A time-motion economic analysis of postoperative nausea and vomiting in ambulatory surgery

Parra-Sánchez, Iván; Abdallah, Rania; You, Jing; Fu, Alex Z.; Grady, Martin; Cummings, Kenneth C.; Apfel, Christian C.; Sessler, Daniel I.

doi:10.1007/s12630-011-9660-x

Cited by 73 publications

(46 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 There can also be significant costs associated with the treatment of PONV and their sequelae. [4][5][6] No single intervention is consistently effective for the prevention of PONV, and many of the strategies are either impractical (e.g., avoiding opiates) or have potential risks of serious side effects (e.g., QTc prolongation with 5-HT receptor antagonists 7 and antidopaminergic drugs). 8 The medical uses of cannabis and cannabinoids are expanding.…”

Section: Résumémentioning

confidence: 99%

A randomized-controlled trial of nabilone for the prevention of acute postoperative nausea and vomiting in elective surgery

Levin

Dulberg

Chan

et al. 2017

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

Section: Résumémentioning

confidence: 99%

A randomized-controlled trial of nabilone for the prevention of acute postoperative nausea and vomiting in elective surgery

Levin

Dulberg

Chan

et al. 2017

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…13 PERIOPERATIVE MEDICINE Both SSI and PoNV remain a crucial topic for anesthetists and surgeons, as they represent a significant clinical and economical burden; SSI may lead to prolonged length of stay and increased hospital costs, [14][15][16] whereas PoNV symptoms are among the most frequent adverse effects of anesthesia and surgery, and they are also associated with incremental costs. [17][18][19] Meta-analyses of clinical trials addressing the potential benefit of high FIo 2 in surgical patients have reported conflicting results. [20][21][22][23][24][25][26] A number of further relevant clinical trials studying these issues have been published recently.…”

mentioning

confidence: 99%

Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

et al. 2013

View full text Add to dashboard Cite

Background: Intraoperative high inspired oxygen fraction (FIo 2 ) is thought to reduce the incidence of surgical site infection (SSI) and postoperative nausea and vomiting, and to promote postoperative atelectasis. Methods: The authors searched for randomized trials (till September 2012) comparing intraoperative high with normal FIo 2 in adults undergoing surgery with general anesthesia and reporting on SSI, nausea or vomiting, or pulmonary outcomes. Results: The authors included 22 trials (7,001 patients) published in 26 reports. High FIo 2 ranged from 80 to 100% (median, 80%); normal FIo 2 ranged from 30 to 40% (median, 30%). In nine trials (5,103 patients, most received prophylactic antibiotics), the incidence of SSI decreased from 14.1% with normal FIo 2 to 11.4% with high FIo 2 ; risk ratio, 0.77 (95% CI, 0.59-1.00). After colorectal surgery, the incidence of SSI decreased from 19.3 to 15.2%; risk ratio, 0.78 (95% CI, 0.60-1.02). In 11 trials (2,293 patients), the incidence of nausea decreased from 24.8% with normal FIo 2 to 19.5% with high FIo 2 ; risk ratio, 0.79 (95% CI, 0.66-0.93). In patients receiving inhalational anesthetics without prophylactic antiemetics, high FIo 2 provided a significant protective effect against both nausea and vomiting. Nine trials (3,698 patients) reported on pulmonary outcomes. The risk of atelectasis was not increased with high FIo 2 . Conclusions: Intraoperative high FIo 2 further decreases the risk of SSI in surgical patients receiving prophylactic antibiotics, has a weak beneficial effect on nausea, and does not increase the risk of postoperative atelectasis. IT has been claimed that patients undergoing surgery with general anesthesia were benefiting from a higher than normal inspired oxygen fraction (FIo 2 ).1,2 Some authors have suggested that a high FIo 2 was a simple, inexpensive, and lowrisk intervention, and that the broader use of this technique should be encouraged in patients undergoing major abdominal procedures.3 Randomized trials have reported on a reduced risk of surgical site infection (SSI) in patients who were ventilated with 80% FIo 2 during surgery. 4,5 It was also shown that patients who were ventilated with high FIo 2 intraoperatively had a reduced incidence of postoperative nausea and vomiting (PoNV). 6,7 other authors were more cautious. 8,9 Skepticism has been partly related to the fact that high FIo 2 may have deleterious What This Article Tells Us That Is New• Intraoperative high inspired oxygen fraction decreases the risk of surgical site infection in surgical patients receiving prophylactic antibiotics, has a weak beneficial effect on nausea, and does not increase the risk of postoperative atelectasis

show abstract

“…Postdischarge nausea and vomiting (PDNV) is experienced by 35%-49% of patients and may continue for up to one week. [4][5][6] Pain may be an additional risk factor for late PDNV. 5 PDNV is particularly concerning, as patients may have limited access to effective therapies, and untreated symptoms have a significant impact on quality of life, functional status, and satisfaction.…”

Section: Postdischarge Nausea and Vomitingmentioning

confidence: 99%

“…The cost of the more commonly administered antiemetic agents has decreased substantially in recent years, and acquisition costs have become less of an issue. 8,9 Parra-Sanchez et al 4 100 90 80 70 60 50 40 30 20 10 0 0 1 2 Number of risk factors (n) 3 4 5…”

Section: Economics Of Ponvmentioning

confidence: 99%

Ambulatory anesthesia and postoperative nausea and vomiting: predicting the probability

Hegarty

Buckley

McCaul

2016

View full text Add to dashboard Cite

Nausea and vomiting are distinctly unpleasant symptoms that may occur after surgery and anesthesia, and high priority is given to their prevention by patients. Research in this area is plentiful and has focused on event prediction and pharmacological prophylaxis but despite this, postoperative nausea and vomiting (PONV) typically occurs in 20%-30% of patients in contemporary practice. Prediction of postoperative and postdischarge nausea and vomiting is particularly important in the ambulatory surgical population as these symptoms may occur following discharge from hospital and continue for up to one week when access to antiemetic therapies is limited. Many of the existing predictive scoring systems are based on data from inpatient populations and limited to the first 24 hours after surgery. Scoring systems based on data from ambulatory surgical populations to predict PONV are only moderately good. The best-performing systems in ambulatory patients are those of Sinclair and Sarin with an area under the receiver operating characteristic curve of 0.78 and 0.74, respectively, but are limited by the short duration of follow-up and a greater emphasis on nausea than vomiting. Given that the ability to predict both PONV and postdischarge nausea and vomiting is clearly limited, emphasis has been placed on prophylactic strategies that incorporate antiemetic medication, intravenous hydration, and nonnarcotic analgesia. PONV has been reduced to <10% in institutions using multimodal approaches. Scoring systems may facilitate "risk tailoring" in which patient risk profile is used as a stratification method for pharmacointervention.

show abstract

A time-motion economic analysis of postoperative nausea and vomiting in ambulatory surgery

Cited by 73 publications

References 26 publications

A randomized-controlled trial of nabilone for the prevention of acute postoperative nausea and vomiting in elective surgery

A randomized-controlled trial of nabilone for the prevention of acute postoperative nausea and vomiting in elective surgery

Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

Ambulatory anesthesia and postoperative nausea and vomiting: predicting the probability

Contact Info

Product

Resources

About