scholarly journals Incidence of post-operative nausea and vomiting and it’s predictors among adult elective surgical patients at Jimma Medical Center, South West Ethiopia

2020 ◽  
Author(s):  
Mohammed Suleiman Obsa ◽  
Dinkisisa Chemeda Edosa ◽  
Zemenu Muluken Desalegn ◽  
Nega Desalegn Fanta ◽  
Sintayehu Mulugeta Tamiru ◽  
...  

Abstract Background Post-operative nausea and vomiting is the most frequent side effect of anesthesia. It affects 20 - 30% of all post-operative and 70%-80% high risk patients. Consequently, it is one of the most frequently observed adverse events associated with the provision of anesthesia. Thus this study is aimed to assess the incidence and associated factors of post-operative nausea and vomiting. Methods This cross-sectional study was conducted using a consecutive sampling method. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. The findings of the study were reported using tables, figures and narration. Variables that were found to be candidate (p value < 0.25) on binary logistic regression entered into a multiple logistic regression analysis to identify independent predictors of post-operative nausea and vomiting. Results The results of this study indicated that the incidence of postoperative nausea and vomiting was 27.4% . Output of multiple logistic regression revealed that female sex (AOR = 4.065 (2.090 - 7.906), history of motion sickness (AOR = 2.836 (1.582 - 5.083), Gynecologic type of surgery (AOR = 3.782 (1.156 - 12.373), long duration of anaesthesia (> 60 min) (AOR = 2.974 (1.491 - 5.933) and administration of post-operative opioids (AOR = 2.333 (1.221 - 4.457) were considered as independent predictors of postoperative nausea and vomiting at P value < 0.05. Conclusion The present finding has shown that the overall incidence of postoperative nausea and vomiting is high 27.4% therefore provision of anti-emetic prophylaxis is reccomended.

2017 ◽  
Vol 8 (3) ◽  
pp. 382
Author(s):  
El Rahmayati ◽  
Anggi Irawan ◽  
Tumiur Sormin

<p class="Normal1">Postoperative Nausea and vomiting (PONV) is a common complication after surgery.The incidence of postoperative nausea vomiting is approximately 30% of all patients undergoing inpatient surgery and 70% of cases occur within the first 24 hours. One of nausea and vomiting treatment is non-pharmacological therapies with complementary acupressure therapy. Furthermore, the research was conducted to determine the effect of acupressure complementary therapies against postoperative nausea and vomiting.The research was Quasi-Experimental research design Non-equivalent Control Group, the sampling technique used purposive sampling technique. Based on results of sample calculation used amounted to 22 respondents, consisting of 11 experimental groups and 11 control groups. Collecting data was used questionnaire and analyzed using univariate and bivariate analysis by Wilcoxon and Mann-Whitney with α values (&lt;0.05).The results showed the difference in score of nausea and vomiting the first and second measurements in the control group given a placebo action is 0.91 with a p-value (0.26). Nausea and vomiting difference in scores obtained before and after acupressure complementary therapies in the experimental group was 2:18 with a p-value (0.004). As well as the difference in scores obtained post-operative nausea and vomiting in the control group and the experiment is 1:27 with the p-value (0.009). The above statistical test results can be concluded that there was the effect of complementary acupressure therapy on postoperative nausea vomiting. Based on the conclusion of the research, the authors suggest that complementary acupressure therapy can be applied as a companion therapy and it is expected that nursing staff can learn complementary acupressure therapy.</p>


2019 ◽  
Author(s):  
Tamiru Tilahun ◽  
Adugna Aregawi ◽  
Temesgen Bati Gelgelu

Abstract Background Postoperative nausea and vomiting (PONV) is a common post- operative unpleasant experience and also common following thyroidectomy that may cause for hematoma and post-operative airway obstruction. Several agents have been tried to reduce severity and incidence PONV.This study intended to compare effectiveness of Metoclopramide alone and its combination with Dexamethasone for prevention of PONV after thyroidectomy at Menelik II Hospital.Methods Prospective cohort study was conducted on 76 American Society of Anesthesiologist (ASA) class I and II, adult patients undergone thyroidectomy. A systematic random sampling was applied to identify sample population through skip interval till required sample size was achieved. Study participants were grouped as Group = M (Metoclopramide alone) and Group = MD (Metoclopramide plus Dexamethasone).Following study participant received either 10 mg Metoclopramide or 5mg Metoclopramide plus 4mg Dexamethasone, PONV was recorded at 6, 12 and 24 hours post operatively. Continuous variables were expressed as mean ± SD or median-IQR as appropriate. Analysis was done by independent two sample t test, Manny Whitney U test and χ2 or fisher exact test. P-Value <0.05 was considered as statistically significant.Results The overall incidence of PONV with in the first 24 hours was significantly higher in Group M as compared to Group MD, 24(63.15%) versus 9 (23.68%) respectively with a P-value of < .01. Although difference was insignificant, severity of nausea at 6th, 12th and 24th was still higher in Group M. From side effects, Sedation was significantly lower in Group MD 6 (15.79%) versus 15 (39.47%) with a P-value of <.05. Despite difference was insignificant headache was found higher in Group M 10 (26.31) vs. 6 (10.52) respectively.Conclusions 5mg Metoclopramide combined with 4mg Dexamethasone has significant effects for prophylaxis of post-operative nausea and vomiting after thyroidectomy. Some side effects of drugs were also significantly reduced in combination group.


