Factors associated with vomiting in orthopedic patients receiving patient-controlled epidural analgesia.
BACKGROUND
Although patient-controlled epidural analgesia (PCEA) can effectively relieve postoperative pain in orthopedic patients, some adverse effects are still troublesome. We conducted this study to survey the possible risk factors related to vomiting induced by PCEA.


METHODS
This retrospective study was conducted to review orthopedic patients receiving postoperative PCEA. The agent for PCEA was bupivacaine prepared as a 0.1% solution with added fentanyl (1 microg/mL). Patients' characteristics including demographic data and types of surgical procedures were collected. All patients were dichotomized into vomiting and non-vomiting groups and subgroup comparisons were also performed. Stepwise logistic regression analyses were conducted to determine significant factors associated with vomiting in these patients.


RESULTS
There were 320 patients (111 men, 209 women) included in the analysis. No significant differences in demographic data were noted between the groups except in sex distribution. Factors related to surgery, anesthesia and PCEA were similar between groups (p > 0.05 in all). The incidence of vomiting for orthopedic patients receiving PCEA was about 9.7% (12.4% for female, 4.5% for male). After stepwise model selection, we found female sex was the only risk factor of vomiting. The odds ratio of vomiting for female gender was 3 (95% confidence interval, 1.1-8.1). General anesthesia was not associated with vomiting in these patients.


CONCLUSIONS
Our study demonstrated the risk factor associated with vomiting for orthopedic patients receiving PCEA was female sex. Other demographic variables and factors related to surgery or anesthesia did not have an influence on vomiting.
Lo
Po-Han
PH
Department of Anesthesiology, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, 201 Section 2 Shih-Pai Road, Taipei, Taiwan, R.O.C.
Chiou
Chiuan-Shiou
CS
Tsou
Mei-Yung
MY
Chan
Kwok-Hon
KH
Chang
Kuang-Yi
KY
D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014839:Vomiting / Q000517:prevention & control*