POSTOPERATIVE NAUSEA AND VOMITING - A RETROSPECTIVE ANALYSIS IN PATIENTS UNDERGOING ELECTIVE CRANIOTOMY

Nausea and vomiting are important complications after craniotomy, for which there are little published epidemiologic data. We retrospectivel y examined the incidence of postcraniotomy nausea and vomiting to defi ne risk factors, Medical records from 199 adults undergoing elective c raniotomy were identified. Data extracted from surgery and the initial 48 hours postoperatively included gender, age, supratentorial versus infratentorial craniotomy, type of anesthesia (general versus monitore d anesthesia care), intraoperative fentanyl dose, duration of anesthes ia, antiemetic administration intraoperatively and postoperatively, an d incidence of postoperative nausea. emesis, and opioid use. Postopera tive nausea was recorded in 99 patients (50%) and emesis in 78 patient s (39%). Postoperative opioids were administered to 170 patients (85%) . Antiemetics were given intraoperatively to 13 patients (7%) and post operatively to 121 patients (61%). More women (61%) than men (37%) had nausea (P = 0.001); emesis (women = 46%; men = 31%, P = 0.03); and po stoperative antiemetic use (women = 69%; men = 51%, P = 0.013). The in cidence of postoperative nausea (P = 0.04) and vomiting (P = 0.06) was greater in patients having infratentorial surgery. Emesis was more fr equent in younger patients (P = 0.03), Postoperative nausea and vomiti ng were independent of anesthetic duration, fentanyl dose, or postoper ative ve opioid use and occurred with similar frequency after general anesthesia or monitored anesthesia care. We conclude that postoperativ e nausea and vomiting occur frequently after craniotomy. Infratentoria l surgery, female gender, and younger age are significant risk factors for this complication.