POSTOPERATIVE VOMITING - A SCORE FOR ITS PREDICTION AFTER INHALATIONAL ANESTHESIA

Despite numerous factors are thought to affect postoperative vomiting (PV) recent studies demonstrated that the risk of PV can be predicted by considering just the most important ones. Therefore, the aim of thi s study was to present the clinically most relevant factors, a risk sc ore based upon those factors and its clinical applicability for other types of surgery. Methods:ln a prospective study 2220 adult inpatients scheduled for elective surgery were monitored for PV after inhalation al anaesthesia over 24 hours. None of the patients received prophylact ic antiemetic treatment. Multivariate analyses were perfomed with data of patients who underwent otolaryngological procedures to identify th e major risk factors and to derive a risk score. The applicability of the score in surgical and ophthalmological procedures was tested by li near regression analysis of expected and observed incidences. Results: ln the multivariate model,clinically most im porta nt risk facto rs fo r PV were female gender,young age, a positive history of postoperative nausea and vomiting or motion sickness, non-smoking and a long durati on of anaesthesia, whereas the relative impact of the ''type of operat ion itself'' was small. Expected and observed incidences in patients u ndergoing other types of surgery were strongly correlated (R-2=0.99, P <0.001). Conclusion:The risk for PV after inhalational anaesthesia in adults can be predicted using a score which is based on individual ris k factors and the duration of anaesthesia only.