Postoperative Nausea and Vomiting After Deep Sedation for Radiofrequency Catheter Ablation in Pediatric Patients

Radiofrequency catheter ablation (RFA) effectively treats pediatric arrhythmias, but postoperative nausea and vomiting (PONV) is a common complication impacting patient experience. This study investigated PONV incidence and its contributing factors in pediatric RFA under deep sedation. This retrospective, single-center cohort study reviewed 70 RFA procedures in 63 pediatric patients (aged ≤ 18 years) performed between January 2013 and December 2025. All procedures were managed under a standardized deep sedation protocol. Data on demographics, arrhythmia type, procedural characteristics (including ablation site: right-sided vs. left-sided), anesthetic management, and the occurrence of PONV within 24 h were collected. PONV occurred in 12 of the 70 procedures (17%). The incidence of PONV was significantly higher following left-sided ablation compared to right-sided ablation (8/24 [33%] vs. 4/46 [9%]; p = 0.017). Notably, there were no significant differences in procedure time, anesthesia time, number of radiofrequency applications, or the types and dosages of anesthetic agents administered between patients who developed PONV and those who did not. In the majority of these patients, PONV symptoms resolved spontaneously within 24 h without the need for rescue medications. The incidence of PONV was 17% in pediatric patients during RFA under deep sedation. Our findings suggest that most pediatric PONV under deep sedation is transient and clinically manageable without additional medical intervention, although careful observation remains essential during the early postoperative period.