title: How patients fare after anaesthesia for elective surgery: a survey of postoperative nausea and vomiting, pain and confusion.
abstract: BACKGROUND
  Postoperative nausea and vomiting (PONV), and postoperative pain are common during the early postoperative period. In addition to these problems, elderly patients risk developing postoperative confusion. This study aimed to identify the risk factors associated with these problems, and the extent of these problems, in a Singapore inpatient surgical population.
  
  
  METHODS
  Over a period of six weeks, we surveyed 707 elective surgical inpatients aged ≥ 18 years who received general anaesthesia and/or regional anaesthesia.
  
  
  RESULTS
  The incidence of PONV was 31.8% (95% confidence interval [CI] 34.8-41.9). The incidence increased with increasing Apfel score (p < 0.001) and were higher in female patients (odds ratio [OR] 1.74, 95% CI 1.28-2.36), non-smokers (OR 1.72, 95% CI 1.04-2.88), patients with a history of PONV and/or motion sickness (OR 3.45, 95% CI 2.38-5.24), patients who received opioids (OR 1.39, 95% CI 1.03-1.88), and patients who received general anaesthesia (OR 1.76, 95% CI 1.11-2.79). Moderate to severe pain at rest and with movement were reported in 19.9% and 52.5% of patients, respectively. Among the patients who were predicted to experience mild pain, 29.5% reported moderate pain and 8.1% reported severe pain. The prevalence of postoperative confusion was 3.9% in the geriatric population.
  
  
  CONCLUSIONS
  Higher Apfel scores were associated with a higher risk of PONV and multimodal treatment for postoperative pain management was found to be insufficient. The incidence of postoperative confusion was low in this study.
authors: Yun Zhi
authors: YZ
authors: Lee
authors: Ruth Qianyi
authors: RQ
authors: Lee
authors: Kyu Kyu
authors: KK
authors: Thinn
authors: Keah How
authors: KH
authors: Poon
authors: Department of Anaesthesia, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. Eugene_Liu_HC@nuhs.edu.sg.
authors: Eugene Hern
authors: EH
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects*; D003221:Confusion / Q000139:chemically induced*; D005260:Female; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D011183:Postoperative Complications / Q000139:chemically induced*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced*; D011184:Postoperative Period; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012846:Singapore; D011795:Surveys and Questionnaires; D055815:Young Adult
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