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Incidence and predictors of postoperative nausea and vomiting in children undergoing electrophysiology ablation

Ye Lee1, Andrew Banooni2, Koichi Yuki1

  • 1Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.

Paediatric Anaesthesia
|December 24, 2019
PubMed

Insights

Postoperative nausea and vomiting (PONV) is a concern after anesthesia for ablation procedures. Shorter anesthesia times and subhypnotic propofol infusions reduce vomiting risk in children.

Area of Science:

  • Anesthesiology
  • Pediatric Cardiology
  • Clinical Research

Background:

  • Postoperative nausea and vomiting (PONV) is a common complication following general anesthesia.
  • Tachyarrhythmia ablation procedures, including radiofrequency and cryoablation, are associated with significant PONV concerns.

Purpose of the Study:

  • To investigate the incidence of PONV in children undergoing electrophysiologic ablation.
  • To identify risk factors associated with PONV in the recovery room setting.

Main Methods:

  • Retrospective review of 611 pediatric patients (ages 2-18) who underwent general anesthesia for percutaneous tachyarrhythmia ablation.
  • Outcomes assessed included postoperative nausea, vomiting, and a composite of both in the postanesthesia care unit.

Main Results:

  • The overall incidence of PONV was 15.5% (nausea: 12.4%, vomiting: 7.4%).
  • Independent predictors for reduced vomiting included subhypnotic propofol infusion (OR 0.45) and shorter anesthetic duration (OR 0.81 per 30 min).
  • A history of PONV was a significant risk factor for composite PONV (OR 2.24).

Conclusions:

  • Shorter anesthetic duration and subhypnotic propofol infusion are associated with decreased postoperative vomiting.
  • These findings can inform anesthetic management to mitigate PONV in pediatric patients undergoing ablation procedures.
Abstract

Keywords:
anesthesiachildrenelectrophysiologyhypnotics and sedativespostoperative nausea and vomitingpropofol

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