Preoperative Gastric Volume and PONV in Pediatric Appendectomy Cases

Postoperative nausea and vomiting is one of the complications frequently encountered in pediatric patients that seriously affects patient comfort. In the literature, the incidence of postoperative nausea and vomiting in the pediatric population is reported to be between 20-50%. This situation reduces patient satisfaction and prolongs discharge times.

Aspiration of stomach contents into the lungs, although its frequency varies in children, is seen between 0.02-0.1% in elective surgeries and can result in severe situations such as the need for mechanical ventilation and hypoxia. Although many factors have been investigated to evaluate the risk of aspiration and predict postoperative nausea and vomiting, the role of gastric volume, which is a physiological parameter, in this regard has not been sufficiently elucidated. A limited number of studies in adults have found a significant relationship between preoperative increased stomach volume and postoperative nausea and vomiting. However, there is not enough data examining this relationship in the pediatric age group. This study aims to contribute to the literature, to determine patients at risk of postoperative nausea and vomiting by measuring preoperative stomach volumes, and to develop preventive strategies. The case group in this study; There will be ASA I, II, III children between the ages of 3-12 who will undergo laparoscopic appendectomy surgery performed by the Pediatric Surgery unit in the Pediatric Operating Room. As a result of the power analysis performed using the G*Power 3.1.9.7 program, a total of at least 118 samples was found to be sufficient with 95% power and 5% margin of error (n1=59- n2=59). The study included the pediatric age group. For this reason, informed consent will be obtained from the family or legal representatives and verbal information will be given to the children appropriate to their age. Patients' age, gender, comorbidities, regular medications, height, weight, fasting period before anesthesia, history of motion sickness Patients will be evaluated in terms of nausea and vomiting, including ASA score, preoperative gastric volume, intraoperative heart rate every 15 minutes, blood pressure, saturation, end-tidal carbon dioxide value, intra-abdominal pressure value applied during laparoscopy, in the postoperative recovery room (0th hour), 6th and 24th hours. The identity information of the participants in this research will not be included in the report, thesis or scientific publication. All individuals will be identified anonymously in the study and each participant will be assigned a code number. History of previous gastrointestinal surgery, any history of gastrointestinal system disease, those with developmental or neurological disorders, those with a history of motion sickness or postoperative nausea and vomiting, those with preoperative antiemetic use, and those whose families do not give consent will not be included in the study.