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Determination of Risk Factors for Nausea and Vomiting in Children After Appendectomy
Rüya Naz1, Nurcan Özyazıcıoğlu2, Mete Kaya3
1Pediatric Surgery Department, University of Health Sciences, Bursa Yüksek Ihtisas Research and Training Hospital, Bursa, Turkey.
Insights
Postoperative nausea and vomiting (PONV) in children undergoing appendectomy is linked to pain, family history, and appendix perforation. Pediatric nurses should assess PONV risk preoperatively for effective management.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Nursing Care
Background:
- Postoperative nausea and vomiting (PONV) is a common complication in pediatric surgery.
- Appendectomy is a frequent surgical procedure in children, with PONV posing a significant challenge.
- Identifying risk factors is crucial for effective PONV management in this population.
Purpose of the Study:
- To investigate the risk factors associated with postoperative nausea and vomiting (PONV) in pediatric patients undergoing appendectomy.
- To identify specific clinical and demographic factors that predict PONV in children.
Main Methods:
- A prospective, descriptive, cross-sectional study was conducted.
- 163 children (aged 5-18) undergoing appendectomy were enrolled.
- Data collected using patient forms, Baxter Retching Faces scale, and Wong-Baker Faces Pain Rating Scale.
Main Results:
- Postoperative pain severity, operative time, and time to first oral feeding were significantly associated with PONV.
- Logistic regression identified postoperative pain, family history of PONV, and appendix perforation as key risk factors.
- Patients with non-perforated appendicitis and no PONV had shorter operative times and earlier oral feeding.
Conclusions:
- Family history of PONV, severe postoperative pain, longer operative times, and delayed oral feeding are significant risk factors for PONV in pediatric appendectomy patients.
- Pediatric nurses play a vital role in preoperative PONV risk assessment and management.
- Evidence-based interventions should be implemented based on individual patient risk levels.
Purpose:
This study aimed at investigating the risk factors for postoperative nausea and vomiting (PONV) in pediatric patients undergoing appendectomy.
Design:
This is a prospective, descriptive, cross-sectional study.
Methods:
The study involved 163 children aged 5 to 18 years who underwent appendectomy in the pediatric surgery clinic of a tertiary hospital between December 2022 and June 2023. The study data were collected through the patient information form, Baxter Retching Faces scale, and Wong-Baker Faces Pain Rating Scale, which included questions about the descriptive and clinical characteristics of the participants and was prepared by the researcher consistent with the literature.
Findings:
A significant relationship was observed between the severity of postoperative pain and the occurrence of PONV in patients with both nonperforated and perforated appendicitis (P < .001). In addition, operative time and the time to the first oral feeding were shorter in patients with nonperforated appendicitis in the non-PONV group (P = .005 and P = .042, respectively) Logistic regression analysis revealed that postoperative pain, family history of PONV and appendix perforation were risk factors for PONV in children with both nonperforated and perforated appendicitis (P < .001, P = .040, and P < .001, respectively).
Conclusions:
In children undergoing appendectomy, family history of PONV, severity of postoperative pain, increased operative time, and increased transition time to oral feeding are risk factors for PONV. Pediatric nurses, who have an important role in the management of PONV, should evaluate patients in terms of PONV risk in the preoperative period within the scope of evidence-based practices and perform pharmacological or nonpharmacological interventions according to the degree of risk.
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