Journal
KOREAN JOURNAL OF ANESTHESIOLOGY
Volume 76, Issue 2, Pages 99-106Publisher
KOREAN SOC ANESTHESIOLOGISTS
DOI: 10.4097/kja.22237
Keywords
Dexamethasone; Orthopedic procedure; Postoperative complications; Postop-erative nausea and vomiting; Serotonin 5-HT3 receptor antagonists; Spinal anesthesia
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This study investigated the incidence rate and predictors of postoperative nausea and vomiting (PONY) after spinal anesthesia in 6,610 patients undergoing orthopedic surgery. The results showed that 22.8% of patients experienced PONY within 24 hours after spinal anesthesia. Female sex, nonsmoker, history of PONY, prophylactic use of 5-hydroxytryptamine receptor antagonists and steroids, baseline heart rate >= 60 beats/min, and postoperative opioid use were significant predictors of PONY.
Background: Postoperative nausea and vomiting (PONY) commonly occurs after spinal anesthesia; however, its incidence rate and predictors have been scarcely studied. There-fore, we aimed to investigate its incidence rate and potential predictors. Methods: The electronic medical records of 6,610 consecutive patients undergoing ortho-pedic surgery under spinal anesthesia were reviewed between January 2016 and December 2020. The primary outcome was PONY incidence within 24 h after spinal anesthesia. Along with its incidence rate, we investigated its predictors using multivariable logistic re-gression analysis. Results: Among the 5,691 patients included in the analysis, 1,298 (22.8%) experienced PONY 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 PONY (OR: 1.52, 95% CI [1.26, 1.82], P < 0.001), prophylactic 5-hydroxytryptamine re-ceptor 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 PONY after spinal anesthesia and its significant predictors. A better understanding of its predictors may provide import-ant information for its management.
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