scholarly journals Risk factors for severe postoperative nausea and vomiting in a randomized trial of nitrous oxide-based vs nitrous oxide-free anaesthesia

2008 ◽  
Vol 101 (4) ◽  
pp. 498-505 ◽  
Author(s):  
K. Leslie ◽  
P.S. Myles ◽  
M.T.V. Chan ◽  
M.J. Paech ◽  
P. Peyton ◽  
...  

This case focuses on the prevention of postoperative nausea and vomiting (PONV) by asking the question: What is the efficacy of six well-established prophylactic antiemetic strategies individually and in combination for the prevention of postoperative nausea and vomiting? Each of the three antiemetics in this study (ondansetron, dexamethasone, and droperidol) reduced the risk for PONV by approximately 26%; substituting propofol for volatile anesthetic reduced the risk by 19%; and substituting nitrogen (air) for nitrous oxide reduced the risk by 12%. A maximum reduction of 70% in the relative risk for PONV can be expected when total intravenous anesthesia is used with three antiemetics. The appropriate approach to the management of PONV depends on the patient’s baseline risk factors as well as the likelihood of adverse events and costs from the antiemetic medications.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Xin Yu Adeline Leong ◽  
Xian Wen Charlene Kwa ◽  
Shu Hui Elizabeth Ng ◽  
Liang Khai Darren Koh

Introduction. We explored how ethnicity affects the risk of postoperative nausea and vomiting (PONV) and established the correlation of suggested risk factors of PONV in the multiethnic population of Singapore. Methods. 785 patients who underwent orthopaedic surgery were recruited. These comprised 619 Chinese (78.9%), 76 Malay (9.7%), 68 Indian (8.7%), and 22 other (2.8%) cases. The presence of possible risk factors of PONV and nausea and/or vomiting within 24 h after surgery was studied. Univariate and multivariate logistic regression analyses were performed. Results. The incidence of PONV was 33.2% (261 patients). There was no statistically significant difference of PONV incidence between Chinese, Malay, and Indian cases (34.6% versus 34.2% versus 29.4%, p=0.695). Indian females younger than 50 years were found to have a higher incidence of vomiting (p=0.02). The significant risk factors for this population include females, use of nitrous oxide, and a history of PONV. Conclusion. In the groups studied, ethnicity is not a significant risk factor for PONV except for young Indian females who have a higher risk of postoperative vomiting. We suggest the selective usage of antiemetic for young Indian females as prophylaxis and avoiding nitrous oxide use in high-risk patients.


2010 ◽  
Vol 27 ◽  
pp. 28-29
Author(s):  
R. Poeira ◽  
I. Antunes ◽  
H. Filipe ◽  
A. Fernandes ◽  
F. Matos

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