Anaesthesia, Movement and Emesis

Kamath, B.S.K.; Curran, James T.; Hawkey, C. J.; Beattie, A. D.; Gorbutt, N.; Guiblin, H.; Kong, Andrew

doi:10.1093/bja/64.6.728

Cited by 59 publications

(23 citation statements)

References 5 publications

(2 reference statements)

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“…Kamath et al reported that 66% of their patients who could identify a cause for postoperative nausea blamed movement [11]. Muir et al ............................................................................................................................................................................................................................................. …”

Section: Discussionmentioning

confidence: 99%

A survey of postoperative nausea and vomiting

et al. 1997

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SummaryA prospective interview-based survey on the incidence of postoperative nausea and vomiting in 1107 in-patients aged 4-86 years was conducted during a 3-month period. Nausea, emetic episodes and the need for anti-emetic medication were recorded for 24 h postoperatively. In the recovery room, the incidence of nausea and vomiting was 18% and 5%, respectively. Over the whole 24-h period, these figures were 52% and 25%, respectively; severe nausea was experienced by 8%. The highest incidence of emetic sequelae was observed in gynaecological patients; 52% of the 822 patients who received general anaesthesia and 38% of the 285 patients who received regional anaesthesia reported nausea. The most important predictive factors associated with an increased risk for nausea and vomiting were female gender, a previous history of postoperative sickness, a longer duration of surgery, nonsmoking and a history of motion sickness. Based on these five items, a simple score predicting the risk of nausea and vomiting was constructed with a moderately good discriminating power. Nausea and emetic episodes still persist as the most common complaints following anaesthesia and surgery. Many adults find postoperative nausea and vomiting even more distressing than postoperative pain. The overall incidence of postoperative nausea and vomiting in the recovery room is around 10% [1] but ranges from 20% to 30% during the first 24 h after surgery according to recent reports [1][2][3][4]. Despite the advances in modern anaesthetic practice and surgical techniques, there is still room for improvement in identifying the causative factors as well as in the prophylaxis and treatment of this problem.The objective of this epidemiological survey of postoperative complications was to get representative numerical estimates of the present incidence of postoperative nausea and vomiting for different types of common surgical procedures in a tertiary care setting. The aim was also to analyse the predictive factors associated with these symptoms and to construct a risk score based on patient-related factors, as well as on some key anaesthetic and surgical factors. Methods

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Section: Discussionmentioning

confidence: 99%

A survey of postoperative nausea and vomiting

et al. 1997

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“…Sudden motion, changes in position, or even transport from the PACU to the ward can precipitate nausea and vomiting in patients who have received opioid compounds. Kamath et al also demonstrated that 66% of PONV was related to movement (20). …”

Section: Discussionmentioning

confidence: 99%

A Korean Predictive Model for Postoperative Nausea and Vomiting

Choi

Ahn

et al. 2005

J Korean Med Sci

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Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after surgery. An identification of risk factors associated with PONV would make it easier to select specific patients for effective antiemetic therapy. We designed a case-controlled study to identify the risk factors for PONV in 5,272 surgical patients. At postoperative 2 and 24 hr, patients were visited and interviewed on the presence and severity of PONV. Thirty nine percent of patients experienced one or more episodes of nausea or vomiting. Five risk factors were highly predictive of PONV: 1) female, 2) history of previous PONV or motion sickness, 3) duration of anesthesia more than 1 hour, 4) non-smoking status, and 5) use of opioid in the form of patient controlled analgesia (PCA), in the order of relevance. The formula to calculate the probability of PONV using the multiple regression analysis was as follows: P (probability of PONV)=1/1+e-Z, Z=-1.885+0.894 (gender)+0.661 (history)+0.584 (duration of anesthesia)+0.196 (smoking status) +0.186 (use of PCA-based opioid) where gender: female=1, male=0; history of previous PONV or motion sickness: yes=1, no=0; duration of anesthesia:more than 1 hr=1, less than or 1 hr=0; smoking status: no=1, yes=0; use of PCA-based opioid: yes=1, no=0.

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“…10 The higher incidence of PONV after discharge in both studies may be attributable to the continued effect of morphine stimulation of the vestibular apparatus with the increase in activity after discharge home. 11 The incidence of PONV varies in previous studies of perioperative morphine. In gynecological patients, 10 mg morphine im administered preoperatively resulted in a 9-15% incidence of nausea and a 3-45% incidence of vomiting.…”

Section: Discussionmentioning

confidence: 99%

Intraoperativevs post-operative morphine improves analgesia without increasing PONV on emergence from ambulatory surgery

Wong

Ritchie

Chung

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To compare the timing of administration of morphine in patients undergoing painful ambulatory surgical procedures to determine whether there was a difference in postoperative nausea or vomiting (PONV), quality of analgesia, and recovery profile. Methods:In a double-blinded, placebo-controlled, prospective study, 70 ASA I-II patients were randomized to receive 0.1 mg·kg -1 morphine intraoperatively (Iop) (n=35), or postoperatively (Pop) (n=35). The severity of nausea and pain were measured using visual analog scales (VAS).Results: There was no difference between the groups in postoperative nausea scores or the incidence of PONV. Upon awakening, patients who received Pop morphine had higher pain VAS scores with movement (7.6 ± 2 vs 5.4 ± 3, P < 0.003) and at rest (6.9 ± 3 vs 5.1 ± 3, P < 0.013) than the Iop morphine group. The total number of PCA attempts and analgesic requirements were similar. Patients who received Pop morphine were able to drink sooner than the Iop group (90 ± 34 vs 111 ± 38 min, P < 0.05). All other recovery milestones were similar. Times to discharge from hospital were similar.

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Anaesthesia, Movement and Emesis

Cited by 59 publications

References 5 publications

A survey of postoperative nausea and vomiting

A survey of postoperative nausea and vomiting

A Korean Predictive Model for Postoperative Nausea and Vomiting

Intraoperativevs post-operative morphine improves analgesia without increasing PONV on emergence from ambulatory surgery

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