scholarly journals Consideration of Migraines Among Risk Factors for Postoperative Nausea and Vomiting

2020 ◽  
Vol 9 (10) ◽  
pp. 3154
Author(s):  
Jong-Ho Kim ◽  
Man-sup Lim ◽  
Sang-Hwa Lee ◽  
Young-Suk Kwon ◽  
Jae Jun Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Data ◽  
Postoperative Nausea ◽  
Medical Center ◽  
Significant Risk ◽  
Postoperative Nausea And Vomiting ◽  
Significant Risk Factor ◽  
Nausea And Vomiting ◽  
History Of ◽  
The Impact

The impact of migraine on postoperative nausea and vomiting (PONV) is controversial, and few studies have focused on their relationship. Thus, we investigated the impact of migraine, among other risk factors, on PONV in a large retrospective study. We analyzed 10 years of clinical data from the Smart Clinical Data Warehouse of Hallym University Medical Center. PONV was defined as nausea or vomiting within the first 24 h after surgery. Patients diagnosed by a neurologist and with a history of triptan use before surgery were enrolled into the migraine group. We enrolled 208,029 patients aged > 18 years who underwent general anesthesia (GA), among whom 19,786 developed PONV within 24 h after GA and 1982 had migraine. Before propensity score matching, the unadjusted and fully adjusted odds ratios (ORs) for PONV in subjects with versus without migraine were 1.52 (95% confidence interval (CI), 1.34–1.72; p < 0.001) and 1.37 (95% CI, 1.21–1.56; p < 0.001), respectively. The OR for PONV in patients with migraine was also high (OR, 1.37; 95% CI, 1.13–1.66; p = 0.001) after matching. Our findings suggest that migraine is a significant risk factor for PONV.

Postoperative Nausea and Vomiting Following Craniotomy: Risk Factors and Complications in Context of Perioperative High-dose Dexamethasone Application

2019 ◽  
Vol 80 (05) ◽  
pp. 381-386
Author(s):  
Till Burkhardt ◽  
Patrick Czorlich ◽  
Klaus Christian Mende ◽  
Annika Treitz ◽  
Rainer Kiefmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Postoperative Nausea ◽  
Significant Risk ◽  
Postoperative Nausea And Vomiting ◽  
Significant Risk Factor ◽  
Nausea And Vomiting ◽  
High Dose ◽  
High Dose Dexamethasone ◽  
Csf Leaks

Introduction Postoperative nausea and vomiting (PONV) is common in patients after craniotomy and may lead to severe postoperative complications. The aim of this study was to identify risk factors and postoperative complications associated with PONV in the context of perioperative high-dose dexamethasone administration. Patients and Methods In this prospective single-center study, all patients planned for elective craniotomy for supra- and infratentorial lesions were eligible to be included. Any PONV in a 24-hour period after craniotomy was recorded and analyzed with regard to time to postoperative complications and the administration of perioperatively administered high-dose dexamethasone. Results The overall PONV rate of 421 patients during a 9-month period was 18.1% (76 patients). Multivariate analysis revealed a significant association of PONV with female sex, infratentorial localization, age, and history of PONV. There was no association between PONV and postoperative complications such as intracranial hemorrhage, cerebrospinal fluid (CSF) leaks, or pneumonia. Perioperative administration of high-dose dexamethasone for prophylactic prevention of edema was the only significant risk factor for postoperative complications (odds ratio [OR]: 3.34; confidence interval [CI], 1.39–8.05; p < 0.01) with a highly significant association with the occurrence of CSF leaks (OR: 6.85; CI, 1.62–29.05; p < 0.01). Conclusion The low PONV rate of 18.1% in this study may be the result of the frequent perioperative administration of high-dose dexamethasone for the prevention of edema. Our data indicate that perioperative high-dose dexamethasone is significantly associated with CSF leaks and can therefore not be recommended on a regular basis.

scholarly journals Singapore General Hospital Experience on Ethnicity and the Incidence of Postoperative Nausea and Vomiting after Elective Orthopaedic Surgeries

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Xin Yu Adeline Leong ◽  
Xian Wen Charlene Kwa ◽  
Shu Hui Elizabeth Ng ◽  
Liang Khai Darren Koh
Keyword(s):  
Risk Factors ◽  
Nitrous Oxide ◽  
Postoperative Nausea ◽  
Significant Risk ◽  
Postoperative Nausea And Vomiting ◽  
Significant Risk Factor ◽  
Nausea And Vomiting ◽  
Singapore General Hospital ◽  
Significant Difference ◽  
Risk Patients

Introduction. We explored how ethnicity affects the risk of postoperative nausea and vomiting (PONV) and established the correlation of suggested risk factors of PONV in the multiethnic population of Singapore. Methods. 785 patients who underwent orthopaedic surgery were recruited. These comprised 619 Chinese (78.9%), 76 Malay (9.7%), 68 Indian (8.7%), and 22 other (2.8%) cases. The presence of possible risk factors of PONV and nausea and/or vomiting within 24 h after surgery was studied. Univariate and multivariate logistic regression analyses were performed. Results. The incidence of PONV was 33.2% (261 patients). There was no statistically significant difference of PONV incidence between Chinese, Malay, and Indian cases (34.6% versus 34.2% versus 29.4%, p=0.695). Indian females younger than 50 years were found to have a higher incidence of vomiting (p=0.02). The significant risk factors for this population include females, use of nitrous oxide, and a history of PONV. Conclusion. In the groups studied, ethnicity is not a significant risk factor for PONV except for young Indian females who have a higher risk of postoperative vomiting. We suggest the selective usage of antiemetic for young Indian females as prophylaxis and avoiding nitrous oxide use in high-risk patients.

