A prospective study to compare the incidence of post-operative nausea, vomiting (PONV) in female patients undergoing surgical procedures under general anaesthesia during proliferative and secretory phase of menstrual cycle

Introduction: As the female hormones are emetogenic in nature, females in their reproductive period are more predisposed to Nausea/Vomiting in the non-pregnant, pregnant state as well as in the post operative period. This study was conducted to find the influence of the phase of the menstrual cycle on PONV, the alertness and pain perception, after general anaesthesia, in the postoperative period. Methodology: After obtaining the approval of IEC, the study was conducted on 60 young, healthy and consenting female patients. As per the date of their last menstrual cycle patients were divided into two groups: Group A: Patients in proliferative phase (1 to 14th day); Group B: Patients in luteal phase (15 to 30th day). All the patients had standardized method of general anaesthesia. The assessment of the patients for nausea, vomiting, pain and sedation was carried out using specific scoring systems & visual analogue score (VAS) at 30 min, 60 min, 90min, 2 hrs, 6hrs, 12hrs and 24 hrs post operatively by a blinded impartial observer. Patients were given rescue antiemetic and NSAID, as and when required. Results: 26 patients were allocated to group A and 36 to group B. No statistically significant difference was found, in demographic profile, vital parameters, sedation score, VAS (pain score) and the duration of surgery. Although Group A patients had higher nausea/ vomiting score than the group B patients, throughout the post-operative period, the difference was highly significant at 90 min and 12 hours postoperatively. The percentage of patients, having PONV (reflecting incidence), in group A was significantly higher (76.8%) than in group B (32.35%). Conclusion: [The incidence and severity of nausea vomiting in the post operative period is definitely influenced/increased by the Proliferative phase of the menstrual cycle.