Predisposing factors for postoperative nausea and vomiting in gynecologic tumor patients

Abstract

Purpose

To evaluate the predictors of postoperative nausea and vomiting (PONV) in women with gynecologic tumor.

Methods

The analysis was based on prospectively collected data of 82 adult patients with gynecologic tumor, who were submitted to open surgical treatment and undergoing general anesthesia. The predictors included were age ≥50 years, non-smoker, use of postoperative opioids, mechanical bowel preparation, intraoperative intravenous hydration (IH) ≥10 mL/kg/h, and IH in the immediate postoperative, first and second postoperative days (PO1 and PO2) ≥30 mL/kg. A score with predictor variables was built. A multiple logistic regression was fitted. To estimate the discriminating power of the chosen model, a receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated. Statistical significance was set at p value <0.05 and the confidence interval at 95 %.

Results

The incidence (%) of nausea, vomiting and both, in the general population, was 36.6, 28.1, 22.0, respectively. The highest incidences of PONV were found in non-smokers and in patients who received >30 mL/kg of IH in the PO2. The results of the adjusted model showed an increased risk of PONV for each 1-point increase in the score punctuation. The relative risk was higher than 2.0 for vomiting in all period and in the PO1. The ROC curve showed great discrimination of postoperative nausea and vomiting from the proposed score (AUC >0.75).

Conclusions

The study population was at high risk of PONV. Therefore, institutional guidelines abolishing modificable variables following temporal evaluation of the effectiveness should be undertaken.

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Correspondence to Gabriela Villaça Chaves.

Ethics declarations

The study protocol was approved by the Brazilian Cancer Institute (INCA – Instituto Nacional de Câncer José Alencar Gomes da Silva) ethics committee (CAAE number 01,052,712.9.0000.5274). Patients were admitted into the study upon providing written formal authorization through a free and informed consent agreement.

Conflict of interest

The authors declare that they have no conflict of interest.

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de Souza, D.S., Costa, A.F. & Chaves, G.V. Predisposing factors for postoperative nausea and vomiting in gynecologic tumor patients. Support Care Cancer 24, 4661–4667 (2016). https://doi.org/10.1007/s00520-016-3311-2

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Keywords

  • Gynecologic tumor
  • Postoperative nausea and vomiting
  • Perioperative care