Nausea and Vomiting After Gynaecological Surgery: A Meta-Analysis of Factors Affecting Their Incidence

Haigh, C. G.; Kaplan, L.A.; Durham, J. M.; Dupeyron, J. P.; Harmer, M.; Kenny, G. N. C.

doi:10.1093/bja/71.4.517

Cited by 88 publications

(34 citation statements)

References 15 publications

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“…Obesity showed only a minor effect on nausea in females. A lack of the influence of body mass index on nausea has also been reported recently [3,15]. Smokers had a decreased risk of nausea and vomiting, a fact also observed by Cohen et al [3].…”

Section: Scoresupporting

confidence: 59%

A survey of postoperative nausea and vomiting

et al. 1997

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SummaryA prospective interview-based survey on the incidence of postoperative nausea and vomiting in 1107 in-patients aged 4-86 years was conducted during a 3-month period. Nausea, emetic episodes and the need for anti-emetic medication were recorded for 24 h postoperatively. In the recovery room, the incidence of nausea and vomiting was 18% and 5%, respectively. Over the whole 24-h period, these figures were 52% and 25%, respectively; severe nausea was experienced by 8%. The highest incidence of emetic sequelae was observed in gynaecological patients; 52% of the 822 patients who received general anaesthesia and 38% of the 285 patients who received regional anaesthesia reported nausea. The most important predictive factors associated with an increased risk for nausea and vomiting were female gender, a previous history of postoperative sickness, a longer duration of surgery, nonsmoking and a history of motion sickness. Based on these five items, a simple score predicting the risk of nausea and vomiting was constructed with a moderately good discriminating power. Nausea and emetic episodes still persist as the most common complaints following anaesthesia and surgery. Many adults find postoperative nausea and vomiting even more distressing than postoperative pain. The overall incidence of postoperative nausea and vomiting in the recovery room is around 10% [1] but ranges from 20% to 30% during the first 24 h after surgery according to recent reports [1][2][3][4]. Despite the advances in modern anaesthetic practice and surgical techniques, there is still room for improvement in identifying the causative factors as well as in the prophylaxis and treatment of this problem.The objective of this epidemiological survey of postoperative complications was to get representative numerical estimates of the present incidence of postoperative nausea and vomiting for different types of common surgical procedures in a tertiary care setting. The aim was also to analyse the predictive factors associated with these symptoms and to construct a risk score based on patient-related factors, as well as on some key anaesthetic and surgical factors. Methods

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Section: Scoresupporting

confidence: 59%

A survey of postoperative nausea and vomiting

et al. 1997

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“…1 The incidence of PONV has been reported to be as high as 75% following some surgical procedures. 2 Besides the discomfort caused by nausea and vomiting following surgery, PONV can contribute to the development of aspiration, wound dehiscence and increased bleeding. 3 Patients who experience PONV consume more resources and require additional health care professional time than do those in whom these complications are avoided.…”

mentioning

confidence: 99%

5-HT3 receptor antagonistsvs traditional agents for the prophylaxis of postoperative nausea and vomiting

Loewen

Marra

Zed

2000

Can J Anesth/J Can Anesth

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Purpose: Numerous antiemetics have been studied for the prevention of postoperative nausea and vomiting (PONV) including traditional agents (metoclopramide, perphenazine, prochlorperazine, cyclizine and droperidol) and the 5-HT 3 receptor antagonists (ondansetron, dolasetron, granisetron and tropisetron). The results have been divergent and inconsistent. The purpose of this quantitative systematic review was to evaluate the effectiveness of 5HT 3 receptor antagonists compared to traditional antiemetics for the prevention of PONV. Methods: A systematic search of the English language literature using computerized MEDLINE, EMBASE, and Pre-MEDLINE databases from 1966 to October 1999 and a manual search of references from retrieved articles were performed. Individual efficacy and adverse effect data was extracted from each of the studies according to a predefined protocol. The summary odds ratios were calculated using the Dersimonian and Laird method under a random effects model. Results: A total of 41 trials met our pre-defined inclusion criteria and were included in our analysis.

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“…For patients undergoing minor gynecological surgery, the risk of nausea and vomiting is 75% and 61% respectively. 5 In laparoscopic cholecystectomy, the frequency (without prophylactic antiemetics) was reported to be 72% in one randomized controlled trial. 6 In the presence of prophylactic antiemetics, the frequency decreased, but remained significant, within a range of 30% to 60% depending on the type of study.…”

Section: Résultats : Aucune Différence Intergroupe N'a éTé Enregistrémentioning

confidence: 99%

Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery

Yang

Choi

McChesney

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To compare sevoflurane-remifentanil induction and propofol-fentanyl-rocuronium induction with regards to the frequency of moderate to severe postoperative nausea and vomiting (PONV) in the first 24 hr after laparoscopic day surgery.M Me et th ho od ds s: : After informed consent, 156 ASA physical status class I to III patients undergoing laparoscopic cholecystectomy or tubal ligation were randomized to either induction with sevoflurane 8%, N 2 O 67% and iv remifentanil 1 to 1.5 µg·kg -1 or induction with iv fentanyl 2 to 3 µg·kg -1 , propofol 2 mg·kg -1 , and rocuronium 0.3 to 0.5 mg·kg -1 . All patients received iv ketorolac 0.5 mg·kg -1 at induction and sevoflurane-N 2 O maintenance anesthesia with rocuronium as needed. PONV was treated with iv ondansetron, droperidol, or dimenhydrinate; postoperative pain was treated with opioid analgesics. Patients were followed for 24 hr with regards to PONV and pain. Intubating conditions, induction and emergence times, time to achieve fast-track discharge criteria, and drug costs were measured. R Re es su ul lt ts s: : No differences were seen between the two groups in their frequencies of 24-hr moderate to severe PONV and postoperative pain, or in their intubating conditions, induction and emergence times, and time to achieve fast-track discharge criteria. Patients undergoing sevoflurane-remifentanil induction received more morphine (11 mg vs 8 mg; P < 0.001) in the postanesthetic care unit. Sevoflurane-remifentanil induction resulted in similar anesthetic and total drug costs for both procedures.C Co on nc cl lu us si io on n: : We did not demonstrate any difference in PONV, pain, or anesthetic/recovery times or costs between the sevoflurane and propofol groups. Sevoflurane-remifentanil induction is a feasible technique for anesthetic induction. Objectif : Comparer l'induction avec sévoflurane-rémifentanil ou propofol-fentanyl-rocuronium quant à la fréquence de nausées et vomissements postopératoires (NVPO) de modérés à sévères pendant les 24 premières heures après une opération en chirurgie d'un jour sous laparoscopie. Méthode : Après avoir accordé leur consentement, 156 patients d'état

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Nausea and Vomiting After Gynaecological Surgery: A Meta-Analysis of Factors Affecting Their Incidence

Cited by 88 publications

References 15 publications

A survey of postoperative nausea and vomiting

A survey of postoperative nausea and vomiting

5-HT3 receptor antagonistsvs traditional agents for the prophylaxis of postoperative nausea and vomiting

Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery

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