TY - JOUR
T1 - Postoperative nausea and vomiting are strongly influenced by postoperative opioid use in a dose-related manner
AU - Roberts, Gregory W.
AU - Bekker, Tenna B.
AU - Carlsen, Helle H.
AU - Moffatt, Christine H.
AU - Slattery, Peter J.
AU - McClure, F.
PY - 2005/11
Y1 - 2005/11
N2 - We prospectively examined the incidence of postoperative nausea and vomiting (PONV) in a group of 193 elderly surgical inpatients receiving no postoperative antiemetic prophylaxis. Risk factors for PONV and detailed data on postoperative opioid use were recorded. The overall postoperative vomiting (POV) rate was 23.8%, whereas postoperative nausea (PON) was 51.3%. Opioid use (P = 0.025), and female gender (P = 0.038) were identified as significantly influencing POV in this relatively small population. There was a strong logarithmic dose-response relationship between postoperative opioid dose and POV (r2 = 0.98, P < 0.01), as well as PON (r2 = 0.98, P = 0.01). Use of patient-controlled analgesia or epidural analgesia was a marker for large-dose opioid use (P < 0.001) and was associated with POV in the 24-h postoperative period of 41% and 31% respectively, compared with 11% for other patients (P < 0.001). Future studies defining risk factors for POV should treat postoperative opioid use as a continuous variable, rather than treat it as a dichotomous variable.
AB - We prospectively examined the incidence of postoperative nausea and vomiting (PONV) in a group of 193 elderly surgical inpatients receiving no postoperative antiemetic prophylaxis. Risk factors for PONV and detailed data on postoperative opioid use were recorded. The overall postoperative vomiting (POV) rate was 23.8%, whereas postoperative nausea (PON) was 51.3%. Opioid use (P = 0.025), and female gender (P = 0.038) were identified as significantly influencing POV in this relatively small population. There was a strong logarithmic dose-response relationship between postoperative opioid dose and POV (r2 = 0.98, P < 0.01), as well as PON (r2 = 0.98, P = 0.01). Use of patient-controlled analgesia or epidural analgesia was a marker for large-dose opioid use (P < 0.001) and was associated with POV in the 24-h postoperative period of 41% and 31% respectively, compared with 11% for other patients (P < 0.001). Future studies defining risk factors for POV should treat postoperative opioid use as a continuous variable, rather than treat it as a dichotomous variable.
UR - http://www.scopus.com/inward/record.url?scp=27444446717&partnerID=8YFLogxK
U2 - 10.1213/01.ANE.0000180204.64588.EC
DO - 10.1213/01.ANE.0000180204.64588.EC
M3 - Article
C2 - 16243992
AN - SCOPUS:27444446717
SN - 0003-2999
VL - 101
SP - 1343
EP - 1348
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
IS - 5
ER -