Cumulative incidence and risks factors for postoperative nausea and vomiting in adult patients undergoing cholecystectomy under balanced general anesthesia

Abstract

Introduction: Postoperative nausea and vomiting (PONV) are common issues arising after general anesthesia, for which several independent risk factors have been described.Objective: To determine the accumulated incidence of PONV during the first 24hours of the postoperative period.Methods: A cohort observational, prospective study was conducted that included all the adults undergoing cholecystectomy under balanced general anesthesia at the EsSalud Talara Hospital from October 2014 until December 2016. The presence of PONV during the first 24hours after surgery was assessed, and univariate, bivariate, and logistic regression analyses were conducted.Results: 244 patients were included, most of them with two risk factors in the Apfel scale, that represented an accumulated incidence of PONV of 0.51 (95% CI 0.45–0.57) during the observation period, notwithstanding the fact that 85.25% received antiemetic prophylaxis. The logistic regression analysis identified that being a female (OR 3.30, 95% CI 1.66–6.55, p=0.0007) and previous PONV or motion sickness (OR 2.67, 95% CI 1.25–5.68, p= 0.011) were independent risk factors for PONV. The administration of antiemetic prophylaxis and the presence of PONV (p=0.92) were found to be independent.Conclusions: The high cumulative incidence of PONV could be the result of the type of surgery, the use of volatile anesthetic agents, and errors in the antiemetic pharmacological prophylaxis.