title: Factors associated with postoperative nausea and vomiting in patients undergoing an ambulatory hand surgery.
abstract: BACKGROUND
  Patients undergoing ambulatory surgery under general anesthesia experience considerable levels of postoperative nausea and vomiting (N/V) after their discharge. However, those complications have not been thoroughly investigated in hand surgery patients yet. We investigated factors associated with postoperative N/V in patients undergoing an ambulatory hand surgery under general anesthesia and determined whether patients' satisfaction with this setting is associated with postoperative N/V levels.
  
  
  METHODS
  We prospectively evaluated 200 consecutive patients who underwent ambulatory hand surgeries under general anesthesia to assess their postoperative N/V visual analogue scale (VAS) levels during the first 24 hours after surgery and their satisfaction with an ambulatory surgery setting. Potential predictors of postoperative N/V were; age, sex, body mass index, smoking behavior, a history of postoperative N/V after previous anesthesia or motion sickness, preoperative anxiety level and the duration time of anesthesia. We conducted multivariate analyses to identify factors associated with postoperative N/V levels. We also conducted multivariate logistic regression analyses to determine whether the N/V levels are associated with the patients' satisfaction with this setting. Here, potential predictors for satisfaction were sex, age, postoperative pain and N/V.
  
  
  RESULTS
  Postoperative N/V were associated with a non-smoking history, a history of motion sickness and a high level of preoperative anxiety. Twenty-two patients (11%) were dissatisfied with the ambulatory setting and this dissatisfaction was independently associated with moderate (VAS 4-7) and high (VAS 8-10) levels of postoperative N/V and with a high level (VAS 8-10) of postoperative pain.
  
  
  CONCLUSIONS
  Although most of the patients were satisfied with the ambulatory surgery setting, moderate to high levels of N/V were associated with dissatisfaction of patients with this setting, suggesting a need for better identifying and managing those patients at risk. The information regarding risk factors for N/V could help in preoperative patient consultation regarding an ambulatory hand surgery under general anesthesia.
authors.affiliation: Department of Orthopaedic Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
authors.forename: Young Hak
authors.initials: YH
authors.lastname: Roh
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyung Pyo
authors.initials: KP
authors.lastname: Nam
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D005260:Female; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000175:diagnosis*; D055815:Young Adult
keywords: Ambulatory hand surgery; Nausea; Satisfaction; Vomiting