Among perioperative related factors, general anesthesia influenced the probability of nausea and vomiting, but there was no direct association between the duration of anesthesia and the incidence of PONV, as demonstrated by Sinclair et al. The inhalational agents are variably associated with postoperative nausea … The majority of them received midazolam (92%) and atropine (74%). Prior to the start of the study, local Ethics Committee (Charleroi, Belgium) approval was obtained, and written informed consent was given by all patients. Several studies have outlined the factors related to an increased incidence of PONV with the aim to target specific patients who might need effective antiemetic prophylaxis. The bivariate Dale model for binary correlated outcomes was used to identify selectively the potential risk factors of postoperative nausea and vomiting. Br J Anaesth 109(5): 742-753. To control for postoperative factors, VAS pain parameters (AUC, mean VAS, VASmax, Tmax, and PVAS > 3) and analgesic drugs (morphine, paracetamol, and nonsteroidal antiinflammatory drugs) were also included in the Dale model. Postoperative nausea and/or vomiting (PONV) is an unpleasant experience that afflicts 20–30% of surgical patients after general anaesthesia.1 PONV decreases patient comfort and satisfaction, and, rarely, may cause dehydration and electrolyte imbalances, aspiration of gastric contents, oesophageal rupture, suture dehiscence, and bleeding.2–9 PONV and its resulting complications are costly for the healthcare sector worldwide, with several hundred million dollars spent annually in the USA alone.10 P… Habib AS, Chen YT, Taguchi A, Hu XH, Gan TJ. 16Postoperative pain and analgesic consumption (morphine, paracetamol, and nonsteroidal antiinflammatory drugs) were also used to control for postoperative status and treatment of the patients. Motion, including transportation on a stretcher during the recovery phase, can precipitate nausea. In that respect, the bivariate Dale model is an interesting alternative to classic approaches, which apply logistic regression to each outcome separately and hence ignore the dependence structure of nausea and vomiting. Risk factors for postoperative nausea and vomiting Risk factors for postoperative nausea and vomiting KENNY, G. N. C. 1994-01-01 00:00:00 Summary Although the aetiology o postoperative nausea and vomiting is not completely clear, a number o key contributing factors f f increase the risk for an individual patient. 13Administration of propofol for anesthesia induction and/or maintenance did not reduce the risk for early nausea or delayed vomiting in our surgical population. Modern PONV risk research began in the 1990s with publication of studies using logistic regression analysis to simultaneously identify multiple independent PONV predictors and publication of meta-analyses and systematic reviews. The patients preoperative characteristics are summarized in table 1. In the present prospective investigation, we studied a fairly large number of surgical inpatients. Patients with vascular surgery were excluded from the analysis because of a singularity in the maximum likelihood estimation process; this was explained by the fact that only one vascular patient experienced vomiting alone as seen in table 4. Recommendations for prevention and treatment, and research agenda. 1,2,6Muir et al. A nesthesiology 1987; 66: 513–8, Apfel CC, Läärä E, Koivuranta M, Greim C-A, Roewer N: A simplified risk score for predicting postoperative nausea and vomiting: Conclusions from cross-validations between two centers. Risk Factors for Postoperative Nausea, Vomiting and Pruritus The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. In assessing a patient’s risk for postoperative nausea and vomiting (PONV), it is important to know which risk factors are independent predictors, and which factors are … Results of the Application of the Bivariate Dale Model to Nausea and Vomiting Data. It has … Wound infiltration with ropivacaine as an adjuvant to patient controlled analgesia for transforaminal lumbar interbody fusion: a retrospective study. Acta Anaesthesiol Scand 2001; 45: 160–6, Tramèr M, Moore A, McQuay H: Propofol anesthesia and post-operative nausea and vomiting: Quantitative systematic review of randomized controlled studies. Overall, however, the type of surgery was significantly associated with nausea but not with vomiting, except for urological procedures (P = 0.037). Br J Anaesth 1997; 78: 247–55, Tramèr M, Moore A, McQuay H: Meta-analytic comparison of prophylactic antiemetic efficacy for postoperative nausea and vomiting: propofol anaesthesia vs omitting nitrous oxide vs a total i.v. The authors thank Professor Geert Molenberghs, Ph.D. (Department of Biostatistics, Limburgs Universitair Centrum, Diepenbeek, Belgium), for helpful discussions and advice on the Dale model. This site needs JavaScript to work properly. Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis. The distribution of patients according to type of surgery was as follows: orthopedics (141), neurosurgery (54), vascular (32), ophthalmology (8), maxillofacial (41), gynecology (69), urology (58), plastic (32), abdominal (184), stomatology (23), and ENT (29). Surgical and patient factors, surgical & anesthetic factors ( e.g Anaesthesia and emesis )! 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