Influence of neoadjuvant chemotherapy on occurrence of postoperative nausea and vomiting after radical mastectomy
10.3760/cma.j.issn.0254-1416.2015.12.002
- VernacularTitle:新辅助化疗对乳腺癌根治术后恶心呕吐发生的影响
- Author:
Zhihong LI
;
Jian YIN
;
Zijing HE
;
Zhiyi FAN
- Publication Type:Journal Article
- Keywords:
Antineoplastic combined chemotherapy protocols;
Postoperative complications;
Breast neoplasms
- From:
Chinese Journal of Anesthesiology
2015;(12):1422-1424
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of neoadjuvant chemotherapy on the occurrence of postoperative nausea and vomiting ( PONV) after radical mastectomy. Methods A total of 286 breast cancer patients, aged 18-60 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective modified radical mastectomy under general anesthesia in our hospital, were divided into either non?chemotherapy group ( n=106 ) or neoadjuvent chemotherapy group ( n=180 ) . General anesthesia was induced with iv propofol 2 mg∕kg, rocuronium 0. 6 mg∕kg and sufentanil 0. 2 μg∕kg. The patients were endotracheally intubated. The concentration of sevoflurane inhaled was adjusted according to the value of bispectral index, and bispectral index value was maintain at 40-50. Ondansetron 8 mg and flurbiprofen axetil 100 mg were injected intravenously at 30 min before the end of surgery. If vomiting occurred for 2 consecutive times, and continuous nausea and vomiting appeared from the time point after extubation to 24 h after surgery, and the patients required treatment, rescue medication was used. The occurrence and severity of PONVwithin 24 h after surgery and requirement for rescue medication were recorded. Results Compared with non?chemotherapy group, the incidence of PONV within 24 h after surgery and requirement for rescue medication were significantly increased, and the severity of PONV was aggravated in neoadjuvent chemotherapy group (P<0.05). Conclusion Neoadjuvant chemotherapy before surgery can increase the risk and severity of PONV after modified radical mastectomy.
