and if so, how many mg are used will be recorded. If postoperative opioids are used, how many mg are used will be recorded.
Time frame: 24 hours
intraoperative body temperature
Intraoperative body temperature values of patients in all groups will be monitored throughout the operation with a thermometer probe placed under the right armpit; axillary body temperature will be recorded every 5 minutes in the first half hour, 10 minutes in the next half hour, and every half hour after the first hour. Body temperature changes of the groups will also be compared.
Time frame: intraoperative
Whether kidney functions are affected
By comparing the kidney function tests (urea-creatinine) of the patients before and after the surgery (postoperative 1st hour), it will be evaluated whether the flow differences (especially low flow) have any negative effects on kidney functions.
Time frame: 1 hour postoperative
whether liver functions are affected
Patients' liver function tests (AST-ALT) before and after surgery (postoperative 1st hour) will be compared to evaluate whether flow differences (especially low flow) have any negative effects on liver functions.
Time frame: 1 hour postoperative
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