Analysis of risk factors for postoperative vomiting following general anesthesia in total knee arthroplasty patients

This study aimed to investigate independent risk factors for postoperative vomiting induced by general anesthesia in total knee arthroplasty (TKA) patients, providing evidence for targeted prevention and intervention in high-risk individuals. This retrospective study analyzed data from patients undergoing TKA at our hospital between January 2020 and December 2023. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for postoperative vomiting following general anesthesia. A total of 452 TKA patients were included in this study. Among them, 96 patients experienced postoperative vomiting induced by general anesthesia, with an incidence rate of 21.24%. Through univariate and multivariate logistic regression analysis, 5 independent risk factors significantly associated with postoperative vomiting were identified. These factors included: history of vomiting (OR, 4.206; 95% CI, 1.148-8.954), history of motion sickness (OR, 4.152; 95% CI, 2.050-8.408), excessive preoperative fasting duration (defined as ≥12 hours, based on clinical practice and published enhanced recovery after surgery guidelines for arthroplasty; OR, 2.791; 95% CI, 1.194-6.521), intraoperative opioid use (OR, 2.884; 95% CI, 1.128-7.374), and absence of antiemetic medication during surgery (OR, 6.250; 95% CI, 2.238-17.455). Postoperative vomiting in TKA patients is significantly associated with multiple factors. The independent risk factors identified in this study provide scientific evidence for identifying high-risk patients preoperatively, optimizing anesthesia management, and reducing postoperative vomiting incidence.