Difference in risk factors for postoperative nausea and vomiting.
BACKGROUND
It is commonly stated that risk factors for postoperative nausea are the same as for vomiting. The authors designed a prospective study to identify and differentiate the risk factors for postoperative nausea and vomiting in various surgical populations in a clinical audit setting.


METHODS
The study included 671 consecutive surgical inpatients, aged 15 yr or more, undergoing various procedures. The study focused on postoperative nausea visual analog scale scores every 4 h and vomiting episodes within 72 h. Both vomiting and retching were considered as emetic events. Patient-, anesthesia-, and surgery-related variables that were considered to have a possible effect on the proportion of patients experiencing postoperative nausea and/or vomiting were examined. The bivariate Dale model for binary correlated outcomes was used to identify selectively the potential risk factors of postoperative nausea and vomiting.


RESULTS
Among the 671 patients in the study, 126 (19%) reported one or more episodes of nausea, and 66 patients (10%) suffered one or more emetic episodes during the studied period. There was a highly significant association between the two outcomes. Some risk factors were predictive of both nausea and vomiting (female gender, nonsmoking status, and general anesthesia). History of migraine and type of surgery were mainly responsible for nausea but not for vomiting. The predictive effect of risk factors was controlled for postoperative pain and analgesic drugs.


CONCLUSIONS
This study shows that differences exist in risk factors of postoperative nausea and vomiting. These could be explained by differences in the physiopathology of the two symptoms.
Stadler
Michaela
M
Department of Anesthesiology, University Hospital Center of Charleroi, Belgium. michaela.stadler@chu-charleroi.be
Bardiau
Françoise
F
Seidel
Laurence
L
Albert
Adelin
A
Boogaerts
Jean G
JG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000765:Anesthesia, Conduction / Q000009:adverse effects; D000768:Anesthesia, General / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012727:Sex Characteristics; D012907:Smoking / Q000503:physiopathology; D013514:Surgical Procedures, Operative; D014839:Vomiting / Q000453:epidemiology*
D000777:Anesthetics