2020 ◽  
Author(s):  
Ashagrie Sintayhu Temesgen ◽  
Getahun Dendir Wolde

Abstract Background Postoperative nausea and vomiting is among the most common postoperative complications, despite modern anesthetics and surgical techniques. It can occur during the operation and persisting in the postoperative period cause reduces patient comfort, delayed discharge from the hospital and an increase in costs. The risk factors that affect the incidence of post-operative nausea and vomiting are multifactorial in origin and occur in 20 to 30% of all patients and can extend up to 60–70% in high-risk patients. The objective of this study was to determine the incidence and associated risk factors of postoperative nausea and vomiting. Methods An institution-based, cross-sectional study was conducted from March to August 2019 in Wolaita Sodo University teaching referral hospital (WSUTRH). A total of 371 adult elective patients who operated during this period were included in the study. Data were collected by interviewing patients and reviewing their cards then entered and analyzed using SPSS version 25. Variables with P value less than < 0.2 in the bivariate analysis were fitted into the multivariable logistic regression analysis to identify factors associated with postoperative nausea and vomiting and a P value of < 0.05 was considered statistically significant. Results The incidence of postoperative nausea and vomiting 24hour after surgery was 29.1%. In multivariable analysis, previous history of PONV (AOR = 5.1, 95%CI = 4.00-6.58), use of opioids (AOR = 4.91, 95%CI = 3.08–10.37), use of inhalational anesthetic agent (AOR = 2.38, 95%CI = 1.45–5.30), and long duration of surgery AOR = 6.65, 95%CI = 5.52–8.30) were significantly associated with the incidence of postoperative nausea and vomiting. Conclusions The incidence of postoperative nausea and vomiting was high compared to other studies done in different settings. Previous history of PONV, use of opioids, use of inhalational anesthetic agents and long duration of surgery are predictors of postoperative nausea and vomiting. We recommend routine preoperative PONV risk evaluation and give antiemetic premedication for those high-risk patients.


Author(s):  
Suchismita Naik ◽  
Shweta Kujur ◽  
Miltan Debbarma ◽  
Miltan Debbarma ◽  
Madhumita G. Murthy

Background: Postoperative nausea and vomiting (PONV) is common complication after general anesthesia and surgery. This randomized double-blind study was designed to compare the effects of acupressure wrist bands and palonosetron for the prevention of post-operative nausea and vomiting (PONV) in laparoscopic cholecystectomy under general anaesthesia.Methods: Sixty ASA I and II patients undergoing elective laparoscopic surgeries under general anaesthesia were divided into two groups. In Group A patients, acupressure wrist bands were applied on p6 point on both hands half an hour before induction. Group P patients received inj. palonosetron 0.075 m.g. i.v. just before induction. Anaesthesia technique was standardized. Post-operatively patients were monitored for nausea, retching or vomiting upto 24 hours. If patients vomited more than once, they were given inj. Metoclopramide 10mg as rescue antiemetic. Efficacy of drugs was compared using Chi square test. ‘p’ value of <0.05 is considered significant.Results: The incidence of PONV and requirement of rescue antiemetic were lower in palonosetron group than acupressure wrist band group.Conclusions: Palonosetron is more effective than acupressure wrist band for prophylaxis of post- operative nausea and vomiting in the patients undergoing laparoscopic cholecystectomy under general anaesthesia, but acupressure wrist band can also be used as an alternative non-pharmacological method.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reem M. Elsaid ◽  
Ashraqat S. Namrouti ◽  
Ahmad M. Samara ◽  
Wael Sadaqa ◽  
Sa’ed H. Zyoud

Abstract Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.


2016 ◽  
Vol 10 (1) ◽  
pp. 505-511 ◽  
Author(s):  
Ran Schwarzkopf ◽  
Nimrod Snir ◽  
Zachary T. Sharfman ◽  
Joseph B. Rinehart ◽  
Michael-David Calderon ◽  
...  

