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The inhalational agents are variably associated with postoperative nausea Among the 671 patients in the study, 126 (19%) reported one or more episodes of nausea, and 66 patients (10%) suffered one or more emetic episodes during the studied period. Possible risk factors include history of migraine, history of PONV or motion sickness in a child's parent or sibling, better ASA physical status, intense preoperative anxiety, certain ethnicities or surgery types, decreased perioperative fluids, crystalloid versus colloid administration, increasing duration of anesthesia, general versus regional anesthesia or sedation, balanced versus total IV anesthesia, and use of longer-acting versus shorter-acting opioids. Acta Anaesthesiol Scand 1998; 42: 495501, Apfel CC, Greim CA, Haubitz I, Grundt D, Goepfert C, Sefrin P, Roewer N: The discriminating power of a risk score for postoperative vomiting in adults undergoing various types of surgery. The proportion of nonsmokers was amounted to 63%. Among the patients, 480 (72%) received general anesthesia, and 191 (28%) received locoregional anesthesia. This is in accordance with the results of a meta-analysis performed by Tramr et al. USA.gov. ASA = American Society of Anesthesiologists; BMI = body mass index; PONV = postoperative nausea and vomiting. Edited by Strunin L, Rowbotham D, Miles A. London, Aesculapius Medical Press, 1999, pp 1330, Tramr MR: A rational approach to the control of postoperative nausea and vomiting: Evidence from systematic reviews: Part I. Efficacy and harm of antiemetic interventions, and methodological issues. as a risk factor for postoperative nausea (OR 4.25, 95% CI 2.37.8) and vomiting (OR 2.62, 95% CI 1.44.9). To our knowledge, this is the first that accounts for the high association between the two outcomes. Br J Anaesth 109(5): 742-753. Anesthetic and Postoperative Analgesic Drugs. Nausea and vomiting were recorded as two different end points, using a quantitative analysis. 36Furthermore, nausea intensity was assessed using a VAS device as a secondary end point. [Risk factors and frequency of postoperative nausea and vomiting in patients operated under general anesthesia]. Br J Anaesth 1992; 69(suppl 1): 2S19S, Camu F, Lauwers MH, Verbessem D: Incidence and aetiology of postoperative nausea and vomiting. In assessing a patients risk for postoperative nausea and vomiting (PONV), it is important to know which risk factors are independent predictors, and which factors are not relevant for predicting PONV. Apfel, C. C., et al. 27and Ericksson and Kortilla. 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. Patient-, anesthesia-, and surgery-related variables that were considered to have a possible effect on the proportion of patients experiencing postoperative nausea and/or vomiting were examined. 13. Consensus guidelines for the management of postoperative nausea and vomiting. Patients were excluded if they were unable to understand or realize a visual analog scale (VAS) test, were transferred directly to an intensive care unit, were undergoing an emergency procedure, had preexisting nausea or vomiting, or had received drugs with antiemetic properties 4 h before surgery. In the present study, the overall incidence rate for nausea amounted to 19%, and that for vomiting amounted to 10%. Nevertheless, our patients benefited from formal acute pain management in the form of an acute pain service. PONV risk factors have been described in the literature since the late 1800s (20). Results were considered to be significant at the 5% critical level (P< 0.05). Some risk factors were predictive of both nausea and vomiting (female gender, nonsmoking status, and general anesthesia). Table 4. BACKGROUND: /st> 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 Please enable it to take advantage of the complete set of features! The time of the peak of VAS (Tmax) occurred at 2.4 8.1 h postoperatively. , 26,27who found that intravenous induction of anesthesia with propofol has no relevant effect on PONV. 2006 Jun;22(6):1093-9. doi: 10.1185/030079906X104830. 29Review of the literature on anesthetic factors contributing to PONV is difficult because of a lack of standardization. J Clin Anesth 1999; 11: 5839, Boogaerts JG, Bardiau FM, Seidel L, Albert A, Ickx BE: Tropisetron in the prevention of postoperative nausea and vomiting. J Clin Anesth 2000; 12: 4028, Dale JR: Global cross-ratio models for bivariate, discrete, ordered responses. Eur J Anaesth 1992; 9(suppl 6): 2531, Andrews PLR: Towards an understanding of the mechanism of PONV, The Effective Management of Postoperative Nausea and Vomiting. 6and Koivuranta et al. Oral mosapride can provide additional anti-emetic efficacy following total joint arthroplasty under general anesthesia: a randomized, double-blinded clinical trial. Nausea was not assessed while the patient was asleep. Habib AS, Chen YT, Taguchi A, Hu XH, Gan TJ. Acta Anaesthesiol Scand 1998; 42: 5029, Sinclair DR, Chung F, Mezei G: Can postoperative nausea and vomiting be predicted. Postoperative nausea and vomiting (PONV), postoperative vomiting (POV), post-discharge nausea and vomiting (PDNV), and opioid-induced nausea and vomiting (OINV) continue to be causes of pediatric morbidity, delay in discharge, and unplanned hospital admission. Our goal is to determine the incidence of postoperative nausea and vomiting Among the 126 patients with nausea, 53 (42%) experienced vomiting. Br J Anaesth 1992; 69(suppl 1): 20S23S, Bellville JW, Bross IDJ, Howland S: Postoperative nausea and vomiting: IV. The survey was performed in a clinical audit setting. 14, As recently stated by Tramr, 14,35more precise quantification of PONV incidence will come from studies where nausea and vomiting are separate endpoints, and the cumulative incidence of nausea and vomiting is reported at different time points. The methodological issue used in this survey considered these recommendations. Table 3. Anesth Analg 2001; 92: 12039, Muir JJ, Warner MA, Offord KP, Buck CF, Harper JV, Kunkel SE: Role of nitrous oxide and other factors in postoperative nausea and vomiting: A randomized and blinded prospective study. 17,18The bivariate Dale model was used to identify risk factors specifically associated with nausea, vomiting, or both complications. There was a strong association between the two outcomes. In table 4, a detailed distribution of postoperative nausea and/or vomiting is given according to type of surgery. Anesth Analg 118 (1): 85 113. Traditionally, investigation focused on a single potential factor at a time, with little to no attempt to control for other variables, i.e., to account for the possible independent effects of additional factors (21,22). History of migraine and a variety of surgeries (gynecological, abdominal, neurologic, ophthalmology, and maxillofacial) do or tend to influence nausea only. Research on the pathophysiology, risk Nevertheless, this study included 46% of children and focused only on patients after specific surgical procedures, i.e. Curr Med Res Opin. These could be explained by differences in the physiopathology of the two symptoms. 19This method models the joint probability of the two binary outcomes, P(nausea, vomiting), where nausea and vomiting are coded 0 for absent and 1 for present, and accounts for the association between them, in contrast to classic approaches, which simply consist of considering the two outcomes as independent and applying logistic regression to each of them separately. Gan, T. J., et al. 34Nausea is not always followed by retching or vomiting. Br J Anaesth 2002; 88: 65968, Pierre S, Benais H, Pouymayou J: Apfel's simplified score may favorably predict the risk of postoperative nausea and vomiting. 2002 Apr;68(4):166-70. A sample of 671 surgical patients with complete case report forms was included in the study. Meng, It is commonly stated that risk factors for postoperative nausea are the same as for vomiting. 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