Incidence and Risk Factors of Postoperative Nausea and Vomiting

Abstract

Background: Postoperative nausea and vomiting (PONV) are a common complication after surgery and frequently the cause of patient’s unsatisfaction. The incidence of PONV varies from 5 to 40%. In order to provide a rational for appropriate management of PONV in Siriraj Hospital, the purpose of this study is to determine the incidence and risk factors of PONV in the categories of patient, anesthesia and surgical – related.

Methods: The study was conducted after approval by Human Research Ethics Committee, Faculty of Medicine Siriraj Hospital ID SI084/2014. The electronic data was retrieved from November, 2013 to November, 2014.The 4,471 patients, > 18 years who underwent general and/or regional anesthesia in obstetrics, gynaecology, general and orthopedic surgery that were completed postoperative visiting were included. Data extracted were age, BMI, gender, smoking status, ASA, previous PONV or motion sickness, type of surgery, type of anesthesia and prophylaxis. Odd ratios and multiple logistic regression analysis were used.

Results: Incidence of PONV was 17.7%. Female, major surgery, orthopedics operation, general surgery, and every 1 hour increase in duration of surgery were statistically significant correlation in the incidence of PONV (p < 0.001). Ondansetron and dexamethasone were suggested as protective factor of PONV.

Conclusions: Incidence of PONV in Siriraj Hospital is quite high. Guideline for prevention of PONV should be implemented such as the systematic use of ondansetron and dexamethasone least in patients following administration of spinal morphine, major surgery and continuous postoperative pain control.