Postoperative Nausea-Vomiting in Adult Patients Undergoing Thoracic and Cardiovascular Surgery in Srinagarind Hospital: Incidence and Risk Factors
Keywords:
cardiovascular thoracic surgery, general anesthesia, incidence, postoperative nausea-vomiting, risk factorAbstract
Background: Postoperative nausea-vomiting (PONV) leads to patient discomfort and may cause serious postoperative complications.
Objectives: To identify the incidence and risk factors of PONV in patients undergoing thoracic and cardiovascular surgery.
Methods: This was a retrospective descriptive and analytical study. The inclusion criteria were patients who were 18 years old and above undergoing elective thoracic and cardiovascular surgery during January 2012 and December 2013. Perioperative demographic and clinical data were retrieved from anesthetic and incident records. The data were analyzed and presented as number (%) and mean ± SD. Risk factors were analyzed with univariate logistic regression and were presented as crude odds ratios.
Results: This study included 328 patients. The incidence of PONV was 10.4%. The identified risk factors were female gender (crude odds ratio = 2.62, p = 0.011) and age less than 50 years (crude odds ratio = 5.45, p <0.001).
The protective factor was higher dose (≥8 mg) of dexamethasone (crude odds ratio = 0.16, p <0.001).
Conclusions: The incidence of PONV in patients undergoing cardiovascular thoracic surgery was 10.4%. The risk factors were female gender and age less than 50 years. The protective factor was higher dose of ≥8 mg dexamethasone.
References
2. Apfel CC, Laara E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology 1999;91(3):693-700.
3. White H, Black RJ, Jones M, Mar Fan GC. Randomized comparison of two anti-emetic strategies in high-risk patients undergoing day-case gynaecological surgery. Br J Anaesth 2007;98(4):470-6.
4. Jokinen J, Smith AF, Roewer N, Eberhart LH, Kranke P. Management of postoperative nausea and vomiting: how to deal with refractory PONV. Anesthesiol Clin 2012;30(3):481-93.
5. Doubravska L, Dostalova K, Fritscherova S, Zapletalova J, Adamus M. Incidence of postoperative nausea and vomiting in patients at a university hospital. Where are we today? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2010;154(1):69-76.
6. Chatterjee S, Rudra A, Sengupta S. Current concepts in the management of postoperative nausea and vomiting. Anesthesiol Res Pract 2011;2011:748031.
7. Kogan A, Eidelman LA, Raanani E, Orlov B, Shenkin O, Vidne BA. Nausea and vomiting after fast-track cardiac anaesthesia. Br J Anaesth 2003;91(2):214-7.
8. van den Bosch JE, Kalkman CJ, Vergouwe Y. Assessing the applicability of scoring systems for predicting postoperative nausea and vomiting. Anaesthesia 2005;60(4):323-31.
9. Weilbach C, Rahe-meyer N, Raymondos K, Weissig A, Scheinichen D, Piepenbrock S. Postoperative nausea and vomiting (PONV) : usefulness of the Apfel-score for identification of high risk patients for PONV. Acta Anaesthesiol Belg 2006;57(4):361-3.
10. Craigo PA. Gastrointestinal physiology: aspiration of gastric contents; postoperative nausea and vomiting. In: Collins VJ, editor. Physiologic and pharmacologic bases of anesthesia. 1st edition. Baltimore: Williams & Wilkins; 1996. p. 361-94.
11. Apfel CC, Kranke P, Eberhart LH, Roos A, Roewer N. Comparison of predictive models for postoperative nausea and vomiting. Br J Anaesth 2002;88(2):234-40.
12. Apfel CC, Roewer N. Risk assessment of postoperative nausea and vomiting. Int Anesthesiol Clin 2003;41(4):13-32.
13. Tribuddharat S KS, Kingsangwan P. Low-dose versus standard-dose droperidol for prevention of postoperative nausea-vomiting and sedation effect. Thai Journal of Anesthesiology 1999;25(3):151-7.
14. Khatiwada S, Bhattarai B, Biswas BK. Postoperative nausea and vomiting in patients undergoing total abdominal hysterectomy under subarachnoid block: a randomized study of dexamethasone prophylaxis. Kathmandu Univ Med J 2012;10(38):41-5.
15. Sawatzky JA, Rivet M, Ariano RE, Hiebert B, Arora RC. Post-operative nausea and vomiting in the cardiac surgery population: who is at risk? Heart Lung 2014;43(6):550-4.
16. Choi DK, Chin JH, Lee EH. Prophylactic control of post-operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery. Acta Anaesthesiol Scand 2010;54(8):962-9.
17. Allen TK, Jones CA, Habib AS. Dexamethasone for the prophylaxis of postoperative nausea and vomiting associated with neuraxial morphine administration: a systematic review and meta-analysis. Anesth Analg 2012;114(4):813-22.
18. McCracken G, Houston P, Lefebvre G. Guideline for the management of postoperative nausea and vomiting. J Obstet Gynaecol Can 2008;30(7):600-7.
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