POSTOPERATIVE VOMITING IN CHILDREN - A PERSISTING UNSOLVED PROBLEM

Nausea and vomiting after anaesthesia and surgery in children remains a major problem. The following survey studies the frequency of postope rative vomiting and relates it to the anaesthestic technique, the surg ical procedure, and postoperative analgesia. During one year, Septembe r 1989 until September 1990, 2370 surgical patients requiring anaesthe sia were studied prospectively with the following protocol: 1) patient data, surgery and anaesthesia technique; and 2) postoperative follow- up were registered. Outpatients were followed up by telephone. The ove rall incidence of vomiting was 19.5 %, which was lower than in other s tudies. An increased incidence of vomiting was found in children over 2 years of age, after certain operative procedures, and after general anaesthesia. Furthermore, postoperative opioid administration on the w ard increased the risk of vomiting. Despite the low overall incidence of vomiting in our study, we still found a high frequency after certai n surgical procedures. The use of regional anaesthesia, prophylactic a ntiemetic medication, and the introduction of new anaesthetics, may he lp to reduce the sometimes high incidence of postoperative nausea and vomiting in paediatric patients.