Background: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol. Methods: All total joint replacement PSH (TJR-PSH) patients who underwent primary THA (n=149) or TKA (n=212) in the study period were included. The modified protocol added a single dose of intravenous (IV) ketorolac given in the operating room and oxycodone immediate release orally instead of IV Hydromorphone in the Post Anesthesia Care Unit (PACU). The outcomes were (1) incidence of PONV and (2) average pain score in the PACU. We also examined the effect of primary anesthetic (spinal vs. GA) on these outcomes. The groups were compared using chi-square tests of proportions. Results: The incidence of post-operative nausea in the PACU decreased significantly with the modified protocol (27.4% vs. 38.1%, p=0.0442). There was no difference in PONV based on choice of anesthetic or procedure. Average PACU pain scores did not differ significantly between the two protocols. Conclusion: Simple modifications to TJR-PSH multimodal pain management protocol, with decrease in IV narcotic use, resulted in a lower incidence of postoperative nausea, without compromising average PACU pain scores. This report demonstrates the need for continuous monitoring of PSH pathways and implementation of revisions as needed.


Author(s):  
Sunil Arjan ◽  
Naila Zahoor ◽  
Kenza Nadeem ◽  
Farah Liaquat ◽  
Tariq Hussain Mughal ◽  
...  

Objective:To evaluate the efficacy of Metoclopramide versus Dexamethasone for prevention of postoperative nausea and vomiting during general anesthesia. Study Design:This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Clinic, Dow University of Health Sciences and  Dr. Ruth Pfau  Hospital Karachi, from December 2018 to June 2019. Materials and Methods:110 patients undergoing elective surgeries, who fulfilled the inclusion criteria and gave informed consent were included in the study. They were randomly assigned to either group M or group D, with 55 patients in each group. All patients were then administered either intravenous dexamethasone (8mg) in group D or intravenous metoclopramide (10mg) in group M at the time of induction of anesthesia. The main outcome measure was postoperative nausea and vomiting, at the end of 6th hour postoperatively. The SPSS version 21 was applied to the data. Results: Majority of the patients 66 (60%) were of age 35 years or less. Mean age of the patients was 35.09±11.55 years. There were more females than males, with male to female ratio being 1:1.03. Overall, in patients receiving metoclopramide, 12(21.8%)  had postoperative nausea and vomiting, while in patients who received dexamethasone, only 4 (7.3%) patients had post-operative nausea and vomiting. When comparing two groups, there was statistically significant (p= 0.02) reduced postoperative nausea/vomiting among those patients who had received intravenous dexamethasone. Conclusion: Intravenous dexamethasone is more effective than Metoclopramide in preventing postoperative nausea and vomiting in patients during general anesthesia.


2001 ◽  
Vol 2 (2) ◽  
pp. 10-13
Author(s):  
Lynn Sealey

AbstractThe workload of the recovery unit can be considerably increased by patients suffering post operative nausea and vomiting (PONV). The unit can often become blocked by patients too sick to discharge back to the main ward. Via a review of the literature and a small research study in the authors own recovery ward, it was concluded that PONV causes patients to stay in recovery longer. In fact the study reveals of those patients who did not receive an antiemetic perioperatively, 31% suffered PONV and those who had PONV spent 29 minutes longer in recovery.Despite ondansatron being one of the most expensive drugs, it was only successful in 81% of cases. However those people who did receive ondansatron, spent an average of 8 minutes less time in recovery, compared with those who were not given it. These findings potentially have considerable cost implications, relevant in todays current climate of economy saving strategies. These findings and their implications are discussed.


2014 ◽  
Vol 24 (2) ◽  
pp. 60-64
Author(s):  
M Younus Ali ◽  
Raihan Uddin ◽  
Amirul Islam ◽  
Mustafa Kamal ◽  
SM Rafiqul Islam ◽  
...  

Background Postoperative nausea and vomiting after laparoscopic cholecystectomy under general anaesthesia are an unpleasant,distressing effects. Prophylactic use of dexamethesone reducing this effects. Objective This study was designed to compare of dexamethasone and ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods Sixty patients who underwent laparoscopic cholesystectomy were randomly allocated into two groups. Group A(n=30) patients received 8mg dexamehtasone intravenously and Group B(n=30) patients received 8mg ondansetron intravenously one minute before induction of anaesthesia. All patients received standard general anaesthesia.Perioperative vital signs and postoperative nausea and vomiting were recorded. Results The incidence of nausea was 13.4% in group A, 16.7% in group B(p>0.05) and vomiting was 6.6% in Group A, 13.4% in group B(p>0.05). The difference among the groups was not statistically significant. Conclusion Intravenous dexamethasone was better to ondansetron in prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19803 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 60-64


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