Factors Affecting Postoperative Nausea and Vomiting in Surgical Patients

Son, Jaesoon; Yoon, Haesang

doi:10.1016/j.jopan.2016.02.012

Cited by 39 publications

(19 citation statements)

References 26 publications

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“…By identifying risk factors for PONV, we can ensure that those patients who are the most in need and stand to gain the greatest benefit receive optimal antiemetic prophylaxis 21 – 26 . A number of factors, including patient-, anesthetic-, and surgical-related factors, influence the occurence of postoperative emetic symptoms ( Table 1 – Table 3 ) 27 , 28 .…”

Section: Risk Factors For Ponv and Pdnvmentioning

confidence: 99%

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

et al. 2020

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Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. The routine use of opioid analgesics for perioperative pain management is a major contributing factor to both PONV and PDNV after surgery. PONV and PDNV can delay discharge from the hospital or surgicenter, delay the return to normal activities of daily living after discharge home, and increase medical costs. The high incidence of PONV and PDNV has persisted despite the introduction of many new antiemetic drugs (and more aggressive use of antiemetic prophylaxis) over the last two decades as a result of growth in minimally invasive ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major surgical procedures (e.g. enhanced recovery protocols). Pharmacologic management of PONV should be tailored to the patient’s risk level using the validated PONV and PDNV risk-scoring systems to encourage cost-effective practices and minimize the potential for adverse side effects due to drug interactions in the perioperative period. A combination of prophylactic antiemetic drugs with different mechanisms of action should be administered to patients with moderate to high risk of developing PONV. In addition to utilizing prophylactic antiemetic drugs, the management of perioperative pain using opioid-sparing multimodal analgesic techniques is critically important for achieving an enhanced recovery after surgery. In conclusion, the utilization of strategies to reduce the baseline risk of PONV (e.g. adequate hydration and the use of nonpharmacologic antiemetic and opioid-sparing analgesic techniques) and implementing multimodal antiemetic and analgesic regimens will reduce the likelihood of patients developing PONV and PDNV after surgery.

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Section: Risk Factors For Ponv and Pdnvmentioning

confidence: 99%

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

et al. 2020

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“…Furthermore, our study showed that female sex was strongly associated with postoperative vomiting, which has been demonstrated a well-known independent risk factor for PONV in many studies. 18,19 For a safe discharge, patients must be able to walk without dizziness. This study showed 28.57% patients reported dizziness during the first 24 hours after surgery.…”

Section: Discussionmentioning

confidence: 99%

<p>Risk Factors Associated with Postoperative Discomfort After Ambulatory Strabismus Surgery Under General Anesthesia</p>

Huang

Lin

Xiong

et al. 2020

JPR

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The aim of this study was to evaluate postoperative discomfort in patients undergoing ambulatory strabismus under general anesthesia, and to identify risk factors associated with the discomfort. Patients and Methods: A cross-sectional study was conducted among 210 consecutive patients undergoing ambulatory strabismus under general anesthesia. Postoperative discomfort including nausea, vomiting, dizziness, and headache was recorded and quantified. Univariable and multivariable logistic regression were performed to detect the risk factors associated with postoperative discomfort. Results: Of 210 participants, 199 (94.76%) patients experienced mild discomfort after ambulatory strabismus surgery under general anesthesia, and 31 (14.76%), 11 (5.24%), 60 (28.57%), 23 (10.95%) patients suffered from nausea, vomiting, dizziness, and headache, respectively. A multivariate analysis indicated that female sex, the surgery on inferior rectus, and the surgery on inferior oblique were the independent risk factors for postoperative vomiting while, mild anxiety was the independent risk factor for postoperative dizziness. Conclusion: Patients undergoing ambulatory strabismus surgery tended to experience postoperative nausea and dizziness. Female sex, the surgery on inferior rectus, mild anxiety, and the surgery on inferior oblique were the independent predictors of postoperative discomfort.

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“…Postoperative nausea and vomiting (PONV) are among the most common adverse effects of anesthesia, affecting up to 30% of the general population and 80% of high-risk patients within 24 h after surgery. 86,87 Customary treatments of PONV are chiefly pharmaceutical, including 5-HT3 receptor antagonists, NK-1 receptor antagonists, corticosteroids, butyrophenones, antihistamines, anticholinergics, and phenothiazines. 88 Even at lower doses, antiemetic drugs are not free of side effects, such as QTc interval changes, visual disturbances, dry mouth, and dizziness.…”

Section: Mechanisms Of Electroacupuncture In Preventing Postoperativementioning

confidence: 99%

<p>Electroacupuncture: A New Approach for Improved Postoperative Sleep Quality After General Anesthesia</p>

Luo¹,

Song²,

Zhu³

2020

NSS

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General anesthesia produces a state of drug-induced unconsciousness that is controlled by the extent and duration of administered agents. Whether inhalation or intravenous in formulation, such agents may interfere with normal sleep-wake cycles, impairing postoperative sleep quality and creating complications. Electroacupuncture is a new approach widely applied in clinical practice during recent years. This particular technology helps regulate neurotransmitter concentrations in the brain, lowering norepinephrine and dopamine levels to improve sleep quality. It also alleviates surgical pain that degrades postoperative sleep quality after general anesthesia by downregulating immune activity (SP, NK-1, and COX-1) and upregulating serotonin receptor (5-HT1AR, 5-HT2AR) and endocannabinoid expression levels. However, large-scale, multicenter studies are still needed to determine the optimal duration, frequency, and timing of electroacupuncture for such use.

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Factors Affecting Postoperative Nausea and Vomiting in Surgical Patients

Cited by 39 publications

References 26 publications

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

<p>Risk Factors Associated with Postoperative Discomfort After Ambulatory Strabismus Surgery Under General Anesthesia</p>

<p>Electroacupuncture: A New Approach for Improved Postoperative Sleep Quality After General Anesthesia</p>

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