Incidence and factors associated with postoperative nausea and vomiting among elective adult surgical patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia, 2019: A cross-sectional study

Abstract

Background: Postoperative nausea and vomiting is a common complication of anaesthesia and surgery. It is considered the most common cause of morbidity following anaesthesia and has significant effects on patient satisfaction and cost. Despite modern anaesthetic and surgical techniques, the incidence of PONV remains high. Objective: The objective of this study was to determine the incidence of postoperative nausea and vomiting and associated factors. Methods: A cross-sectional study was conducted from January 1 to May 30, 2019. A total of 355 adult elective patients who were operated on this period were included in the study. Results: The incidence of postoperative nausea and vomiting was 17.2% within 24 h after operation. Factors that were associated with postoperative nausea and vomiting were history of motion sickness (AOR = 6.0, CI = 2.51–14.49), previous history of postoperative nausea and vomiting (AOR = 13.55, CI = 6.37–28.81) and long duration of surgery (AOR = 10.1, CI = 3.97–25.92). Conclusion: and recommendations: The incidence of postoperative nausea and vomiting was still high compared with most studies conducted in the world. However, when it compared to the previous study done in the study area, it showed significant reduction in the incidence of PONV by 19%.We suggest that the use of anti-emetic prophylaxis and the introduction of postoperative nausea and vomiting treatment protocols. Highlights:

Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

“…It is postulated that a history of PONV points to the presence of an underlying susceptibility to PONV [ 6 ]. This finding was also in agreement with the findings of other studies that were conducted in Ethiopia [ 20 ], Korea [ 21 ] and Uganda [ 22 ].…”

“…Although non-smoking status and postoperative opioid use were among the predictors of PONV in Apfel’s predictive model [ 19 ], no such associations were significant in the current study, similar to other studies from Ethiopia [ 20 ] and Uganda [ 22 ]. Furthermore, a study that assessed PONV in patients undergoing arthroscopic surgery concluded that short-acting opioids did not have a significant effect on patients’ risk of developing PONV [ 32 ].…”

Investigating the Association Between a Risk-Directed Prophylaxis Protocol and Postoperative Nausea and Vomiting: Validation in a Low-Income Setting

“…Although we cannot assign causality to this association, it is in agreement with previous studies linking duration of hospitalization to PONV. [10][11][12][13][14][15][16] This would be a particularly important benefit of PONV reduction, as hospital capacity is frequently a major challenge in low-income settings.…”

“…Unresolved PONV may result in a prolonged postanesthesia care unit (PACU) stay and unanticipated prolonged hospital admission, which results in a significant increase in overall health care cost. 9–16…”

“…7,10 Unresolved PONV may result in a prolonged postanesthesia care unit (PACU) stay and unanticipated prolonged hospital admission, which results in a significant increase in overall health care cost. [9][10][11][12][13][14][15][16] PONV scoring systems and guideline-driven prophylaxis are well established in high-income countries. Well-established risk factors include: female gender, postpubescence, nonsmoking status, history of PONV or motion sickness, childhood and young adulthood, prolonged surgery duration, type of surgery, use of volatile anesthetics, nitrous oxide, large-dose neostigmine, and intraoperative or postoperative opioid use.…”