title: Relationship between the incidence and risk factors of postoperative nausea and vomiting in patients with intravenous patient-controlled analgesia.
abstract: OBJECTIVE
  This study aims to evaluate retrospectively the electronic medical records of surgical patients who received intravenous patient-controlled analgesia, to identify potential relationships between the incidence and risk factors of postoperative nausea and vomiting (PONV).
  
  
  METHODS
  Records of 6773 adult patients who received fentanyl-based intravenous patient-controlled analgesia after surgery at Chung-Ang University Hospital between January 1, 2010 and December 31, 2015 were reviewed. Multiple logistic regressions were used to identify risk factors for PONV.
  
  
  RESULTS
  Of 6773 patients, 1216 (18.0%) were recorded to have PONV. In multiple logistic regression analysis, female gender, nonsmoking status, history of motion sickness or PONV, use of desflurane and nitrous oxide, and preintubation use of opioid analgesia were independent risk factors for PONV.
  
  
  CONCLUSIONS
  Despite the use of antiemetic prophylaxis, 18.0% of patients with intravenous patient-controlled analgesia had PONV. Use of desflurane and nitrous oxide, in addition to risk factors included in the Apfel score (female gender, nonsmoking status, history of PONV or motion sickness, and use of postoperative opioids) were identified as independent risk factors. As the incidence of PONV was 2.8%, 6.0%, 11.7%, 15.2%, 21.1%, 50.0%, and 100% for patients who had 0, 1, 2, 3, 4, 5, and all these risk factors, respectively, risk-adapted, multimodal, or combination therapy should be applied for patients receiving general anesthesia.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Myung Sub
authors.initials: MS
authors.lastname: Yi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea. Electronic address: roman00@naver.com.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Min Kyoung
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Geun-Joo
authors.initials: GJ
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong-Hee
authors.initials: YH
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Chong Wha
authors.initials: CW
authors.lastname: Baek
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Hun
authors.initials: YH
authors.lastname: Jung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Cheol
authors.initials: YC
authors.lastname: Woo
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects* / Q000379:methods; D000768:Anesthesia, General / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D000932:Antiemetics / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D000932:Antiemetics; D005283:Fentanyl
keywords: analgesia; antiemetics; patient-controlled analgesia; postoperative nausea and vomiting