Incidence and predictors of postoperative nausea and vomiting in children undergoing electrophysiology ablation procedures.

Abstract

Postoperative nausea and vomiting remains a significant concern for patients undergoing general anesthesia for percutaneous radiofrequency catheter ablation and cryoablation for tachyarrhythmias. Our objective was to examine the incidence and risk factors for nausea and vomiting in the recovery room. Children aged>2 and≤18years who underwent general anesthesia for a percutaneous radiofrequency catheter ablation or cryoablation for a tachyarrhythmia between January 1, 2013, and January 1, 2016, were retrospectively reviewed. Outcomes included postoperative nausea, vomiting, and a composite of postoperative nausea and vomiting in the recovery room. We identified 611 patients with a mean age of 13.3±3.9years, 54.5% male, and a mean length of anesthesia was 3.9±1.0hours. Vomiting or retching in the postanesthesia care unit occurred in 7.4% of patients and nausea in an additional 12.4%. A composite of nausea and vomiting occurred in 95 patients (15.5%). On multivariable analysis, a subhypnotic propofol infusion (OR 0.45, 95% CI 0.23-0.88, P=.019) and shorter anesthetic duration (OR 0.81 per 30minutes, 95% CI 0.70-0.94, P=.006) were independently associated with less vomiting in the recovery room. A history of PONV (OR 2.24, 95% CI 1.24-4.05, P=.007) was independently associated with a composite of nausea and vomiting in the recovery room. A shorter anesthetic time and a subhypnotic propofol infusion were predictive of a lower rate of postoperative vomiting in patients undergoing general anesthesia for electrophysiologic ablation procedures.