Evidence-based analysis of risk factors for postoperative nausea and vomiting

Apfel, Christian C.; Heidrich, Felix M.; Jukar-Rao, S.; Jalota, Leena; Hornuß, Cyrill; Whelan, Rachel; Zhang, Kun; Çakmakkaya, Özlem Serpil

doi:10.1093/bja/aes276

Cited by 645 publications

(635 citation statements)

References 52 publications

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“…6,76 Habib and Gan 77 found in their review that major gynecological, laparoscopic, and breast surgeries were risk factors for PONV. In line with this a recent review by Apfel et al 78 also suggest that cholecystectomy, laparoscopic, and gynecological surgeries are significantly associated with the incidence of PONV.…”

Section: Surgery As a Risk Factor For Ponvsupporting

confidence: 58%

Acupuncture in ambulatory anesthesia: a review

Norheim¹,

Liodden²,

Alræk³

2015

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Background: Post-anesthetic morbidities remain challenging in our daily practice of anesthesia. Meta-analyses and reviews of acupuncture and related techniques for postoperative nausea and vomiting (POVN) and postoperative vomiting (POV) show promising results while many clinicians remain skeptical of the value of acupuncture. Given the interest in finding safe nonpharmacological approaches toward postoperative care, this body of knowledge needs to be considered. This review critically appraises and summarizes the research on acupuncture and acupressure in ambulatory anesthesia during the last 15 years. Methods: Articles were identified through searches of Medline, PubMed, and Embase using the search terms "acupuncture" or "acupuncture therapy" in combination with "ambulatory anesthesia" or "ambulatory surgery" or "day surgery" or "postoperative". A corresponding search was done using "acupressure" and "wristbands". The searches generated a total of 104, 118, and 122 references, respectively. Results: Sixteen studies were included; eight studies reported on acupuncture and eight on acupressure. Nine studies found acupuncture or acupressure effective on primary endpoints including postoperative nausea and vomiting, postoperative pain, sore throat, and emergence agitation. Four studies found acupuncture had a similar effect to antiemetic medication. Conclusion: Overall, the studies were of fairly good quality. A large proportion of the reviewed papers highlights an effect of acupuncture or acupressure on postoperative morbidities in an ambulatory setting. However, one should bear in mind that research on acupuncture/acupressure in an ambulatory setting contributes to ambiguous conclusions. Hence, we have addressed some of the issues related to this diversity in acupuncture research.

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Section: Surgery As a Risk Factor For Ponvsupporting

confidence: 58%

Acupuncture in ambulatory anesthesia: a review

Norheim¹,

Liodden²,

Alræk³

2015

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“…Additionally, a history of PONV or motion sickness, as well as the use of volatile anaesthetic increases the risk of PONV [100].…”

Section: Anaesthesiamentioning

confidence: 99%

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background During the last two decades, an increasing number of bariatric surgical procedures have been performed worldwide. There is no consensus regarding optimal perioperative care in bariatric surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence-based ''enhanced'' perioperative protocol. Methods The English-language literature between January 1966 and January 2015 was searched, with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation. Results Although for some elements, recommendations are extrapolated from non-bariatric settings (mainly colorectal), most recommendations are based on good-quality trials or meta-analyses of good-quality trials. Conclusions A comprehensive evidence-based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatric surgery.

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“…They are increased by volatile agents and high doses of opioids [1]. By reducing the requirement for anesthetic agents, we suppose to decrease these side effects, shorten recovery and extubation time, and reduce anesthetic procedure costs.…”

Section: Introductionmentioning

confidence: 99%

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Nakhli

Kahloul

Guizani

et al. 2018

Libyan Journal of Medicine

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The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1.5 mg/kg followed by a continuous infusion at the rate of 2 mg/kg/hr until skin closure) or normal saline (0.9% NaCl solution) (Group C). The depth of anesthesia was monitored using the Bispectral Index Scale (BIS), which is based on measurement of the patient’s cerebral electrical activity. Primary outcome of the study was End-tidal of isoflurane concentration (Et-Iso) at BIS values of 40–60. Secondary outcomes include remifentanil consumption during the operation and time to extubation. Et-Iso was significantly lower in group L than in group C (0.63% ± 0.10% vs 0.92% ± 0.11%, p < 10–3). Mean remifentanil consumption of was significantly lower in group L than in group C (0.13 ± 0.04 µg/kg/min vs 0.18 ± 0.04 µg/kg/min, p < 10–3). Thus, IV lidocaine infusion permits a reduction of 31% in isoflurane concentration requirement and 27% in the intraoperative remifentanil need. In addition, recovery from anesthesia and extubation time was shorter in group L (5.8 ± 1.8 min vs 7.9 ± 2.0 min, p < 10–3). By reducing significantly isoflurane and remifentanil requirements during renal surgery, intravenous lidocaine could provide effective strategy to limit volatile agent and intraoperative opioids consumption especially in low and middle income countries.

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Evidence-based analysis of risk factors for postoperative nausea and vomiting

Cited by 645 publications

References 52 publications

Acupuncture in ambulatory anesthesia: a review

Acupuncture in ambulatory anesthesia: a review

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

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