Developing a Guideline for the prevention of Postoperative Nausea and Vomiting after general anesthesia in Srinagarind Hospital

Abstract

Background: Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia. These cause patients feel uncomfortable or even pulmonary aspiration in semiconscious patients. This serious complication requires longer hospital stays and consumes higher cost. There is no explicit guideline for prevention of nausea and vomiting after surgery in our routine practice. Therefore, we would like to develop our standard guideline for patient caring and to enhance the quality of our anesthesia services.

Methods: This is a retrospective descriptive study data of nausea and vomiting were collected from anesthetic record and 24 hours postoperative visit from our computer record system for one month. We excluded patients who received spinal morphine because standard doctor’s order was well established. The data were analyzed. The trial guideline for prevention of PONV was introduced into routine practice after approval by the department the trial guideline was monitored and evaluated for problems and difficulties.

Results: One thousands and fifty three patients underwent anesthesia during the period of one month. The PONV was found in 80 patients (7.6%). The severity of PONV was mild (57.5%), moderate (40%) and severe (2.5%). The 24 - hours postoperative period had the highest incidence (92.5). Female was the most frequent. We found the PONV incidence in ASA 1; 37.5% and ASA 2; 33.7%. Mean age of study group was 41 + 12.6 years. Patients who received general anesthesia had the highest frequency of PONV of 83.7%. The types of surgery with high PONV incidence were general surgery, gynecological and orthopedic surgery (27.5%, 27.5%, 26.2%) respectively.

Conclusion: This study produce fundamental data for further development of the PONV guideline to suit our context.