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Association between intraoperative hypotension and postoperative nausea and vomiting: a retrospective cohort study

  • 0Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany.
Current Medical Research and Opinion +

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July 1, 2024

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July 1, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Intraoperative hypotension, defined as mean arterial pressure (MAP) below 70mmHg, significantly increases the risk of postoperative nausea and vomiting (PONV). Lower MAP levels correlated with a higher incidence of PONV in surgical patients.

Area Of Science

  • Anesthesiology and Perioperative Medicine
  • Clinical Research
  • Patient Safety

Background

  • Postoperative nausea and vomiting (PONV) affects up to 30% of patients, with unclear pathophysiology.
  • Hypotension and reduced cardiac output are suspected contributors to PONV.
  • The link between intraoperative hypotension and PONV requires further investigation.

Purpose Of The Study

  • To investigate the hypothesis that intraoperative hypotension influences the incidence of PONV.
  • To quantify the association between different levels of intraoperative hypotension and PONV.
  • To analyze the impact of mean arterial pressure (MAP) on early PONV outcomes.

Main Methods

  • Retrospective, large, single-center cohort study.
  • Inclusion of surgical patients under general anesthesia (2018-2019).
  • Classification into groups based on lowest MAP (H50: <50mmHg, H60: <60mmHg, H70: <70mmHg, H0: no MAP <70mmHg) and propensity-score matching.

Main Results

  • Overall PONV incidence was 11% in 18,674 patients.
  • Patients experiencing hypotension showed a significantly increased incidence of PONV compared to the control group (H0).
  • Risk ratios indicated a dose-dependent relationship between lower MAP and higher PONV incidence (e.g., H0 vs. H50: RR 1.285, p<0.001).

Conclusions

  • A significant association exists between intraoperative hypotension and early PONV.
  • More severe intraoperative hypotension demonstrates a more pronounced effect on PONV incidence.
  • Managing intraoperative MAP may be crucial for mitigating PONV risk.

Keywords:

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