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Original Article

Influence of the Phase of Menstrual Cycle on Postoperative Nausea and Vomiting after Breast Cancer Surgery

Jong Wha Lee, Jun Seop Lee, Jong Hak Kim, Youn Jin Kim, Jae Hee Woo, Dong Yeon Kim, Jeong Jeong
The Ewha Medical Journal 2018;41(1):19-23. Published online: January 31, 2018

Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Corresponding author: Dong Yeon Kim. Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea. Tel: 82-2-2650-5285, Fax: 82-2-2650-2924, kdyeon@ewha.ac.kr
• Received: December 11, 2017   • Revised: January 12, 2018   • Accepted: January 19, 2018

Copyright © 2018. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    The phase of the menstrual cycle was demonstrated to have an influence on the incidence of postoperative nausea and vomiting (PONV) after gynecologic laparoscopic surgery, but little was known for breast surgery, which was shown to have relatively higher incidence of PONV, >60%. We performed this study to investigate the influence of the phase of menstrual cycle on PONV after breast cancer surgery.
  • Methods
    A total of 103 patients, who were scheduled for breast cancer surgery under general anesthesia, were recruited, and patients with irregular menstrual cycles, history of previous history of PONV were excluded. Groups were divided in two ways as follows: 1) gynecologic classification: premenstrual and menstrual (days 25 to 6), follicular (days 8 to 12), ovulation (days 13 to 15), and luteal phase (days 20 to 24); 2) menstrual classification: menstrual (days 1 to 8) and non-menstrual (days 9 to 28). PONV were recorded using Rhodes index of nausea, vomiting and retching at postoperative 6 and 24 hours.
  • Results
    The overall incidence of PONV during postoperative 24 hours was 35.4%. At the menstrual classification, the incidence of PONV at postoperative 24 hours was higher in the menstrual group than that in the non-menstrual group (16.7% vs. 4.2%, P=0.057). The severity of PONV, measured with Rhodes index of nausea, vomiting and retching was significantly different between menstrual and non-menstrual groups (P=0.034).
  • Conclusion
    The duration and severity of the PONV after breast cancer surgery were demonstrated to be prolonged and aggravated during menstruation, respectively. Therefore, consideration of menstrual cycle for scheduling breast cancer surgery could effectively prevent the PONV and reduce medical cost.
  • Keywords: Postoperative nausea and vomiting; Breast neoplasms; Surgery; Menstrual cycle
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Fig. 1

The incidence and degree of postoperative nausea and vomiting at 6 and 24 hours after surgery. *P<0.05 compared to non-menstrual group.

emj-41-19-g001.jpg
Table 1

Rhodes index of nausea, vomiting and retching

emj-41-19-i001.jpg
Table 2

Patient characteristics

Values are presented as mean±standard deviation.

emj-41-19-i002.jpg
Table 3

Overall incidence of PONV in different phases of the menstrual cycle

Values are presented as number or number (%).

PONV, postoperative nausea and vomiting.

emj-41-19-i003.jpg
Table 4

Overall incidence of PONV in different types of surgery

Values are presented as number (%), or mean±standard deviation.

PONV, postoperative nausea and vomiting.

emj-41-19-i004.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Postoperative Nausea and Vomiting in Female Patients Undergoing Breast and Gynecological Surgery: A Narrative Review of Risk Factors and Prophylaxis
      Marco Echeverria-Villalobos, Juan Fiorda-Diaz, Alberto Uribe, Sergio D. Bergese
      Frontiers in Medicine.2022;[Epub]     CrossRef

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    Influence of the Phase of Menstrual Cycle on Postoperative Nausea and Vomiting after Breast Cancer Surgery
    Ewha Med J. 2018;41(1):19-23.   Published online January 31, 2018
    DOI: https://doi.org/10.12771/emj.2018.41.1.19
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    • Citation for the content below
    Influence of the Phase of Menstrual Cycle on Postoperative Nausea and Vomiting after Breast Cancer Surgery
    Ewha Med J. 2018;41(1):19-23.   Published online January 31, 2018
    DOI: https://doi.org/10.12771/emj.2018.41.1.19
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    Influence of the Phase of Menstrual Cycle on Postoperative Nausea and Vomiting after Breast Cancer Surgery
    Image
    Fig. 1 The incidence and degree of postoperative nausea and vomiting at 6 and 24 hours after surgery. *P<0.05 compared to non-menstrual group.

    Fig. 1

    Influence of the Phase of Menstrual Cycle on Postoperative Nausea and Vomiting after Breast Cancer Surgery

    Rhodes index of nausea, vomiting and retching

    Patient characteristics

    Values are presented as mean±standard deviation.

    Overall incidence of PONV in different phases of the menstrual cycle

    Values are presented as number or number (%).

    PONV, postoperative nausea and vomiting.

    Overall incidence of PONV in different types of surgery

    Values are presented as number (%), or mean±standard deviation.

    PONV, postoperative nausea and vomiting.
    Table 1 Rhodes index of nausea, vomiting and retching

    Table 2 Patient characteristics

    Values are presented as mean±standard deviation.

    Table 3 Overall incidence of PONV in different phases of the menstrual cycle

    Values are presented as number or number (%).

    PONV, postoperative nausea and vomiting.

    Table 4 Overall incidence of PONV in different types of surgery

    Values are presented as number (%), or mean±standard deviation.

    PONV, postoperative nausea and vomiting.

    Table 1

    Table 2

    Table 3

    Table 4

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