[Postoperative nausea and vomiting--still a problem?]

Based on a questionnaire of the General Hospital of Hamburg-Altona, we asked 738 patients about postoperative complaints such as nausea, vomiting, pain in the operating field and feeling of coldness in order to record the quality of the results of operation and anaesthesia in 1997 and 1998. The incidence of nausea and vomiting amounted to only 29% on average. One of our earlier studies of postoperative vomiting from 1995-1997 and the results gained from a control group of non-treated patients in our ondansetron study from 1995, which was conducted using information drawn from the routinely-used anaesthesia protocol and was therefore limited to data from the immediate pre- and postoperative period up to discharge of the patients from the recovery ward, showed much higher frequencies of nausea and vomiting (44 and even 66% on average, respectively). We cannot definitely evaluate whether the reduction in the average rates of nausea and vomiting in our present study is due to the additional preoperative application of 150 mg vomex supp. and 1.0-2.5 mg dehydrobenzperidol and/or 20-30 mg metoclopramid given i.v. shortly before the end of anaesthesia or to more intensive observation of non-medicinal prophylactic possibilities. But when we look at the frequency of nausea and vomiting in special groups of our present study, we can still find unacceptably high rates of nausea and vomiting, for instance 40% after cholecystectomies and abruptios and even 50% after struma operations. This shows that a satisfactory solution to this problem has not yet been found--partly due, unfortunately, to financial restrictions. Nevertheless, for 15% of the patients postoperative nausea and vomiting were of only minor importance for general satisfaction with the treatment given them. This was probably due to good premedication of amnestic after-effects of narcosis.