Comparison of Postoperative Nausea and Vomiting in Percutaneous Nephrolithotomy (PCNL) through Two Supine and Prone Methods: A Clinical Trial Study

Nausea and vomiting is one of the most common complications of anesthesia that can cause dissatisfaction and stress in the patient and medical staff. On the other hand, Percutaneous Nephrolithotomy (PCNL) is one of the least invasive surgical procedures which can be optimized by reducing the postoperative complications. According to the above mentioned points, the present study was designed to investigate the supine and prone position on the rate of postoperative nausea and vomiting.

This study was a clinical trial on 200 patients in 4 groups of 50 (group A: 3cc of Marcain spinal 0.5% in supine position, group B: 2cc of marcain spinal 0.5% + 20 micrograms of fentanyl in supine position, group C: 3cc of Marcain spinal 0.5% in prone position, group D: 2cc of Marcain spinal 0.5% + 20 micrograms of fentanyl in prone position). Nausea and vomiting were measured in recovery and 6 hours after the operation. The patient's heart rate and blood pressure were measured before the anesthesia and spinal anesthesia, after anesthesia, at minutes 10 and 15 of the operation, in recovery and after recovery.

The highest rates of nausea and vomiting in recovery were in groups A (44%), C (28%), D (14%) and B (12%), respectively. However, after surgery, there was no difference between the two methods of supine and prone position with different doses of marcain in terms of NV recovery (p<0.05). Moreover, there was no significant difference between the two methods of supine and prone position with different doses of Marcain in terms of drug use during and after surgery (p<0.05). Meanwhile, hospitalization in group C (with a standard deviation of 1.73±1.81) was longer than the other groups. The highest mean systolic blood pressure was observed in the prone position and group D and the lowest was observed in the supine position and group A after the anesthesia.

According to the obtained results, it can be concluded that the highest rate of nausea and vomiting was observed during the transfer to recovery and the highest risk was related to the supine position. However, in other cases, there was no significant relationship between nausea and vomiting and other variables.