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J Family Med Prim Care · Feb 2021
Reduction in post-operative nausea and vomiting (PONV) by preoperative risk stratification and adherence to a standardized anti emetic prophylaxis protocol in the day-care surgical population.
- Sam Jenkins Stephenson, Meghna Jiwanmall, Noble E Cherian, S Kamakshi, and Aparna Williams.
- Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.
- J Family Med Prim Care. 2021 Feb 1; 10 (2): 865-870.
ContextPostoperative nausea (PON) and postoperative vomiting (POV) are the most undesirable morbidity after anaesthesia. There is paucity of data on PONV from the Indian subcontinent.AimsWe aim to study the prevalence of PON and POV, associated risk factors and the effect of following standardized risk stratification and prophylaxis protocols in the day care patient population.Settings And DesignThis was a prospective cohort study at a tertiary care teaching institute.Methods And MaterialData from 500 patients undergoing day care surgery over a period of 12 months were analysed. We used the Apfel scoring system for evaluation of risk of post-operative nausea and vomiting (PONV) for each participant. A standard PONV prophylaxis protocol was used intra-operatively.Statistical Analysis UsedData analysis was done using the Mann-Whitney U test, the Chi-square and Fisher's exact test.ResultsThe period prevalence of post-operative nausea (PON) and post-operative vomiting (POV) was 2.04% and 2.45%, respectively, in this study. The prevalence of PONV in each risk category was lower than that predicted by the Apfel score due to utilization of a standard anti-emetic prophylactic protocol. We found younger age, previous history of nausea, previous history of vomiting, urological surgeries and alcohol consumption as significant risk factors for postoperative nausea. Longer duration of surgery, previous history of nausea, alcohol consumption and higher BMI were the significant risk factors for postoperative vomiting.ConclusionsAdherence to preoperative risk stratification and a standard anti-emetic prophylactic protocol can significantly reduce the prevalence of postoperative nausea and vomiting.Copyright: © 2021 Journal of Family Medicine and Primary Care.
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