Abstract

PurposeThe first purpose of this study was to determine the incidence of postoperative nausea and/or vomiting (PONV) 0–48 h after anesthesia at a Japanese cancer center. The second purpose of this study was to collect information on PONV risk factors, independently, in the categories of patient-related, anesthesia-related, and surgery-related factors.MethodsThe frequency of nausea and vomiting was prospectively investigated from 0 to 48 h after anesthesia in 1645 patients (11–94 years of age) at a single medical institution. The occurrence of nausea and vomiting and the use of antiemetics were recorded up to 48 h after anesthesia. Patient-related, anesthesia-related, and surgery-related factors were also recorded and submitted to multiple logistic regression analysis to determine the relationship of these factors to nausea and vomiting.ResultsThe incidences of nausea and vomiting from 0 to 24 h after anesthesia were 40 and 22 %, respectively. The incidences 24–48 h after anesthesia were 10 and 3 %, respectively. Female sex, previous history of PONV, prolonged anesthesia, and remifentanil use during surgery were identified as risk factors for both nausea and vomiting. The use of a volatile anesthetic, use of fentanyl during surgery, postoperative use of opioids, nonsmoking status, and drinking alcohol on 4 or fewer days per week were identified as risk factors for nausea alone.ConclusionThe incidence of and risk factors for PONV at a Japanese cancer center according to this study are comparable to those reported elsewhere.

Highlights

  • Postoperative nausea and/or vomiting (PONV) is a significant postoperative complication that has been repeatedly investigated in surveys of incidence [1,2,3,4]

  • Purpose The first purpose of this study was to determine the incidence of postoperative nausea and/or vomiting (PONV) 0–48 h after anesthesia at a Japanese cancer center

  • Previous history of PONV, prolonged anesthesia, and remifentanil use during surgery were identified as risk factors for both nausea and

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Summary

Introduction

Postoperative nausea and/or vomiting (PONV) is a significant postoperative complication that has been repeatedly investigated in surveys of incidence [1,2,3,4]. Numerous antiemetics have been developed [7,8,9,10,11] and are used for PONV as recommended in various guidelines [12,13,14]. Antiemetics such as 5-HT3 receptor antagonists, dexamethasone, and neurokinin-1 (NK1) receptor antagonists are still unapproved for use in Japan. This leaves metoclopramide as the only therapeutic option and deprives Japanese physicians of effective therapies for PONV. Conclusive evidence that PONV is a significant concern in Japan with an incidence essentially no different from that in other countries would substantiate the approval of the new antiemetics, a class of agents widely used elsewhere, for use in Japan

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