Abstract
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.
Highlights
Postoperative nausea and vomiting (PONV) are the most frequent side effects of anesthesia [1]
In the only randomized-controlled study to assess the role of migraine history in the development of PONV, 127 women were randomized into groups according to the anesthesia method
This study collected the clinical data of a large number of patients from the Smart CDW, in addition to data on numerous risk factors for PONV
Summary
Postoperative nausea and vomiting (PONV) are the most frequent side effects of anesthesia [1]. PONV has been reported to occur in 10–30% of all surgical patients, and the rate is as high as 80% in high-risk patients [2]. Prophylaxis and management of PONV are crucial for optimizing patient outcomes. The first step for prophylaxis of PONV is identifying the risk factors and high-risk populations. Surgery, and patient-related factors can increase PONV risk [5]. Of these risk factors, female gender, a history of PONV, being the first-degree relative of a PONV patient, being a nonsmoker, history of motion sickness, age < 50 years, lengthy surgery, and postoperative opioid use are well-established [5,6,7]
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