Cardiothoracic and Vascular Anesthesia

The Effect of Nasogastric Tube Application During Cardiac Surgery on Postoperative Nausea and Vomiting—A Randomized Trial

Lavi R, Katznelson R, Cheng D, et al (Univ of Toronto, Ontario, Canada) J Cardiothorac Vasc Anesth 25:105-109, 2011^§

Abstract

Objective

Postoperative nausea and vomiting (PONV) are significant morbidities following cardiac surgery. The purpose of this study was to determine if application of a nasogastric (NG) tube during cardiac surgery can reduce the prevalence of postoperative PONV.

Design

This study was a prospective randomized controlled trial.

Setting

University tertiary referral center.

Participants

Two hundred two patients undergoing elective cardiac procedures.

Interventions

Patients were prospectively enrolled and randomized to either receive or not receive an NG tube after induction of anesthesia. Standard anesthetic technique and postoperative care were employed in all patients. Preoperative demographic data, pain score, nausea score and incidence of vomiting were recorded early (0-8 hours) and late (8-16 hours) following extubation. Antiemetic and analgesic medications were compared between the 2 groups.

Measurements and Main Results

One hundred three patients were randomized to no an NG tube (controls) and 99 received an NG tube as part of their perioperative management. Demographic data and surgical characteristics were similar between the 2 groups. However, the control group had more smokers. Incidence and severity of nausea, pain scores, and analgesic requirements were similar between the 2 groups. Prevalence of vomiting was more frequent in the control group (24%) than in the NG tube group (10%, p = 0.007), and was more frequent in patients who underwent valve and redo procedures.

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