A risk score to predict the probability of postoperative vomiting in adults

Apfel, Christian C.; Greim, Clemens‐Alexander; Haubitz, Imme; Goepfert, Christine; Usadel, J.; Sefrin, Peter; Roewer, Norbert

doi:10.1111/j.1399-6576.1998.tb05157.x

Cited by 271 publications

(224 citation statements)

References 24 publications

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“…O uso de anticolinesterásicos em doses elevadas, para reverter o bloqueio neuromuscular, aumenta a motilidade gás-trica e NVPO 18 . A anestesia inalatória também acarreta risco acrescido relativamente à anestesia venosa total, principalmente no que respeito a NVPO em fase precoce 19 . Tendo em conta que numerosos fatores intervêm na gênese e agravamento de NVPO, várias tentativas têm sido efetuadas para obter fatores preditivos e identificar pacientes com risco elevado para NVPO.…”

Section: Identificação De Fatores De Risco Para Nvpounclassified

“…Koivuranta e col. concluíram, num estudo prospectivo de 1107 pacientes com idade entre 4 e 86 anos, que os fatores preditivos para desenvolvimento de NVPO seriam o sexo feminino, a história prévia de NVPO, a duração da cirurgia, a história de tabagismo e a história de náuseas e vômitos com movimento 11 . Vários estudos têm sido efetuados, mas o modelo preditivo mais usado é o de Apfel e col. 19 . Este modelo baseia-se em 4 fatores de risco: sexo feminino, história de náusea e vômitos com movimento e/ou história de NVPO, ausência de tabagismo e uso pós-operatório de opiói-des.…”

Section: Identificação De Fatores De Risco Para Nvpounclassified

“…High doses of anticholinesterase drugs used to antagonize neuromuscular block increase gastric motility and PONV 18 . Inhalational anesthesia is also of higher risk as compared to total intravenous anesthesia, especially in terms of early PONV 19 . Considering that several factors influence PONV genesis and worsening, many attempts have been made to obtain predictive factors and identify patients at high risk for PONV.…”

Section: Identification Of Ponv Risk Factorsmentioning

confidence: 99%

“…There are several studies on the subject, but the most popular predictive model is the model developed by Apfel et al 19 . This model is based on 4 risk factors: female gender, history of motion sickness and/or history of PONV, no smoking and postoperative opioids.…”

Section: Identification Of Ponv Risk Factorsmentioning

confidence: 99%

See 3 more Smart Citations

Náuseas e vômitos no pós-operatório: uma revisão do "pequeno-grande" problema

Lages¹,

Fonseca²,

Neves³

et al. 2005

Rev. Bras. Anestesiol.

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Section: Identificação De Fatores De Risco Para Nvpounclassified

Section: Identification Of Ponv Risk Factorsmentioning

confidence: 99%

Section: Identification Of Ponv Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Náuseas e vômitos no pós-operatório: uma revisão do "pequeno-grande" problema

Lages¹,

Fonseca²,

Neves³

et al. 2005

Rev. Bras. Anestesiol.

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show abstract

“…In addition, there have been suggestions that nonsmoking may be a risk factor in the genesis of PONV [1,6,7]. We therefore decided to test the hypothesis that smoking protects against this distressing symptom in the context of day case surgery.…”

mentioning

confidence: 99%

The effect of smoking on postoperative nausea and vomiting

Chimbira

Sweeney

2000

Anaesthesia

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SummaryIn an attempt to quantify the postoperative effects of smoking, 327 consecutive patients undergoing arthroscopic day case knee surgery were given a standard anaesthetic consisting of an intravenous induction with propofol and fentanyl followed by inhalational maintenance using isoflurane in an oxygen and nitrous oxide mixture. Pre-operatively, patients were asked inter alia to give details of social smoking habits. Postoperatively, patients were given standard analgesic and anti-emetic drugs. Prior to discharge patients were asked to give details of postoperative nausea and vomiting together with details of the severity of postoperative pain. There were 85 smokers and 242 nonsmokers. Of the 327 patients, a total of 42 (13%) complained of postoperative nausea and vomiting. Of the smokers, only 6% complained of postoperative nausea and vomiting in contrast to 15% of the nonsmokers (p , 0.05). It is postulated that enzyme induction is the most likely reason for this anti-emetic effect. Possible ways in which this clinically beneficial mechanism can be utilised to improve outcome after anaesthesia are discussed.

