Intraoperative Brainstem Auditory Evoked Potentials and Postoperative Nausea and Vomiting After Microvascular Decompression

Kyeong-O Go; So Young Ji; Ji-Eyon Kwon; Kihwan Hwang; Minjae Cho; Byung Hwa Park; Kyung Seok Park; Jong-Min Kim; Chang-Hoon Koo; Young-Tae Jeon; Sanghon Park; Jung-Hee Ryu; Jung Ho Han

doi:10.1016/j.wneu.2024.03.041

Intraoperative Brainstem Auditory Evoked Potentials and Postoperative Nausea and Vomiting After Microvascular Decompression

World Neurosurg. 2024 Mar 15:S1878-8750(24)00426-1. doi: 10.1016/j.wneu.2024.03.041. Online ahead of print.

Authors

Kyeong-O Go¹, So Young Ji², Ji-Eyon Kwon², Kihwan Hwang², Minjae Cho³, Byung Hwa Park⁴, Kyung Seok Park⁵, Jong-Min Kim⁵, Chang-Hoon Koo⁶, Young-Tae Jeon⁶, Sanghon Park⁶, Jung-Hee Ryu⁶, Jung Ho Han⁷

Affiliations

¹ Department of Neurosurgery, Gyeongsang National University Hospital, Jinju-si, Gyengsangnam-Do, South Korea.
² Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea.
³ Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea.
⁴ Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea.
⁵ Department of Neurology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea.
⁶ Department of Anesthesiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Anesthesiology, Seoul National University College of Medicine, Seoul, South Korea.
⁷ Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-Do, South Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: nstaus29@daum.net.

PMID: 38493889
DOI: 10.1016/j.wneu.2024.03.041

Abstract

Background: We performed this study to investigate the effect of intraoperative brainstem auditory evoked potential (IBAEP) changes on the development of postoperative nausea and vomiting (PONV) after microvascular decompression (MVD) for neurovascular cross compression.

Methods: A total of 373 consecutive cases were treated with MVD. The use of rescue antiemetics after surgery was used as an objective indicator of PONV. IBAEP monitoring was routinely performed in all.

Results: The use of rescue antiemetics was significantly associated with female sex (OR = 3.427; 95% CI, 2.077-5.654; P < 0.001), PCA use (OR = 3.333; 95% CI, 1.861-5.104; P < 0.001), and operation time (OR = 1.017; 95% CI, 1.008-1.026; P < 0.001). A Wave V peak delay of more than 1.0 milliseconds showed a significant relation with the use of rescue antiemetics (OR = 1.787; 95% CI, 1.114-2.867; P = 0.016) and a strong significant relation with the use of rescue antiemetics more than 5 times (OR = 2.426; 95% CI, 1.372-4.290; P = 0.002).

Conclusions: A wave V peak delay of more than 1.0 milliseconds might have value as a predictor of PONV after MVD. More detailed neurophysiological studies will identify the exact pathophysiology underlying PONV after MVD.

Keywords: Brainstem auditory evoked potential; Hemi facial spasm; Microvascular decompression; Postoperative nausea and vomiting; Trigeminal neuralgia.