An analysis of the management and incidence of postoperative nausea and vomiting

J Perioper Pract. 2021 Oct;31(10):366-372. doi: 10.1177/1750458920950659. Epub 2021 Mar 28.

Abstract

Background: Postoperative nausea and vomiting significantly increases recovery time, reduces patient satisfaction, and increases time to discharge. Consensus guidelines for the management of postoperative nausea and vomiting highlight effective methods for prophylaxis and treatment. Implications of adherence to these guidelines include both improved patient outcomes and reduced healthcare costs.

Objective: This study aimed to assess the incidence, contributing factors, and current prescribing practices for prophylaxis and treatment of postoperative nausea and vomiting.

Methods: Electronic medical records were assessed for adult patients who had an elective gastrointestinal or gynaecologic surgical procedure over a one-year period. Patient demographics and perioperative data were collected to assess risk factors and the incidence of postoperative nausea and vomiting. The appropriateness of prophylaxis and treatment was assessed according to current guidelines.

Results: The incidence of postoperative nausea and vomiting was consistent with previously noted findings. The average time spent under anaesthesia was significantly higher in patients who experienced postoperative nausea and vomiting. Appropriate evidence-based rescue therapy was administered in a minority of the cohort experiencing postoperative nausea and vomiting.

Conclusion: There is substantial opportunity for provider education and adherence to best prescribing practices. Enhanced adherence to evidence-based rescue therapy prescribing may improve patient outcomes and satisfaction.

Keywords: Evidence-based practice; Outcomes; Patient safety; Pharmacology; Post-anaesthetic care; Quality of care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiemetics* / therapeutic use
  • Elective Surgical Procedures
  • Humans
  • Incidence
  • Patient Satisfaction
  • Postoperative Nausea and Vomiting* / drug therapy
  • Postoperative Nausea and Vomiting* / epidemiology
  • Postoperative Nausea and Vomiting* / prevention & control

Substances

  • Antiemetics