Difference in Risk Factors for Postoperative Nausea and Vomiting

2003 ◽  
Vol 98 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Michaela Stadler ◽  
Françoise Bardiau ◽  
Laurence Seidel ◽  
Adelin Albert ◽  
Jean G. Boogaerts
Keyword(s):  
Risk Factors ◽  
Postoperative Nausea ◽  
Clinical Audit ◽  
Postoperative Nausea And Vomiting ◽  
Female Gender ◽  
Nausea And Vomiting ◽  
Scale Scores ◽  
Potential Risk Factors ◽  
History Of ◽  
A Prospective Study

Background It is commonly stated that risk factors for postoperative nausea are the same as for vomiting. The authors designed a prospective study to identify and differentiate the risk factors for postoperative nausea and vomiting in various surgical populations in a clinical audit setting. Methods The study included 671 consecutive surgical inpatients, aged 15 yr or more, undergoing various procedures. The study focused on postoperative nausea visual analog scale scores every 4 h and vomiting episodes within 72 h. Both vomiting and retching were considered as emetic events. 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. The bivariate Dale model for binary correlated outcomes was used to identify selectively the potential risk factors of postoperative nausea and vomiting. Results 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. There was a highly significant association between the two outcomes. Some risk factors were predictive of both nausea and vomiting (female gender, nonsmoking status, and general anesthesia). History of migraine and type of surgery were mainly responsible for nausea but not for vomiting. The predictive effect of risk factors was controlled for postoperative pain and analgesic drugs. Conclusion This study shows that differences exist in risk factors of postoperative nausea and vomiting. These could be explained by differences in the physiopathology of the two symptoms.

scholarly journals Mechanism and risk factors of nausea and vomiting after TACE: a retrospective analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haohao Lu ◽  
Chuansheng Zheng ◽  
Bin Liang ◽  
Bin Xiong
Keyword(s):  
Risk Factors ◽  
Postoperative Nausea ◽  
Previous History ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Smoking History ◽  
Binary Logistic Regression Analysis ◽  
Chemotherapeutic Drugs ◽  
Operative Trauma ◽  
History Of

Abstract Purpose The mechanism of postoperative nausea and vomiting after TACE is not clear. This study retrospectively analyzed the patient data to explore the mechanism and risk factors of postoperative nausea and vomiting after TACE. Materials and methods The data of 221 patients who underwent TACE in the interventional department from January 2019 to December 2020 were collected. Including: gender, age, liver function before TACE, etiology of liver cirrhosis, BCLC stage of hepatocellular carcinoma, preoperative use of analgesic drugs, preoperative limosis, previous history of vomiting, history of kinetosis, smoking history, history of drinking, chemotherapeutic drugs used during TACE, Dosage of lipiodol, and occurrence of postoperative nausea and vomiting. Results There were 116 cases of nausea after TACE, using binary logistic regression analysis, Sig: ALT0.003; ALP0.000; history of vomiting 0.043; kinetosis 0.006; history of alcohol consumption 0.011; preoperative limosis 0.006; dosage of lipiodol (5–10 mL) 0.029, dosage of lipiodol (> 10 mL) 0.001.There were 89 cases of vomiting after TACE, all accompanied by nausea, Sig: ALP0.000; BCLC stage (B) 0.007; kinetosis 0.034; chemotherapeutic drugs 0.015; dosage of lipiodol (5–10 ml) 0.015, dosage of lipiodol (> 10 ml) 0.000; patients used analgesics before TACE 0.034. Conclusions Causes of post-TACE nausea and vomiting included operative trauma, aseptic inflammation caused by ischemia and hypoxia, chemotherapeutic drugs, ischemia of liver and bile duct, stress and pain during TACE, and patient factors. ALP, BCLC stage, kinetosis, chemotherapeutic drugs, dosage of lipiodol, and preoperative usage of analgesics were risk factors affecting nausea and vomiting after TACE.

scholarly journals Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reem M. Elsaid ◽  
Ashraqat S. Namrouti ◽  
Ahmad M. Samara ◽  
Wael Sadaqa ◽  
Sa’ed H. Zyoud
Keyword(s):  
Logistic Regression ◽  
Observational Study ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Binary Logistic Regression ◽  
Nausea And Vomiting ◽  
Prior History ◽  
Factors Associated ◽  
Duration Of Surgery ◽  
History Of

Abstract Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.

Prevention of Postoperative Nausea and Vomiting

2018 ◽  
pp. 147-152
Keyword(s):  
Risk Factors ◽  
Nitrous Oxide ◽  
Relative Risk ◽  
Adverse Events ◽  
Postoperative Nausea ◽  
Volatile Anesthetic ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Baseline Risk ◽  
Maximum Reduction

This case focuses on the prevention of postoperative nausea and vomiting (PONV) by asking the question: What is the efficacy of six well-established prophylactic antiemetic strategies individually and in combination for the prevention of postoperative nausea and vomiting? Each of the three antiemetics in this study (ondansetron, dexamethasone, and droperidol) reduced the risk for PONV by approximately 26%; substituting propofol for volatile anesthetic reduced the risk by 19%; and substituting nitrogen (air) for nitrous oxide reduced the risk by 12%. A maximum reduction of 70% in the relative risk for PONV can be expected when total intravenous anesthesia is used with three antiemetics. The appropriate approach to the management of PONV depends on the patient’s baseline risk factors as well as the likelihood of adverse events and costs from the antiemetic medications.

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