Use of Apfel Simplified Risk Score to Guide Postoperative Nausea and Vomiting Prophylaxis in Adult Patients Undergoing Same-day Surgery

Choy, Robynn; Pereira, Katherine; Silva, Susan G.; Thomas, Neel; Tola, Denise H.

doi:10.1016/j.jopan.2021.10.006

Cited by 9 publications

(3 citation statements)

References 26 publications

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“…The same phenomenon was observed in NRS scores for PONV in the overall patients. According to the Apfel risk assessment scale for nausea and vomiting, the most common risk indicators currently used are history of motion sickness, smoking, sex (male or female), and opioid exposure 17 , 18 . These factors were simultaneously included in the multivariate regression analysis in the present study.…”

Section: Discussionmentioning

confidence: 99%

Slower intravenous tramadol administration can prevent nausea and vomiting and predict postoperative nausea and vomiting: a randomized controlled trial

Gan,

Zheng,

Chen

et al. 2023

Annals of Medicine &Amp; Surgery

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Objective: Nausea and vomiting are the most common complications in patients who use tramadol for analgesia. This study evaluated the risk of nausea and vomiting related to intravenous tramadol administration. Methods: In this study, 315 patients who received pre-analgesia before elective surgery were selected, and participants were divided into groups based on the Apfel risk assessment of nausea and vomiting, as follows: high-risk (Apfel=4), medium-risk (Apfel=2– 3), and low-risk (Apfel=1). Tramadol (1.5 mg/kg) was administered intravenously over a duration of 1 min, 2 min, or 3 min before anesthesia induction to observe preoperative nausea and vomiting reactions within 10 min. Results: In the low-risk group, the numeric rating scale for postoperative nausea scores and the incidence of nausea and vomiting were significantly lower in the 3 min group than those in the 1 min group, and the incidence of preoperative nausea and vomiting after intravenous administration of tramadol in the 1 min and 3 min groups were significantly related to the incidence of postoperative nausea and vomiting. The incidence of nausea and vomiting during pre-administration in the 1 min and 3 min groups was identified as an independent risk factor for postoperative nausea and vomiting. Conclusion: In the clinical treatment of pain with tramadol, the slow intravenous application of tramadol within 3 min is worthy of being adopted and promoted by clinicians in their daily work.

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Section: Discussionmentioning

confidence: 99%

Slower intravenous tramadol administration can prevent nausea and vomiting and predict postoperative nausea and vomiting: a randomized controlled trial

Gan,

Zheng,

Chen

et al. 2023

Annals of Medicine &Amp; Surgery

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“…MMSE scores ranged from 0 to 30, with 27 to 30 being normal and<27 being possible cognitive impairment. As for PONV scores, 0 indicated no nausea and vomiting, 1 indicated nausea only, 2 indicated vomiting only, and 3 indicated nausea and vomiting 10 …”

Section: Methodsmentioning

confidence: 99%

“…As for PONV scores, 0 indicated no nausea and vomiting, 1 indicated nausea only, 2 indicated vomiting only, and 3 indicated nausea and vomiting. 10 Statistical Analysis SPSS 26.0 statistical software was used for data analysis. Normally distributed measures were expressed as mean ± SD, and independent samples t-test was used for comparison between groups.…”

Section: Data Collectionmentioning

confidence: 99%

Risk Factors of Acute Pain in Elderly Patients After Laparoscopic Radical Resection of Colorectal Cancer

Zhu,

Qu,

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Objective: To investigate the risk factors of acute pain after laparoscopic radical resection of colorectal cancer (CRC) in elderly patients. Methods: Totally, 143 elderly patients (≥ 60 y old) who received laparoscopic radical resection of CRC in the People’s Hospital of Xinjiang Uygur Autonomous Region from March 2021 to August 2022 were retrospectively analyzed. The patients were divided into 2 groups according to visual analog scale (VAS) scores 24 h after surgery: mild pain group (VAS score ≤ 3, n=108) and moderate to severe pain group (VAS score >3, n=35). The data of the patients, including sex, age, height, body mass, intraoperative blood loss, intraoperative urine volume, intraoperative opioid dosage, operation duration, preoperative Hospital Anxiety and Depression Scale (HADS) scores, preoperative Mini-Mental State Examination scores, VAS scores, postoperative nausea and vomiting scores were recorded. Multivariate logistic regression analysis was used to screen the risk factors of postoperative acute pain in elderly patients undergoing laparoscopic radical resection of CRC. Results: The preoperative HADS score of the moderate to severe pain group was significantly increased compared with that of the mild pain group (10.8±2.4 vs. 6.2±1.9), as well as the operation duration (226.4±18.3 vs. 186.1±12.7), the intraoperative dosage of remifentanil (3.7±0.2 vs. 3.2±0.4), the preoperative VAS score [4(2, 7) vs. 2 (0, 4)] and postoperative VAS score [5 (4, 6) vs. 3 (2, 3)] (P<0.05). Multivariate logistic regression analysis showed that high preoperative HADS score, long operation duration, and high preoperative VAS score (P<0.05) were independent risk factors for acute pain after laparoscopic radical resection of CRC in elderly patients. Conclusion: Preoperative anxiety and depression, preoperative pain, and long operation duration are risk factors for acute pain in elderly patients after laparoscopic radical resection of CRC.

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Comparison of predictive models in postoperative nausea and vomiting in patients undergoing breast cancer surgery

Maraş,

Kalaycı,

Ceyhan

2024

Support Care Cancer

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Background Post-operative nausea and vomiting remain an unresolved concern in Türkiye and some parts of the world, impacting the quality of the patient's recovery process and diminishing overall satisfaction. Objective This study was conducted as a descriptive investigation to compare the incidence of nausea and vomiting following breast cancer surgery with the nausea and vomiting risk scores proposed by Apfel and Koivuranta. Methods This study was conducted with 100 patients admitted to the General Surgery service of a university hospital between 31 August 2019 and 31 May 2021 for breast cancer surgery. The patient information form developed by the researchers, Apfel Nausea and Vomiting Risk Score, and Koivuranta Nausea and Vomiting Risk Score were used as data collection tools. Results It was identified that 61% of the patients experienced nausea and vomiting within the initial 24 h following surgery. A significant correlation was found between age, post-operative opioid use, motion sickness or history of PONV, and nausea and vomiting (p < 0,05). The sensitivity of the Apfel score obtained was 80%, the specificity was 46%, and the AUC value was 0.686. The sensitivity of the Koivuranta score was 80%, the specificity was 35%, and the AUC value was 0.675 (p < 0.05). Conclusion It has been observed that patients experience high rates of nausea and vomiting after breast cancer surgery and that the Apfel and Koivuranta Risk Scores are equally applicable in predicting post-operative nausea and vomiting.

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Use of Apfel Simplified Risk Score to Guide Postoperative Nausea and Vomiting Prophylaxis in Adult Patients Undergoing Same-day Surgery

Cited by 9 publications

References 26 publications

Slower intravenous tramadol administration can prevent nausea and vomiting and predict postoperative nausea and vomiting: a randomized controlled trial

Slower intravenous tramadol administration can prevent nausea and vomiting and predict postoperative nausea and vomiting: a randomized controlled trial

Risk Factors of Acute Pain in Elderly Patients After Laparoscopic Radical Resection of Colorectal Cancer

Comparison of predictive models in postoperative nausea and vomiting in patients undergoing breast cancer surgery

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