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Incidence and factors contributing to postdischarge nausea and vomiting in pediatric ambulatory surgical cases

Proshad N Efune1,2, Abu Minhajuddin1, Peter Szmuk1,2,3

  • 1Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Paediatric Anaesthesia
|February 14, 2018
PubMed

Insights

Postdischarge nausea and vomiting (PDNV) affects 14% of pediatric day surgery patients. Intraoperative and postdischarge opioid use significantly increases the risk of PDNV.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Postoperative Care

Background:

  • Postdischarge nausea and vomiting (PDNV) is a common concern in pediatric day surgery.
  • Limited data exists on PDNV incidence and risk factors in children.

Purpose of the Study:

  • To determine the incidence of PDNV in pediatric day surgery patients.
  • To identify demographic, intraoperative, and postoperative factors influencing PDNV risk.

Main Methods:

  • Prospective observational study of 1041 ambulatory pediatric patients.
  • Postdischarge questionnaires for parents and electronic health record review.
  • Analysis of variables including opioid administration, anesthesia type, and fluid management.

Main Results:

  • 14% of patients experienced PDNV.
  • Intraoperative opioid use (short-acting and long-acting) and postdischarge opioid use were independent risk factors for PDNV.
  • Long-acting intraoperative opioids showed a higher risk compared to short-acting opioids.

Conclusions:

  • The incidence of PDNV in pediatric day surgery is 14%.
  • Opioid administration, both intraoperatively and post-discharge, significantly elevates PDNV risk.
  • Minimizing opioid use, particularly long-acting formulations, may reduce PDNV incidence.
Abstract

Keywords:
childnauseaopioid analgesicsoutpatientsrisk factorsvomiting

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