The Development and Validation of a Risk Score to Predict the Probability of Postoperative Vomiting in Pediatric Patients

Eberhart, Leopold; Geldner, Götz; Kranke, Peter; Morin, A. M.; Schäuffelen, A.; Treiber, H.; Wulf, Hinnerk

doi:10.1213/01.ane.0000135639.57715.6c

Cited by 259 publications

(219 citation statements)

References 23 publications

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“…PONV has been listed as the most undesirable scenario postoperatively, followed by pain and sedation [26]. PONV is also a limiting factor in the timely discharge of ambulatory patients with significant economic consequences.…”

Section: Discussionmentioning

confidence: 99%

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

Keramidas¹,

Vasileiou²,

Pascovitis³

et al. 2017

JACCOA

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Background: Breast augmentation is the plastic surgery procedure associated with the greatest risk of postoperative nausea and vomiting (PONV). The purpose of this study is to evaluate the efficacy of a specific antiemetic protocol applied in breast augmentation in order to diminish the incidence of PONV Methods: A prospective-level of evidence II-study was performed in 247 patients that underwent breast augmentation from October 2010 to October 2014. General anesthesia was induced with propofol, fentanyl and rocuronium. Anesthetic maintenance was accomplished with total intravenous anesthesia and air with oxygen at 50%. All patients received metoclopramide 10 mg intravenously (iv) and 8 mg of ondasetron iv (2 mg at the induction and 6 mg over 30 minutes). Intergroup comparison of means was performed using unpaired t tests and analysis of variance, where applicable.Results: Nausea and emesis occurred with an overall frequency of 4.9% and 2.8% respectively. The 95.1 percent of the patient didn't complaint having nausea on the day of operation, and only 3 (1.2%) of them had this symptom remaining until the fifth post op day. Only 7 patients reported vomiting on the day of the operation. There is no significant difference in nausea between smokers and no smokers (p= 0.510). Conclusion:Τhe specific antiemetic protocol applied in breast augmentation operations seems to be highly effective. The fact that we observed no difference between smokers and nonsmokers regarding the incidence of PONV should be further investigated since till now a protective role for smoking against PONV was suggested. Introduction 1Postoperative nausea and vomiting (PONV) are common adverse effects that occur after several types of surgical procedures. The general incidence of vomiting is about 30%, the incidence of nausea is about 50%, and in high-risk patients, the PONV rate can be as high as 80% [1][2][3]. The mechanism of PONV is multifactorial and not well-deciphered. The emesis reflex is coordinated by the vomiting center, located in the hindbrain within the medulla oblongata in close proximity to the chemoreceptor trigger zone within the area postrema. Stimuli from peripheral organs and tissues, including the genitalia are transmitted to the vomiting center by the afferent neurons of the vagus nerve [4].However, not all patients have the same risk profile for PONV. The incidence of PONV varies with patient-related factors, the nature of surgery performed, type of anesthesia used, and duration of surgery and perioperative management of the patient (Table 1) [5]. The risk of PONV in adult women has been found to be two to three times greater than in adult men. Progesterone 1 Presented:1) The 12th Congress of the ESPRAS -July 6-11, 2014, Edinburgh, Scotland.2) 22nd Congress of the ISAPS -September 19-22, 2014 Rio de Janeiro, Brazil.3) Accepted for presentation in Euroanaesthesia 2016 London UK May 28-30. or serum gonadotropin seem to be the contributing factor in the higher incidence of PONV in women [5,6]. Furthermore, obese p...

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Section: Discussionmentioning

confidence: 99%

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

Keramidas¹,

Vasileiou²,

Pascovitis³

et al. 2017

JACCOA

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“…25,26 It has been reported that the incidence of POV in children is twice as high as in adults, and age [ 3 yr has been proposed as an independent risk factor for POV. 27,28 In view of these findings, we included children from two to seven years of age in our study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of dexmedetomidine, ketamine, and placebo on emergence agitation after strabismus surgery in children

Chen¹,

Jia²,

Liu³

et al. 2013

Can J Anesth/J Can Anesth

123

130

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“…Perioperative acupuncture and postoperative acupressure can prevent postoperative vomiting following paediatric tonsillectomy or adenoidectomy: a pragmatic randomised controlled trial Ingrid Liodden, 1,2 Michael Howley, 2 Anne Sameline Grimsgaard, 3,4 Vinjar Magne Fønnebø,…”

Section: Introductionmentioning

confidence: 99%

Perioperative Acupuncture and Postoperative Acupressure Can Prevent Postoperative Vomiting following Paediatric Tonsillectomy Or Adenoidectomy: A Pragmatic Randomised Controlled Trial

Liodden

Howley²,

Grimsgaard

et al. 2011

Acupunct Med

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Objective To investigate the effectiveness of acupuncture and acupressure as supplements to standard treatment for postoperative vomiting in children undergoing tonsillectomy and/or adenoidectomy. Methods A pragmatic, open, block-randomised controlled trial. The results were analysed according to the intention-to-treat principle. The study was conducted without extra resources in a normal setting at the day-surgery department of Lovisenberg Diakonale Hospital in Oslo. 154 children with an American Society of Anesthesiologists grade 1-2, weighing at least 10 kg, were included. Children with concomitant gastrointestinal diseases, emesis or antiemetic treatment <24 h preoperatively, rash or local infection over the actual acupuncture points were excluded together with patients whose parents' informed consent could not be obtained. The intervention group received acupuncture at pericardium 6 bilaterally, at a depth of approximately 0.7 cm with a median of 21 min during anaesthesia, followed by acupressure wristbands for 24 h and standard treatment. The control group received standard treatment. The primary end point was the occurrence of vomiting or retching during 24 h postoperatively. Results Children in the acustimulation group experienced less retching and vomiting than the control group-46.8% versus 66.2% (p=0.015). The effect of acustimulation was specifi cally pronounced in girls and children aged 1-3 years. Conclusion This trial indicates the effectiveness of acustimulation as an adjunct to standard treatment. The results should encourage and promote the implementation of acustimulation for postoperative vomiting in children undergoing adenoidectomy or tonsillectomy.

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The Development and Validation of a Risk Score to Predict the Probability of Postoperative Vomiting in Pediatric Patients

Cited by 259 publications

References 23 publications

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

Breast Augmentation: Reducing Postoperative Nausea and Vomiting. A Prospective Study

Comparison of the effects of dexmedetomidine, ketamine, and placebo on emergence agitation after strabismus surgery in children

Perioperative Acupuncture and Postoperative Acupressure Can Prevent Postoperative Vomiting following Paediatric Tonsillectomy Or Adenoidectomy: A Pragmatic Randomised Controlled Trial

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