A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics, anesthetic routines and surgical procedures.
We performed a prospective study on 421 patients subjected to routine general-, orthopaedic-, urologic-, gynecological and paediatric surgery to estimate the current incidences of nausea and vomiting during the first 24 hours after surgery. The overall incidences of postoperative nausea or vomiting were 17% and 28%, respectively. Postoperative emetic symptoms were not related to age in adults. Women had more often emetic symptoms than men (P < 0.01). In general, opiate premedication was more frequently associated with postoperative nausea and vomiting than benzodiazepines (P < 0.01), but in otherwise comparable subgroups of patients undergoing major surgery, this difference was not confirmed. Balanced general anaesthesia caused more nausea (23%) and vomiting (53%) than face-mask anaesthesia (13% and 15%, respectively) or regional blocks (12% and 7%, respectively) (P < 0.001). There was a positive correlation between the duration of anaesthesia and the incidence of postoperative emetic symptoms (P < 0.001). The incidences of postoperative nausea and vomiting after abdominal surgery were 23% and 58% respectively. Corresponding figures for orthopaedic surgery were 25% and 34%, other kinds of extra-abdominal surgery 18% and 32% and for laparoscopy 21% and 25%. After minor gynecological-, urological- and paediatric surgery the incidences were less than 20%. In conclusion female gender, balanced anaesthesia, lengthy duration of anaesthesia, and abdominal and orthopaedic operations appeared to be most frequently associated with postoperative emetic symptoms.
Larsson
S
S
Department of Anesthesiology, University Hospital, Lund, Sweden.
Lundberg
D
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects / Q000706:statistics & numerical data*; D000769:Anesthesia, Inhalation / Q000009:adverse effects / Q000706:statistics & numerical data; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects; D009325:Nausea / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D011229:Preanesthetic Medication / Q000009:adverse effects / Q000706:statistics & numerical data; D011446:Prospective Studies; D012737:Sex Factors; D013514:Surgical Procedures, Operative / Q000145:classification / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014839:Vomiting / Q000453:epidemiology*
D014151:Anti-Anxiety Agents; D009294:Narcotics; D001569:Benzodiazepines