Postoperative Vomiting

Burtles, R.; Peckett, B. W.

doi:10.1093/bja/29.3.114

Cited by 85 publications

(12 citation statements)

References 9 publications

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“…Adult women are 2 4 times more likely to suffer PONV than men, and their symptoms may be more severe [37,38]. The greater incidence of PONV in women may be linked to female hormones, as it has been found that most PONV occurs in the luteal phase of the menstrual cycle.…”

Section: Gendermentioning

confidence: 99%

Risk factors for postoperative nausea and vomiting

KENNY

1994

Anaesthesia

237

139

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Although the aetiology of postoperative nausea and vomiting is not completely clear, a number of key contributing factors increase the risk for an individual patient. The inhalational agents are variably associated with postoperative nausea and vomiting, and nitrous oxide is particularly emetogenic. Older inhalational anaesthetics, such as cyclopropane, are associated with a high incidence, while the currently used agents, isoflurane, enflurane and halothane, cause less, but still significant postoperative nausea and vomiting. Intravenous anaesthetics are also associated with differing degrees of emesis, though the newer agent, propofol, may be less emetogenic than the older anaesthetics. Opioids, used extensively throughout surgery, are further strong emetogens. Patient factors are also important--postoperative nausea and vomiting is three times more prevalent in adult females than in males, and children are around twice as susceptible as adults. Furthermore, a previous history of postoperative nausea and vomiting or motion sickness is a known risk factor. Superimposed on this is the type of surgery--abdominal and gynaecological surgery are particularly emetogenic, and the incidence of postoperative nausea and vomiting following strabismus surgery is high. Increased quality of healthcare, and a growing awareness of the importance of patient satisfaction, are providing new incentives to ensure that postoperative nausea and vomiting is dealt with adequately.

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Section: Gendermentioning

confidence: 99%

Risk factors for postoperative nausea and vomiting

KENNY

1994

Anaesthesia

237

139

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“…Premedication with morphine leading to an increase in the incidence of postoperative emetic symptoms is well known) 9 Riding, in a study among women undergoing uterine curettage observed that only 22.4 per cent of them suffered from nausea, retching or vomiting when unpremedicated. However, when morphine was added those affected rose to 67 per cent.…”

Section: Premedicationmentioning

confidence: 99%

Anaesthesia and emesis. I: Etiology

1984

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One of the most distressing side effects following anaesthesia is the occurrence of nausea, often followed by retching and vomiting.In a review of the subject in 1963 Riding felt that postoperative "sickness" was less frequent and severe than in the preceding twenty years. ~ However, examination of more recent literature suggests that the incidence of postoperative "sickness" has probably not changed although its severity may have. It is, however, difficult to compare these studies as there was little attempt by many authors to define nausea, retching, or vomiting, indeed postoperative "sickness" is often used interchangeably with these terms. The studies variably included one or all of these symptoms; population samples, anaesthetic conditions, and periods of follow up also differed (Table I).This article will review our current understanding of the physiology of emesis (nausea, retching and vomiting) and evaluates the part played by anaesthesia in its aetiology. In a second review we will examine the methods and agents available to anaesthetists for prevention or treatment of emetic symptoms. Clearly there are several factors not directly related to anaesthesia that influence the incidence of emetic episodes (nausea, retching, or vomiting). These factors include metabolic, vestibular and psychogenic disturbances, gastro-intestinal and intraeranial disorders and administration of agents with emetic potential such as ergometrine.In these cases there is often little the anesthetist can do to influence the primary pathology and so brief mention will be made of these.

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“…Postoperative sickness (nausea, retching and vomiting) occurs frequently after anaesthesia and surgery. Clinical impressions of a decrease in the incidence and severity of sickness are not supported by evidence published over the past 35 years [1][2][3][4][5][6][7][8][9] (table I). This may reflect, in part, variability in the method of investigation.…”

mentioning

confidence: 96%

Logistic Regression Analysis of Fixed Patient Factors for Postoperative Sickness: A Model for Risk Assessment

Palazzo¹,

Evans²

1993

British Journal of Anaesthesia

206

142

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One hundred and forty-seven patients undergoing minor orthopaedic surgery were studied prospectively by logistic regression analysis to determine the association of independent fixed patient factors with the incidence of postoperative sickness (nausea, retching or vomiting). Gender, history of previous postoperative sickness, postoperative opioids and interaction between gender and previous history of sickness were significant independent factors for postoperative sickness; history of motion sickness was weakly associated. The probability of postoperative sickness in the first 24 h after surgery may be estimated from the equation: logit postoperative sickness = -5.03+2.24(postoperative opioids) +3.97 (previous sickness history) +2.4 (gender) +0.78 (motion sickness) -3.2 (gender x previous sickness history). (Log likelihood ratio test for 5 degrees of freedom for the coefficients, chi-square = 53.5 (P < 0.001).) It is suggested that the calculated probability for sickness may be a useful addition for balancing patient treatment groups and allowing between-study comparisons.

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Postoperative Vomiting

Cited by 85 publications

References 9 publications

Risk factors for postoperative nausea and vomiting

Risk factors for postoperative nausea and vomiting

Anaesthesia and emesis. I: Etiology

Logistic Regression Analysis of Fixed Patient Factors for Postoperative Sickness: A Model for Risk Assessment

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