Postoperative nausea and vomiting in the post-anesthetic care unit, a 5-year survey of a quality assurance program in surgical cancer patients

Motamed, Cyrus; Bourgain, Jean-Louis

doi:10.1016/j.bulcan.2015.03.002

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…Current guidelines for the prevention of postoperative PONV recommend multimodal prophylaxis before and during anaesthesia based on this risk scoring (Gan et al, 2014). It has been shown that the use of this strategy can decrease PONV after major surgery from 30% to 13% on the day of surgery (Motamed & Bourgain, 2015). However, nausea on the day after surgery, which in the worst scenario can lead to vomiting, can be caused by inflammation following tissue trauma (Horn, Wallisch, Homanics, & Williams, 2014).…”

Section: Introduction and Backg Roundmentioning

confidence: 99%

Patients’ self‐reported nausea: Validation of the Numerical Rating Scale and of a daily summary of repeated Numerical Rating Scale scores

Wikström

Nilsson

Broström

et al. 2018

Journal of Clinical Nursing

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Aim and objectives To validate the Numeric Rating Scale (NRS) for postoperative nausea assessments, and determine whether a central tendency, median, based on patients’ self‐rated nausea is a clinically applicable daily measure to describe patients’ nausea after major surgery. Background Postoperative nausea causes major discomfort, risks for complications and prolonged hospital stays. The NRS is recommended for the assessment of pain but is little explored for assessing nausea. Design A repeated measure design was carried out on patients who had undergone major surgery in three Swedish hospitals. Methods Nonparametric statistical methods were used to analyse (a) associations between the NRS and a verbal scale (no, mild, moderate and severe) and (b) to analyse associations between Measure 1 (nausea scores postoperative Day 1) and Measure 2 (retrospective nausea scores at rest and during activity, postoperative Day 2). Reporting of this research adheres to the Strobe Guidelines. Results The mean age of the 479 patients (44% women) in the sample was 65 years (range, 22–93 years). Self‐assessed nausea scores from the NRS and the verbal scale correlated well (rSpearman = 0.79). Correlation between nausea at rest and nausea during activity was rSpearman = 0.81. The calculated median scores (Measure 1) showed only moderate correlations with retrospective nausea scores (Measure 2); 4–9 ratings, rSpearman = 0.41; 6–9 ratings, rSpearman = 0.54. Conclusions Numeric Rating Scale scores showed strong associations with a verbal scale; therefore, the NRS seems to be a valid tool to measure nausea intensity. The quality of daily summarised median nausea scores needs to be further explored before clinical use. Relevance to clinical practice The use of the NRS in assessments of nausea in postoperative care will facilitate communication between patients and health care professionals regarding nausea intensity. When documenting nausea, it seems unnecessary to distinguish nausea at rest from nausea during activity.

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Section: Introduction and Backg Roundmentioning

confidence: 99%

Patients’ self‐reported nausea: Validation of the Numerical Rating Scale and of a daily summary of repeated Numerical Rating Scale scores

Wikström

Nilsson

Broström

et al. 2018

Journal of Clinical Nursing

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“…However, once again, our AIMS system served as part of a quality assurance tool that allowed us to indirectly assess our new protocol. 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

“…A previous retrospective single center database analysis conducted as part of our quality assurance program assessed the incidence and trend of intensity of PONV in our PACU over a 5-year period. 7 However, to improve outcomes, we changed our local protocol (2013) by shifting from a previous risk-tailored preventive prophylaxis (dexamethasone droperidol, ondansetron) to a generally simpler and broader prophylaxis to further reduce the incidence of PONV. In addition, in response to new general guidelines for the prevention of PONV 8 we replaced intraoperative droperidol i ntravenous (IV) with ondansetron IV and used droperidol IV for rescue injection in the PACU.…”

Section: Introductionmentioning

confidence: 99%

“…Our primary objective was to reassess the intensity score of PONV from 2015...2018 (P2) and to compare it to the trend of our historical data from 2007 to 2010 (P1), when PONV had been assessed based on a local riskadapted PONV score protocol and had consisted of the same doses of dexamethasone, followed by intraoperative droperidol and then ondansetron in the PACU as a rescue. 7 Our secondary outcomes included the putative compliance, defined as the application of the algorithm by expecting a steep increase in anti-PONV medication, the number of antiemetic including rescue medications, and the declared specific or other possible related side effects.…”

Section: Introductionmentioning

confidence: 99%

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Impact of extending prevention of postoperative nausea and vomiting for cancer surgical patients in the PACU: a before and after retrospective study

Motamed

Weil

Bourgain

2022

Brazilian Journal of Anesthesiology (English Edition)

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“…In the postoperative period of surgical intervention under anesthesia, emesis is a side effect, characterized by nausea and vomiting [1,2]. The incidences of nausea and vomiting after surgery under anesthesia are 50% and 30%, respectively [3]. Patient-controlled analgesics, such as morphine, provide pain relief but can also induce postoperative nausea and vomiting (PONV).…”

Section: Introductionmentioning

confidence: 99%

Effects of auriculotherapy for postoperative nausea and vomiting: A systematic review protocol

Santos¹,

Silva²,

Melo³

et al. 2021

Preprint

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Background Postoperative nausea and vomiting (PONV) is a distressing complication of anesthesia and can lead to aspiration, dehydration, and electrolyte imbalance. Antiemetic agents are conventionally prescribed to manage PONV; however, they have associated side effects. Therefore, unconventional methods, such as auricular acupuncture (AA), are also utilized to prevent and control emesis after surgery. AA originated in traditional Chinese medicine and is based on a diagnostic and treatment system that aims to normalize dysfunction through stimulation of reflex points on the ear. The aim of this study is to evaluate the effects of AA in controlling PONV. Methods We will perform a systematic review according to the Cochrane methodology. An overall search strategy will be developed and adapted for PubMed, PEDro, the Virtual Health Library, SciELO, EMBASE, the Web of Science, SciVerse Scopus, and the Cochrane Library to search for the following descriptors: “Acupressure”; “Antiemetics”; “Postoperative nausea and vomiting”; “Surgery”; “Auriculotherapy”; “Nausea”; “Vomiting”; and “Postoperative period.” Articles with a mean score of 6 ± 1.5 on the PEDro scale will be evaluated. The size of the intervention effect (Z) will be calculated for each outcome included in this review. The primary outcome will be the incidence of PONV. The secondary outcome will be the severity of PONV. Quality assessment will be performed with the Cochrane instrument. If possible, a meta-analysis will be performed using Review Manager 5.3 software. Discussion Several studies have reported positive outcomes of AA for patients with PONV. This study could provide robust and conclusive evidence of the usefulness of AA as an effective treatment alternative for emesis without the side effects of conventional medication. Trial registration Systematic review registration number: CRD42020149772 (S1 File)

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Postoperative nausea and vomiting in the post-anesthetic care unit, a 5-year survey of a quality assurance program in surgical cancer patients

Cited by 5 publications

References 21 publications

Patients’ self‐reported nausea: Validation of the Numerical Rating Scale and of a daily summary of repeated Numerical Rating Scale scores

Patients’ self‐reported nausea: Validation of the Numerical Rating Scale and of a daily summary of repeated Numerical Rating Scale scores

Impact of extending prevention of postoperative nausea and vomiting for cancer surgical patients in the PACU: a before and after retrospective study

Effects of auriculotherapy for postoperative nausea and vomiting: A systematic review protocol

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