Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T13:02:23.307Z Has data issue: false hasContentIssue false
  • English
  • Français

Risk factors for nausea and vomiting following vitrectomyin adults

Published online by Cambridge University Press:  18 September 2006

K. Nitahara ,
Y. Sugi ,
S. Shono ,
T. Hamada  and
K. Higa
K. Nitahara
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
Y. Sugi
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
S. Shono
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
T. Hamada
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
K. Higa
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
Get access

Abstract

Summary

Background and objective: Postoperative nausea and vomiting (PONV) after ophthalmic surgery under general anaesthesia remains a complex and perturbing complication associated with several factors. Little information is available regarding the risk factors for nausea and vomiting after vitrectomy in adults. In this study, we evaluated the potential risk factors for PONV after vitrectomy in adult patients. Methods: Univariate and multivariate analyses of clinical factors associated with PONV were undertaken in a retrospective case–control series of 247 adult patients undergoing vitrectomy under general anaesthesia. We examined PONV for the first 48 h. Factors examined were age, body mass index (BMI), smoking status, H2-blocker as premedication, type of general anaesthesia (sevoflurane and fentanyl or total intravenous (i.v.) anaesthesia with propofol and fentanyl), duration of surgery, and intraoperative fentanyl dose. Results: Fifty-nine patients (24%) reported one or more episodes of PONV during the study period. Female gender (P < 0.01), lower BMI (P < 0.01) and general anaesthesia with inhalational anaesthetics (P < 0.01) were significantly related to nausea during the first 2 h postoperatively. Female gender (P < 0.01) was significantly related to nausea and vomiting throughout the study period. Other factors, including smoking status, did not alter the risk for nausea and/or vomiting. Conclusions: We conclude that female gender, lower BMI and inhalation anaesthesia are the main risk factors for PONV after vitrectomy in adults. Smoking status did not reduce the incidence of PONV in our patients.

Keywords

ANAESTHESIA, GENERALPOSTOPERATIVE NAUSEA AND VOMITINGPOSTOPERATIVE PERIOD, complicationsVITRECTOMYSURGERY OPHTHALMIC
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 2 , February 2007 , pp. 166 - 170
Copyright
2007 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Pavlin DJ, Rapp SE, Polissar NLet al. Factors affecting discharge time in adult outpatients. Anesth Analg 1998; 87: 816–826.Google Scholar
Watcha MF, White PF. Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology 1992; 77: 162–184.Google Scholar
van den Berg AA, Lambourne A, Clyburn PA. The oculo-emetic reflex. Anaesthesia 1989; 44: 110–117.Google Scholar
Eberhart LHJ, Morin AM, Hoerle Set al. Droperidol and doasetron alone or in combination for prevention of postoperative nausea and vomiting after vitrectomy. Ophthalmology 2004; 111: 1569–1575.Google Scholar
Iwamoto K, Schwartz H. Antiemetic effect of droperidol after ophthalmic surgery. Arch Ophthalmol 1978; 96: 1378–1379.Google Scholar
Cohen MM, Duncan PG, DeBoer DP, Tweed WA. The postoperative interview: assessing risk factors for nausea and vomiting. Anesth Analg 1994; 78: 7–16.Google Scholar
Quinn AC, Brown JH, Wallace PG, Asbury AJ. Studies in postoperative sequelae: nausea and vomiting – still a problem. Anaesthesia 1994; 49: 62–65.Google Scholar
Koivuranta M, Laara E, Snare L, Alahunta S. A survey of postoperative nausea and vomiting. Anaesthesia 1997; 52: 443–449.Google Scholar
Apfel CC, Greim CA, Haubitz GIet al. A risk score to predict the probability of postoperative vomiting in adults. Acta Anaesth Scand 1998; 42: 495–501.Google Scholar
Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted? Anesthesiology 1999; 91: 109–118.Google Scholar
Tramer M, Moore A, McQuay H. Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies. Br J Anaesth 1997; 78: 247–255.Google Scholar
Apfel CC, Kranke P, Katz MHet al. Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design. Br J Anaesth 2002; 88: 659–668.Google Scholar
Larsson S, Lundberg D. A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics, anaesthetic routines and surgical procedures. Acta Anaesth Scand 1995; 39: 539–545.Google Scholar
Kranke P, Apfel CC, Papenfuss Tet al. An increased body mass index is no risk factor for postoperative nausea and vomiting. A systematic review and results of original data. Acta Anaesth Scand 2001; 45: 160–166.Google Scholar
Chimbira W, Sweeney BP. The effect of smoking on postoperative nausea and vomiting. Anaesthesia 2000; 55: 540–544.Google Scholar
Stadler M, Bardiau F, Seidel Let al. Difference in risk factors for postoperative nausea and vomiting. Anesthesiology 2003; 98: 46–52.Google Scholar
Kim K, Johnson JA, Deredorf H. Differences in drug pharmacokinetics between east Asians and Caucasians and the role of genetic polymorphisms. J Clin Pharmacol 2004; 44: 1083–1105.Google Scholar
Inoue K, Yamazaki H, Shimada T. CYP2A6 genetic polymorphism and liver microsomal coumarin and nicotine oxidation activities in Japanese and Caucasians. Arch Toxicol 2000; 73: 532–539.Google Scholar