[Postoperative vomiting. A score for prediction of vomiting risk following inhalation anesthesia].
Despite numerous factors are thought to affect postoperative vomiting (PV) recent studies demonstrated that the risk of PV can be predicted by considering just the most important ones. Therefore, the aim of this study was to present the clinically most relevant factors, a risk score based upon those factors and its clinical applicability for other types of surgery.


METHODS
In a prospective study 2220 adult inpatients scheduled for elective surgery were monitored for PV after inhalational anaesthesia over 24 hours. None of the patients received prophylactic antiemetic treatment. Multivariate analyses were performed with data of patients who underwent otolaryngological procedures to identify the major risk factors and to derive a risk score. The applicability of the score in surgical and ophthalmological procedures was tested by linear regression analysis of expected and observed incidences.


RESULTS
In the multivariate model, clinically most important risk factors for PV were female gender, young age, a positive history of postoperative nausea and vomiting or motion sickness, non-smoking and a long duration of anaesthesia, whereas the relative impact of the "type of operation itself" was small. Expected and observed incidences in patients undergoing other types of surgery were strongly correlated (R2 = 0.99, P < 0.001).


CONCLUSIONS
The risk for PV after inhalational anaesthesia in adults can be predicted using a score which is based on individual risk factors and the duration of anaesthesia only.
Apfel
C C
CC
Klinik für Anaesthesiologie der Universität Würzburg.
Greim
C A
CA
Goepfert
C
C
Grundt
D
D
Usadel
J
J
Sefrin
P
P
Roewer
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors