A Prospective Study On Incidence And Associated Risk Factors Of Postoperative Nausea And Vomiting After General And Spinal Anesthesia At Jimma University Specialized Hospital

Abstract

Background:- Nausea and vomiting post operatively occurs in 20 to 30 % of all patients. Patients find postoperative nausea and vomiting the most distressing and it is often the worst memory of their hospital stay. It is among the most common events related to surgery and anesthesia and despite modern anesthetics and surgical techniques its incidence remains at 25 to 30% which extends 70 to 80% in high risk patients. Objective:- to determine the incidence and associated risk factors of postoperative nausea and vomiting following general and spinal anesthesia in Jimma University Specialized Hospital from May 19, 2014 to June 9, 2014. Method:- this study was conducted in Jimma University Specialized Hospital among surgical ward patients by using general cohort study design who underwent surgery. Data was collected by interviewing of patients using structured questionnaire and review of their cards including anesthesia charts. Results:- from a total of 290 surgical patients admitted to JUSH 22.76% 66/290 had postoperative nausea, vomiting or both. From those patients 60.61% (40/66) are females. Higher incidence is occurred in surgeries done under general anesthesia 95.46% (63/66) when compared to spinal anesthesia 4.55% (3/66). Majority (74.24%) of postoperative nausea and vomiting occurred within 24hrs after surgery and 69.7% had prolonged (>8hrs) preoperative fasting. Among surgical procedures done in JUSH in the study period obstetrics and orthopedics had higher incidence of PONV 24.24% &16.66% respectively. Conclusion:- generally the incidence of postoperative nausea and vomiting among surgical patients admitted to JUSH in the study period is 22.758%(66/290) indicating that the problem is common. The incidence is higher in females (60.6%) and in age group between 19 and 64 (65.15%). General anesthesia was the most dominantly (96.97%) used type of anesthesia which has greater incidence of postoperative nausea and vomiting. The risk factors for postoperative nausea and vomiting in this study include: female gender, history of motion sickness or PONV on previous surgery, use of opoids, prolonged fasting, nonsmokers and intraoperative use of inhalational agents (halothane).