scholarly journals Incidence and Risk Factors associated with Post-operative Nausea and Vomiting in Elective Adult Surgical Patients at Wolaita Sodo Teaching Referral Hospital: An Institutional Based Cross-sectional Study

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.

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.


2021 ◽  
pp. 24-25
Author(s):  
Kothari Asit ◽  
Shah Priyal ◽  
Patel Urvi

INTRODUCTION: Post Operative Nausea and Vomiting (PONV) are the most common distressing symptom after LSCS. Antiemetic drugs play an important role to prevent it. Though many drugs have been tried as prophylaxis and treatment of PONV, no drug has been proved signicantly effective and hence, the present study was undertaken to compare the efcacy and safety of IVmetoclopramide and IVOndansetron as prophylaxis for postoperative nausea and vomiting in LSCS under spinal Anaesthesia OBJECTIVES: To study comparison of IV Ondansetron and IV Metoclopramide for prevention of postoperative nausea and vomiting as well as to compare any adverse effect occurrence through drugs in elective LSCS under spinal Anaesthesia. METHODS: It was a prospective study in which 100 patients were selected and randomly allotted into 2 groups, 50 patients in each group, according to inclusion criteria. Group A: Inj. Ondansetron 0.15 mg/kg i.v. Group B: Inj. Metoclopramide 0.25 mg/kg i.v. RESULT: Mean Age, Weight and Duration of surgery are comparable in both the groups without any statistical signicant difference. Incidence of nausea was 12% in group B and there was no incidence of nausea in group A in 30 min after injecting drugs. The incidence of nausea was 14% in group Aand 28% in group B in 45 min after injecting drugs. Incidence of vomiting was 16% in group B and there was no incidence of vomiting in group Ain 30 min after injecting drugs. The incidence of vomiting was 8% in group Aand 22% in group B in 45 min after injecting drugs CONCLUSION: Efcacy and safety of ondansetron is more than metoclopramide for prevention of nausea and vomiting in LSCS under spinal Anaesthesia


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haohao Lu ◽  
Chuansheng Zheng ◽  
Bin Liang ◽  
Bin Xiong

Abstract Purpose The mechanism of postoperative nausea and vomiting after TACE is not clear. This study retrospectively analyzed the patient data to explore the mechanism and risk factors of postoperative nausea and vomiting after TACE. Materials and methods The data of 221 patients who underwent TACE in the interventional department from January 2019 to December 2020 were collected. Including: gender, age, liver function before TACE, etiology of liver cirrhosis, BCLC stage of hepatocellular carcinoma, preoperative use of analgesic drugs, preoperative limosis, previous history of vomiting, history of kinetosis, smoking history, history of drinking, chemotherapeutic drugs used during TACE, Dosage of lipiodol, and occurrence of postoperative nausea and vomiting. Results There were 116 cases of nausea after TACE, using binary logistic regression analysis, Sig: ALT0.003; ALP0.000; history of vomiting 0.043; kinetosis 0.006; history of alcohol consumption 0.011; preoperative limosis 0.006; dosage of lipiodol (5–10 mL) 0.029, dosage of lipiodol (> 10 mL) 0.001.There were 89 cases of vomiting after TACE, all accompanied by nausea, Sig: ALP0.000; BCLC stage (B) 0.007; kinetosis 0.034; chemotherapeutic drugs 0.015; dosage of lipiodol (5–10 ml) 0.015, dosage of lipiodol (> 10 ml) 0.000; patients used analgesics before TACE 0.034. Conclusions Causes of post-TACE nausea and vomiting included operative trauma, aseptic inflammation caused by ischemia and hypoxia, chemotherapeutic drugs, ischemia of liver and bile duct, stress and pain during TACE, and patient factors. ALP, BCLC stage, kinetosis, chemotherapeutic drugs, dosage of lipiodol, and preoperative usage of analgesics were risk factors affecting nausea and vomiting after TACE.


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.


2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Nebyou Seyoum ◽  
Daba Ethicha ◽  
Zelalem Assefa ◽  
Berhanu Nega

Background: This study was done to identify risk factors that affect the morbidity and mortality of patients operated for a perforated peptic ulcer in a resource-limited setting.Methods: A two years (January 1, 2016 - December 30, 2018) retrospective cross- sectional study was done on patients admitted and operated for PPU at Yekatit 12 Hospital, Addis Ababa,Ethiopia.Results: A total of 93 patients were operated. The median age affected was 29 years (Range 15-75 years). Male to female ratio was 7.5:1. Chewing chat, smoking and alcohol use were seen in 22 (23.6%), 35(37.6%), and 34(36.5%), cases respectively. Only 23.6% gave previous history of dyspepsia. The median duration of illness was 48hours and the duodenal to gastric ulcer perforation ratio was 6.5:1. In majority of the cases (63.3%) the perforation diameter was <10mm (63.3%). Cellan-Jones repair of the perforations was done in 92.5% of cases. A total of 47 complications were seen in 25 cases. The total complications and mortality rates were 25(26.8%) and 6(6.5%) respectively. The most common postoperative complication was pneumonia (13.97%) followed by superficial surgical site infection (10.8%). Mortality rate was highest among patients >50yrs [AOR (95%CI) =2.4(2-30)]. Delayed presentation of >24 hours [AOR (95%CI) =4.3(1.4-13.5)] and a SBP <90mmhg [AOR (95%CI) =4.8(1-24)] were found to be significantly related with higher complication rate.Conclusions: Patients who presented early and immediate corrective measures were instituted had better outcomes while those seen late developed unfavorable out-come with significantly higher complications. Therefore, early detection and treatment of PPU is essential.


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.


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