Nausea and vomiting after laparoscopic surgery are not associated with an increased peripheral release of serotonin

• Published in: Canadian journal of anesthesia Vol. 49; no. 5; pp. 453 - 457
• Main Authors: NICOLE, Pierre C, TREPANIER, Claude A, LESSARD, Martin R
• Format: Journal Article
• Language: English
• Published: Toronto, ON Canadian Anesthesiologists' Society 01.05.2002; Springer Nature B.V
• Subjects: Abdominal surgery. Urology. Gynecology. Obstetrics; Adult; Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Case-Control Studies; Chromatography, High Pressure Liquid; Confidence intervals; Drug therapy; Female; Humans; Hydroxyindoleacetic Acid - urine; Laparoscopy - adverse effects; Medical sciences; Peripheral Nervous System - metabolism; Postoperative Nausea and Vomiting - etiology; Postoperative Nausea and Vomiting - physiopathology; Postoperative period; Prospective Studies; Serotonin; Serotonin - metabolism; Sterilization, Tubal; Surgery; Human; Postoperative; Urine; Endoscopic surgery; Biological fluid; Pathophysiology; Serotonin; Metabolite; General anesthesia; Laparoscopy; Nausea; Fallopian tube; Ligature; Vomiting; Digestive diseases; Complication; Female; Endoscopy
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/BF03017919

To determine whether patients suffering postoperative nausea and vomiting (PONV) present a different serotonin release pattern from those who do not present this complication. Forty-eight consecutive women undergoing outpatient laparoscopic tubal ligation were enrolled in this prospective, cumulative case-control study. The study compared serotonin activity in 15 patients totally free of emetic symptoms (asymptomatic group) and, among patients with PONV (n = 33), those 15 who presented the most severe symptoms (PONV group). Patients were anesthetized with a regimen including sufentanil (0.1-0.3 microg x kg(-1)) plus thiopental (3-5 mg x kg(-1)) for induction and isoflurane (0.6-1%) in nitrous oxide (60%) for maintenance. Peripheral serotonin activity was assessed by measurement with high-performance liquid chromatography of serotonin's principal urinary metabolite: 5-hydroxyindoacetic acid (5-HIAA) corrected for urinary creatinine. The preoperative and postoperative urinary 5-HIAA:creatinine ratios were 6.9 ng x microg(-1) (confidence interval; CI 95%, 2.7-11.0) and 5.9 ng x microg(-1) (CI 95%, 2.4-9.4) respectively in the asymptomatic group (P = 0.69), and were 5.1 ng x microg(-1) (CI 95%, 2.5-7.7) and 5.6 ng x micro(-1) (CI 95%, 3.4-7.7) respectively in the PONV group (P = 0.75). There was also no difference between groups in the variation of 5-HIAA:creatinine ratios from the preoperative to the postoperative period (P = 0.21). PONV after laparoscopic tubal ligation are not associated with an increased urinary excretion of serotonin metabolites. Patients with severe PONV present a peripheral serotonin release comparable to asymptomatic patients.