title: Preoperative orthostatic dysfunction is associated with an increased incidence of postoperative nausea and vomiting.
abstract: BACKGROUND
  Postoperative nausea and vomiting (PONV) occurs frequently after gynecologic surgery. Because hemodynamic condition seems to be influential, women presenting with preoperative orthostatic dysregulation may have an increased risk for PONV. The aim of the present study was to assess the relationship between preoperative orthostatic dysregulation and the incidence of PONV.
  
  
  METHODS
  In a prospective observer-blinded clinical trial, 200 women who were scheduled for elective gynecologic surgery underwent an orthostatic test on the day before surgery. Based on the orthostatic test results, women were stratified into orthostatic dysregulation (OR; systolic blood pressure decrease > 20 mmHg on standing up) and nonorthostatic dysregulation (NOR; systolic blood pressure decrease < 20 mmHg) groups.
  
  
  RESULTS
  Forty-nine women were stratified to the OR group and 151 to the NOR group. Frequencies of PONV and vomiting during the study period were higher in the OR group compared with the NOR group (77.6% vs. 31.1% and 55.1 vs. 18.5%, respectively; all P < 0.001). Women with hypotension in their history showed a significantly higher frequency of PONV within 24 h (P < 0.05).
  
  
  CONCLUSIONS
  Women presenting with orthostatic dysregulation and arterial hypotension in their history exhibit an increased risk of PONV.
authors.affiliation: Department of Anesthesiology and General Intensive Care, University of Vienna, Vienna, Austria. franz.pusch@univie.ac.at
authors.forename: Franz
authors.initials: F
authors.lastname: Pusch
authors.forename: Alexander
authors.initials: A
authors.lastname: Berger
authors.forename: Eckart
authors.initials: E
authors.lastname: Wildling
authors.forename: Michael
authors.initials: M
authors.lastname: Zimpfer
authors.forename: Martin
authors.initials: M
authors.lastname: Moser
authors.forename: Christine
authors.initials: C
authors.lastname: Sam
authors.forename: Peter
authors.initials: P
authors.lastname: Krafft
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology* / Q000209:etiology; D011187:Posture; D011446:Prospective Studies