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Nausea and vomiting after fast-track cardiac anaesthesia
A Kogan1, L A Eidelman, E Raanani
1Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petah-Tiqva 49100, Israel. akogan@clalit.org.il
British Journal of Anaesthesia
|July 25, 2003
Summary
Postoperative nausea and vomiting (PONV) is uncommon after fast-track cardiac anaesthesia (FTCA) and does not extend intensive care unit (ICU) stays. Prophylactic anti-emetics are not needed for these patients.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Surgical Outcomes
Background:
- Postoperative nausea and vomiting (PONV) is a common concern following anesthesia.
- Fast-track cardiac anaesthesia (FTCA) aims to expedite recovery after cardiac surgery.
- Understanding PONV prevalence and risk factors post-FTCA is crucial for optimizing patient care.
Purpose of the Study:
- To determine the incidence of PONV after FTCA.
- To identify risk factors associated with PONV in this patient population.
- To assess the impact of PONV on intensive care unit (ICU) length of stay.
Main Methods:
- A prospective study involving 1221 patients undergoing FTCA in a university hospital's cardiothoracic ICU.
- PONV severity was monitored hourly post-extubation until CTICU discharge.
- Rescue medications included metoclopramide (10 mg IV) and ondansetron (4 mg IV).
Main Results:
- Nausea occurred in 19.7% of patients; vomiting in 4.3%.
- Risk factors for PONV included younger age (<60 years), female gender, and prior PONV history.
- PONV caused minor delays in CTICU discharge for only eight patients, all discharged the same day.
Conclusions:
- The incidence of PONV after FTCA is low.
- PONV does not significantly prolong ICU stay in patients undergoing FTCA.
- Routine prophylactic anti-emetic administration before FTCA is not indicated.
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