Postoperative nausea and vomiting at Landspitali: A prospective study

Area of Science:

• Anesthesiology
• Surgical Patient Care

Background:

• Anesthesia practices have evolved, with increased use of antiemetic prophylaxis and total intravenous anesthesia (TIVA).
• Assessing postoperative nausea and vomiting (PONV) incidence and risk factors is crucial in current anesthesia settings.

Purpose of the Study:

• To prospectively evaluate the incidence of PONV.
• To examine the utilization of PONV prophylaxis.
• To identify clinical risk factors associated with PONV.

Main Methods:

• Prospective cohort study of 438 adult patients at Landspitali University Hospital.
• Data collected via questionnaires in the postoperative care unit (PACU) and 24 hours post-discharge.
• Analysis included incidence rates, prophylaxis use, and risk factor identification for PONV.

Main Results:

• Low incidence of moderate/severe PONV (4% in PACU, 3% on day 1).
• High rates of TIVA (91%) and PONV prophylaxis (82%).
• Risk factors identified: female gender (OR 1.90) and history of motion sickness/PONV (OR 2.74); increasing age was protective (OR 0.83/decade).

Conclusions:

• PONV incidence is low in a surgical population with prevalent TIVA and prophylaxis.
• PONV remains a predictable complication, indicating potential for improved prevention strategies.
• Risk stratification remains important despite widespread prophylaxis and TIVA.