[Can postoperative nausea or vomiting be predicted?].
BACKGROUND
In order to identify patients who may benefit from prophylactic anti-emetic medication during surgery, it is of interest to evaluate risk factors for postoperative nausea and vomiting preoperatively by a simple scoring system.


METHODS
In this retrospective study we evaluated the ability to assess the risk of PONV by a preoperative clinical score developed in our institution (U-score, 0-13 points) and two simple scoring systems from the literature (A-score, 0-4 points and K-score, 0-5 points). 120 patients were interviewed 24 hours after a surgical procedure. Possible risk factors for PONV were scored and compared to the occurrence of PONV.


RESULTS
60% of patients experienced PONV during the first 24 postoperative hours. No difference was seen between those who had received droperidol prophylaxis and those who had not. A significant correlation (p < 0.01) were seen on all scoring systems between occurrence of PONV and high score. With the U-score, 78% of the patients with a score > 7 experienced PONV, compared to only 41% of those with a score < 6.


CONCLUSIONS
We suggest that patients with a U-score > 7 should receive effective prophylaxis against PONV, i.e. not droperidol only. Further evaluation of different scoring systems should be carried out in larger patient populations. Simplified systems, such as the A-score or K-score or simplified U-score, may be sufficient in uniform surgical populations. The U-score may be more universal because anaesthetic method and use of postoperative opioids are also included.
Tropé
A
A
Medisinske fakultet HälsoUniversitetet i Linköping SE-58 185 Linköping.
Raeder
J C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage; D004329:Droperidol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012307:Risk Factors
D000932:Antiemetics; D004329:Droperidol