Korean J Anesthesiol.  2023 Apr;76(2):99-106. 10.4097/kja.22237.

Retrospective analysis of the incidence and predictors of postoperative nausea and vomiting after orthopedic surgery under spinal anesthesia

• Ju JW
• Kwon J
• Yoo S
• Lee HJ

• KMID: 2540999
• DOI: http://doi.org/10.4097/kja.22237

Abstract

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.

Keyword

Dexamethasone; Orthopedic surgery; Postoperative complications; Postoperative nausea and vomiting; Serotonin 5-HT receptor antagonists; Spinal anesthesia