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KMID : 0356920230760020099
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Korean Journal of Anesthesiology
2023 Volume.76 No. 2 p.99 ~ p.106
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Retrospective analysis of the incidence and predictors of postoperative nausea and vomiting after orthopedic surgery under spinal anesthesia
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Ju Jae-Woo
Kwon Jina
Yoo Seok-Ha
Lee Ho-Jin
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Abstract
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Background: Postoperative nausea and vomiting (PONV) commonly occurs after spinal anesthesia; however, its incidence rate and predictors have been scarcely studied. Therefore, we aimed to investigate its incidence rate and potential predictors.
Methods: The electronic medical records of 6,610 consecutive patients undergoing orthopedic surgery under spinal anesthesia were reviewed between January 2016 and December 2020. The primary outcome was PONV incidence within 24 h after spinal anesthesia. Along with its incidence rate, we investigated its predictors using multivariable logistic regression analysis.
Results: Among the 5,691 patients included in the analysis, 1,298 (22.8%) experienced PONV within 24 h after spinal anesthesia. Female sex (odds ratio [OR]: 3.23, 95% CI [2.72, 3.83], P < 0.001), nonsmoker (OR: 2.12, 95% CI [1.46, 3.07], P < 0.001), history of PONV (OR: 1.52, 95% CI [1.26, 1.82], P < 0.001), prophylactic 5-hydroxytryptamine receptor antagonist use (OR: 0.35, 95% CI [0.24, 0.50], P < 0.001), prophylactic steroid use (OR: 0.53, 95% CI [0.44, 0.62], P < 0.001), baseline heart rate ≥ 60 beats/min (OR: 1.38, 95% CI [1.10, 1.72], P = 0.005), and postoperative opioid use (OR: 2.57, 95% CI [1.80, 3.67], P < 0.001), were significant predictors of the primary outcome.
Conclusions: Our study showed the common incidence of PONV after spinal anesthesia and its significant predictors. A better understanding of its predictors may provide important information for its management.
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KEYWORD
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Dexamethasone, Orthopedic procedure, Postoperative complications, Postoperative nausea and vomiting, Serotonin 5-HT3 receptor antagonists, Spinal anesthesia
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