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Effect of Intravenous Acetaminophen on Postoperative Hypoxemia After Abdominal Surgery

Turan

Essber

Saasouh

et al. 2020

JAMA

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for the FACTOR Study Group IMPORTANCE Opioid-induced ventilatory depression and hypoxemia is common, severe, and often unrecognized in postoperative patients. To the extent that nonopioid analgesics reduce opioid consumption, they may decrease postoperative hypoxemia.OBJECTIVE To test the hypothesis that duration of hypoxemia is less in patients given intravenous acetaminophen than those given placebo. DESIGN, SETTING, AND PARTICIPANTS Randomized, placebo-controlled, double-blind trial conducted at 2 US academic hospitals among 570 patients who were undergoing abdominal surgery, enrolled from February 2015 through October 2018 and followed up until February 2019.INTERVENTIONS Participants were randomized to receive either intravenous acetaminophen, 1 g (n = 289), or normal saline placebo (n = 291) starting at the beginning of surgery and repeated every 6 hours until 48 postoperative hours or hospital discharge, whichever occurred first. MAIN OUTCOMES AND MEASURESThe primary outcome was the total duration of hypoxemia (hemoglobin oxygen saturation [SpO 2 ] <90%) per hour, with oxygen saturation measured continuously for 48 postoperative hours. Secondary outcomes were postoperative opioid consumption, pain (0-10-point scale; 0: no pain; 10: the most pain imaginable), nausea and vomiting, sedation, minimal alveolar concentration of volatile anesthetic, fatigue, active time, and respiratory function.RESULTS Among 580 patients randomized (mean age, 49 years; 48% women), 570 (98%) completed the trial. The primary outcome, median duration with SpO 2 of less than 90%, was 0.7 (interquartile range [IQR], 0.1-5.1) minutes per hour among patients in the acetaminophen group and 1.1 (IQR, 0.1-6.6) minutes per hour among patients in the placebo group (P = .29), with an estimated median difference of −0.04 (95% CI,−0.18 to 0.11) minutes per hour. None of the 8 secondary end points differed significantly between the acetaminophen and placebo groups. Mean pain scores within initial 48 postoperative hours were 4.2 (SD, 1.8) in the acetaminophen group and 4.4 (SD, 1.8) in the placebo group (difference, −0.28; 95% CI, -0.71 to 0.15); median opioid use in morphine equivalents was 50 mg (IQR, 18-122 mg) and 58 mg (IQR, 24-151 mg) , respectively, with a ratio of geometric means of 0.86 (95% CI, 0.61-1.21).CONCLUSIONS AND RELEVANCE Among patients who underwent abdominal surgery, use of postoperative intravenous acetaminophen, compared with placebo, did not significantly reduce the duration of postoperative hypoxemia over 48 hours. The study findings do not support the use of intravenous acetaminophen for this purpose.

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A risk score to predict the probability of postoperative vomiting in adults

Abstract: The data suggest that the probability of PV following ENT surgery under inhalational anaesthesia with low-dose opioids can be predicted by a score mainly based upon patient-related risk factors.

Cited by 271 publications

References 24 publications

Náuseas e vômitos no pós-operatório: uma revisão do "pequeno-grande" problema

Náuseas e vômitos no pós-operatório: uma revisão do "pequeno-grande" problema

The effect of smoking on postoperative nausea and vomiting

Effect of Intravenous Acetaminophen on Postoperative Hypoxemia After Abdominal Surgery

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