Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients
Background The overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur early in the post‐anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to i...
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Published in | Acta anaesthesiologica Scandinavica Vol. 65; no. 9; pp. 1229 - 1239 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Copenhagen
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01.10.2021
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Abstract | Background
The overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur early in the post‐anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV.
Methods
This single‐centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post‐operative charts. Early PONV was defined as PONV occurring up to 4 hours post‐operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV.
Results
A total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m−2 and major surgery and anaesthesia time ≥60 minutes.
Conclusion
We found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV. |
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AbstractList | BACKGROUNDThe overall risk of post-operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%-40%. The first episode of PONV may occur early in the post-anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV. METHODSThis single-centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post-operative charts. Early PONV was defined as PONV occurring up to 4 hours post-operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV. RESULTSA total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m-2 and major surgery and anaesthesia time ≥60 minutes. CONCLUSIONWe found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV. BackgroundThe overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur early in the post‐anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV.MethodsThis single‐centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post‐operative charts. Early PONV was defined as PONV occurring up to 4 hours post‐operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV.ResultsA total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m−2 and major surgery and anaesthesia time ≥60 minutes.ConclusionWe found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV. Background The overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur early in the post‐anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV. Methods This single‐centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post‐operative charts. Early PONV was defined as PONV occurring up to 4 hours post‐operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV. Results A total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m−2 and major surgery and anaesthesia time ≥60 minutes. Conclusion We found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV. Background: The overall risk of post-operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur early in the post-anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV. Methods: This single-centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post-operative charts. Early PONV was defined as PONV occurring up to 4 hours post-operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV. Results: A total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m−2 and major surgery and anaesthesia time ≥60 minutes. Conclusion: We found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV. Background The overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur early in the post‐anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV. Methods This single‐centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post‐operative charts. Early PONV was defined as PONV occurring up to 4 hours post‐operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV. Results A total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m −2 and major surgery and anaesthesia time ≥60 minutes. Conclusion We found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV. |
Author | Hultin, Magnus Johansson, Emma Myrberg, Tomi Walldén, Jakob |
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CitedBy_id | crossref_primary_10_1038_s41598_023_33807_7 crossref_primary_10_1016_j_clinthera_2023_01_013 crossref_primary_10_1111_jocn_16940 crossref_primary_10_2147_JPR_S389564 crossref_primary_10_2147_DMSO_S465814 crossref_primary_10_1186_s12871_022_01835_x crossref_primary_10_23736_S0375_9393_22_16272_3 crossref_primary_10_1016_j_pcorm_2022_100283 crossref_primary_10_1097_EJA_0000000000001795 crossref_primary_10_1016_j_aan_2023_05_002 crossref_primary_10_1038_s41598_023_32730_1 crossref_primary_10_1097_SLE_0000000000001269 crossref_primary_10_7759_cureus_37419 |
Cites_doi | 10.1016/j.bja.2017.08.003 10.1093/bja/aes276 10.1097/EJA.0000000000000473 10.1097/00000542-199909000-00022 10.1097/EJA.0b013e32834a4e1e 10.1097/EJA.0000000000000520 10.1016/j.jopan.2019.06.002 10.1097/ALN.0b013e318267ef31 10.1213/ANE.0000000000000002 10.1097/00000539-200012000-00020 10.1046/j.1365-2346.1998.00319.x 10.1007/s00268-008-9472-5 10.1054/jpai.2002.123652 10.1097/00000542-200109000-00012 10.1097/EJA.0000000000000491 10.1007/s11695-018-3605-1 10.1016/S0895-4356(96)00236-3 10.1016/0028-3908(91)90136-Y 10.1213/ANE.0000000000004833 10.1093/bja/88.5.659 10.1007/s12630-017-1013-y 10.1177/147323001003800330 10.1245/s10434-020-08880-1 10.1016/j.ejphar.2013.10.037 |
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Notes | Funding information This study was funded by the Västernorrland county council (Region Västernorrland), ‘Akademisk Miljö' and departmental funding. Preliminary results from the study were presented as a conference abstract at the Swedish Society of Anaesthesia and Intensive Care's (SFAI) annual meeting in September 2019, Gothenburg, Sweden. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
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References | 2014; 118 2018; 120 1998; 15 2014; 722 2010; 38 2020; 131 1991; 30 2002; 88 2020; 27 2002; 3 2019; 29 2008; 32 2020; 35 2000; 91 2011; 28 2018; 65 1999; 91 1996; 49 2012; 117 2001; 95 2012; 109 2016; 33 e_1_2_7_6_1 e_1_2_7_5_1 e_1_2_7_4_1 e_1_2_7_3_1 e_1_2_7_9_1 e_1_2_7_8_1 e_1_2_7_7_1 e_1_2_7_19_1 e_1_2_7_18_1 e_1_2_7_17_1 e_1_2_7_16_1 e_1_2_7_2_1 e_1_2_7_15_1 e_1_2_7_14_1 e_1_2_7_25_1 e_1_2_7_13_1 e_1_2_7_24_1 e_1_2_7_12_1 e_1_2_7_23_1 e_1_2_7_11_1 e_1_2_7_22_1 e_1_2_7_10_1 e_1_2_7_21_1 e_1_2_7_20_1 |
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Snippet | Background
The overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur... BackgroundThe overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur... BACKGROUNDThe overall risk of post-operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%-40%. The first episode of PONV may occur... Background: The overall risk of post-operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur... |
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SubjectTerms | Anesthesia Body mass Body mass index Body size Charts Disease prevention General anesthesia Medical records Narcotics Nausea Observational studies observational study Opioids Patients post-anaesthesia care unit post-operative nausea and vomiting Prophylaxis Risk analysis Risk factors Surgery Vomiting |
Title | Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients |
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