Cumulative incidence and risks factors for postoperative nausea and vomiting in adult patients undergoing cholecystectomy under balanced general anesthesia
| Autor: | Carlos Javier Shiraishi-Zapata, Giancarlo J. Rodríguez-Velarde, Sheyla J. Arellano-Adrianzén |
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| Rok vydání: | 2020 |
| Předmět: |
Colecistectomía
medicine.drug_class medicine.medical_treatment Critical Care and Intensive Care Medicine Logistic regression 03 medical and health sciences 0302 clinical medicine Náusea y vómito posoperatorio 030202 anesthesiology medicine Antiemetic Cholecystectomy Cumulative incidence Prospective cohort study Postoperative nausea and vomiting business.industry Incidence Incidence (epidemiology) 030208 emergency & critical care medicine Balanced anesthesia Anesthesiology and Pain Medicine Risk factors Anesthesia Cohort medicine.symptom Incidencia business Anestesia balanceada Factores de riesgo |
| Zdroj: | Revista Colombiana de Anestesiología, Volume: 48, Issue: 1, Pages: 11-3, Published: 28 FEB 2020 |
| ISSN: | 2256-2087 |
| DOI: | 10.1097/cj9.0000000000000142 |
| Popis: | Introduction: Postoperative nausea and vomiting (PONV) are common issues arising after general anesthesia, for which several independent risk factors (RF) have been described. Objective: To determine the accumulated incidence of PONV during the first 24hours of the postoperative period. Methods: A cohort observational, prospective study was conducted that included all the adults undergoing cholecystectomy under balanced general anesthesia at the EsSalud Talara Hospital from October 2014 until December 2016. The presence of PONV during the first 24hours after surgery was assessed, and univariate, bivariate, and logistic regression analyses were conducted. Results: A total of 244 patients were included, most of them with 2 RFs in the Apfel scale, that represented an accumulated incidence of PONV of 0.51 (95% confidence interval [CI] 0.45-0.57) during the observation period, notwithstanding the fact that 85.25% received antiemetic prophylaxis. The logistic regression analysis identified that being a female (odds ratio [OR] 3.30,95% CI 1.66-6.55, P = 0.0007) and previous PONV or motion sickness (OR 2.67, 95% CI 1.25-5.68, P = 0.011) were independent RFs for PONV. The administration of antiemetic prophylaxis and the presence of PONV (P = 0.92) were found to be independent. Conclusion: The high cumulative incidence of PONV could be the result of the type of surgery, the use of volatile anesthetic agents, and errors in the antiemetic pharmacological prophylaxis. Resumen Introducción: Las náuseas y vómitos posoperatorios (NVPO) son problemas comunes que aparecen luego de la anestesia general, para los que se han descrito varios factores independientes de riesgo. Objetivo: Determinar la incidencia acumulada de NVPO durante las primeras 24 horas del periodo posoperatorio. Métodos: Se realizó un estudio observacional prospectivo de cohorte que incluyó a todos los adultos sometidos a colecistectomía bajo anestesia general balanceada en el Hospital EsSalud Talara desde octubre de 2014 hasta diciembre de 2016. Se evaluó la presencia de NVPO durante las primeras 24 horas posoperatorias y se ejecutaron análisis univariado, bivariado y de regresión logística. Resultados: Se incluyeron 244 pacientes, la mayoría con dos factores de riesgo en la escala de Apfel, que presentaron una incidencia acumulada de NVPO de 0.51 (IC 95% 0.45-0.57) en el periodo de observación, a pesar de que el 85.25% recibió profilaxis antiemética. El análisis de regresión logística identificó la presencia de sexo femenino (OR 3.30, IC 95% 1.66-6.55, p = 0.0007) y la historia de NVPO previos o cinetosis (OR 2.67, IC 95% 1.25-5.68, p = 0.011) como factores de riesgo independientes para NVPO. Se halló independencia entre la presencia de profilaxis antiemética y la presencia de NVPO (p=0.92). Conclusiones: La alta incidencia acumulada de NVPO pudiera ser ocasionada por el tipo de cirugía, uso de anestésicos volátiles y falencias en la profilaxis farmacológica antiemética. |
| Databáze: | OpenAIRE |
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