[Postoperative nausea and vomiting in major trauma surgery]

Postoperative nausea and vomiting (PONV) are common complications during the postoperative period, causing important discomfort to the patient and also can increase morbidity. The objective of our article is to predict the prevalence of postoperative nausea and vomiting, the factors that have an influence on its appearance, and to obtain a predictive model based on prognostic factors.

A prospective observational study was conducted on 201 patients who underwent major Orthopaedic and Trauma surgery during the year 2008. A questionnaire was designed to collect the required data as established previously by a standardized protocol, in which was requested, patient demographics, intraoperative and postoperative data, as well as details on any antiemetic treatment that was needed in the recovery ward.

A total of 39.8% patients suffered PONV. Of the females, 46.6% suffered PONV, and 75% had previous history of PONV. A higher prevalence was observed in patients who were subjected to more aggressive surgery. There was a concentration of cases between 5 pm and 7 pm, and also at 8 am. The predictive model was obtained from this formula: Y= -1,334 + 0,753*S + 1,5602*NVP + 0,769*IQa

The prevalence of PONV in this study has been high, as more a third of the studied population suffered from it. The predictive model should help determine the specific risk of each patient of suffering from PONV, thus being able to define a therapeutic strategy during the preoperative period as well as during the postoperative period. Being female, a previous history of PONV, and undergoing an aggressive surgical procedure are risk factors. Patient mobilization and family visits increase the number of PONV episodes.