The effect of menstrual cycle phase on the meperidine and metoclopramide consumption rate for controlling postoperative pain, nausea and vomiting

Abstract

Vahabi S1, Ghafarzade M2, Lorzade N2, Moradkhani MR1, Frazan B1, Geranghadr P3 1. Assistant professor, Department of anesthesiology, Faculty of medicine, Lorestan University of medical sciences 2. Assistant professor, Department of gynecology, Faculty of medicine, Lorestan University of medical sciences 3. General practitioner Abstract Background: Postoperative nausea, vomiting (PONV) and pain are common causes of postoperative morbidity. Menstrual cycle may be one of the several factors that influence the incidence of them. This study was done to evaluate the effect of menstrual cycle phase on the on the Meperidine and Metoclopramide consumption rate for controlling postoperative pain, nausea and vomiting. Materials and methods: On the basis of the menstrual cycle {pre ± menstrual (PD 25-6) follicular phase (PD 8-12) ovulatory phase (PD 13-15) and luteal (PD 20-24)}, 63 patients enrolled in this blinded, prospective study. All patients underwent a standardized surgery. Meperidine 1mg/kg was given to patients who had pain intensity more than 5 on Visual Analog Scale (VAS) intravascularly in recovery, and intramuscularly in the ward. Metoclopramide 0.3mg/kg was administered intravascularly to patients who had vomiting. A blinded person recorded PONV and pain score as well as required amount of Meperidine and Metoclopramide in the recovery and ward arrival time, 6, 12, 18 and 24 hours postoperatively. Results: At the first 24 h post gynecological operation, PONV score was higher in luteal and follicular phase and lowest in pre ± menstrual phase (P< 0.001, X²= 41.64). The need for Metoclopramide in luteal phase was more than other phases (P < 0.001, X² =32.9). The highest pain score was in luteal phase (P< 0.001, X² =4.6) and the required dose of Meperidine was higher in luteal and follicular phase (P< 0.001, X² = 22.2). Conclusion: We suggest that scheduling of surgery according to the menstrual phase may reduce the incidence of PONV and postoperative pain intensity as well as the required dose of Meperidine and Metoclopramide and hospitalization costs.