Incidence of Postoperative Nausea and Vomiting in Patients at a University Hospital. Where Are We Today?

Abstract

Aim.To determine the incidence of postoperative nausea and vomiting (PONV), identify risk factors, assess treatment and its effectiveness.Design. A prospective, observational, questionnaire-and interview-based study. Setting. Standard and intensive care units of the following university hospital departments: abdominal, thoracic and vascular surgery; gynecology; plastic and esthetic surgery; urology; and traumatology.Material and methods. Adult patients scheduled for elective surgery who gave informed consent were enrolled. A questionnaire-based study was performed on the first postoperative day. The collected data relevant to PONV were statistically analyzed.Conclusion. The incidence of PONV was significantly lower than generally presumed and was related to the patient gender, type of surgery and overall health status. PONV was more frequent in obese patients and when drugs antagonizing opioids or muscle relaxants were used. Early administration of antiemetic agents led to considerably less discomfort.

A Comparative Study of Ondansetron and Granisetron in the Prevention of Postoperative Nausea and Vomiting (Ponv) in Day-Care Surgery

“…In addition, there were no significant differences in the duration of surgery or recovery time in the three groups. A relationship between PONV and airway management was demonstrated by L. Doubravska [6] was highest after orotracheal intubation (18.8%), but lower with face mask (8.9%) or laryngeal mask (6.2%) placement. Kovac AL [7] and Gan TJ [8] observed that certain surgical like abdominal, laparoscopic, ophthalmic, gynaecological, neurological, plastic and aesthetic or middle ear surgery and strumectomy and anaesthetic management influencing PONV include premedication, type of anaesthesia, induction agents used, opioids, nasogastric suction, muscle relaxation reversal, anaesthesiologist's experience, etc.…”

Incidence of Postoperative Nausea and Vomiting in Dr. Hasan Sadikin General Hospital Bandung Period May to October 2013

“…The incidence of PONV varies with many potential causes.This depends on involving anesthetic agents, the type of procedure, and patient factors. 2,3,6,10 Despite many other studies about PONV in the other regions, the descriptive data about the incidence of PONV in Dr. Hasan Sadikin General Hospital Bandung is still unknown. Considering the huge effects of PONV, this study was aimed to determine the incidence of PONV in Dr. Hasan Sadikin General Hospital Bandung.…”

“…According to the literature, the procedure on middle ear will stimulate vestibular afferent nerve that will stimulate the vomiting center. 7,8,10,11 Despite the high incidence of PONV in surgeries mentioned earlier, PONV was also common in patients with digestive surgery, and ortophaedic surgery. It has to be noted that the emetic center is stimulated by several visceral afferents including digestive tract, and manipulation in this area could activate gastrointestinal responses.…”

“…Koivuranta et al 14 reported that the proportion of females was about twice as male and men are generellay less succeptible to nausea. 10,12 Based on other studies, female sex was an important risk factor for PONV that maybe caused by variations in serum gonadotropin or other hormon levels. Some studies were even concerned with the relationship of PONV and phase of menstrual cycle.…”

“…It has to be noted that the emetic center is stimulated by several visceral afferents including digestive tract, and manipulation in this area could activate gastrointestinal responses. 1,7,10 Also, laparoscopy was one of the procedure performed in digestive surgery. Based on the references, laparoscopic surgeries was known to be a risk of PONV.…”