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Audit of postoperative nausea and vomiting in paediatric day case surgery

Fauzia Minai1, Faraz Shafiq, Azhar Rehman

  • 1Department of Anaesthesia, Aga Khan University Hospital, Karachi.

JPMA. the Journal of the Pakistan Medical Association
|April 7, 2011
PubMed

Insights

Postoperative vomiting is rare in pediatric day surgery patients, with low incidence rates observed. Routine prophylactic antiemetics may not be necessary for these cases.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Postoperative nausea and vomiting (PONV) is a common concern in pediatric surgical patients.
  • Day surgery units aim for efficient patient throughput, making PONV a significant factor in discharge delays or readmissions.

Purpose of the Study:

  • To determine the incidence of PONV in pediatric surgical day cases.
  • To evaluate the impact of PONV on discharge timing and unplanned admissions.

Main Methods:

  • Retrospective audit of 163 pediatric patients (6 months to 18 years, ASA 1-2) undergoing day case surgery.
  • Data collected from preoperative, intraoperative, and postoperative records, including nurse's notes.
  • Incidence of vomiting, delayed discharge, and unplanned admissions due to PONV were documented.

Main Results:

  • Only one patient (0.6%) experienced vomiting in the recovery room.
  • Two patients (1.2%) had vomiting in the step-down unit.
  • No delays in discharge or unplanned admissions were attributed to PONV.

Conclusions:

  • The low incidence of PONV in pediatric day surgery cases suggests that routine polymodal prophylaxis may not be cost-effective.
  • Individualized PONV risk assessment might be more appropriate than a universal prophylactic protocol.
Abstract

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