Postoperative Nausea & Vomiting in Malawi
Affiliation(s)
Department of Anaesthesia and Intensive Care, College of Medicine, University of Malawi, Blantyre, Malawi.
Department of Anaesthesia and Intensive Care, College of Medicine, University of Malawi, Blantyre, Malawi.
ABSTRACT
Background: Postoperative nausea and vomiting are common complications of anaesthesia and surgery. Known risk factors include motion sickness, migraine, gender and types of surgery. Other possible risk factors for postoperative nausea and vomiting are ethnicity and genetics surgery. Objective: The main objective of the study was to describe factors associated with postoperative nausea and vomiting among adult Malawians. Methods: This was a prospective observational study. 138 adult patients were recruited into the study. Data were collected using a predesigned questionnaire. Patients were followed up to 18 hours postoperatively and any episodes of postoperative nausea and vomiting were noted. Results: A total of 138 patients were enrolled in the study. 78 were female (56.5%) and 60 were males (43.5%). The ages ranged from 18 to 87 years. The mean age was 36.9 years. The overall incidence of postoperative nausea and vomiting was 29.6%. It was higher among women than men. Patients with motion sickness had the highest incidence of postoperative nausea and vomiting (78.6%) followed by those with migraine (73.3%). Patients whose intraoperative systolic blood pressure fell <80 mmHg had an incidence of 71.4% and those who received postoperative opioids had an incidence of 37.7%. Conclusions: Patients with a history of migraine, motion sickness, whose intraoperative blood pressures fall below a systolic of 80 mmHg and who receive postoperative opioids are at an increased risk for postoperative nausea and vomiting.
Background: Postoperative nausea and vomiting are common complications of anaesthesia and surgery. Known risk factors include motion sickness, migraine, gender and types of surgery. Other possible risk factors for postoperative nausea and vomiting are ethnicity and genetics surgery. Objective: The main objective of the study was to describe factors associated with postoperative nausea and vomiting among adult Malawians. Methods: This was a prospective observational study. 138 adult patients were recruited into the study. Data were collected using a predesigned questionnaire. Patients were followed up to 18 hours postoperatively and any episodes of postoperative nausea and vomiting were noted. Results: A total of 138 patients were enrolled in the study. 78 were female (56.5%) and 60 were males (43.5%). The ages ranged from 18 to 87 years. The mean age was 36.9 years. The overall incidence of postoperative nausea and vomiting was 29.6%. It was higher among women than men. Patients with motion sickness had the highest incidence of postoperative nausea and vomiting (78.6%) followed by those with migraine (73.3%). Patients whose intraoperative systolic blood pressure fell <80 mmHg had an incidence of 71.4% and those who received postoperative opioids had an incidence of 37.7%. Conclusions: Patients with a history of migraine, motion sickness, whose intraoperative blood pressures fall below a systolic of 80 mmHg and who receive postoperative opioids are at an increased risk for postoperative nausea and vomiting.
Cite this paper
Mndolo, S. , Jung, K. and Pollach, G. (2014) Postoperative Nausea & Vomiting in Malawi. International Journal of Clinical Medicine, 5, 447-451. doi: 10.4236/ijcm.2014.58062.
Mndolo, S. , Jung, K. and Pollach, G. (2014) Postoperative Nausea & Vomiting in Malawi. International Journal of Clinical Medicine, 5, 447-451. doi: 10.4236/ijcm.2014.58062.
References
[1] Gan, T.J., Meyer, T., Apfel, C.C., Chung, F., Davis, P.J., Eubanks, S. and Watcha, M. (2003) Consensus Guidelines for Managing Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 97, 62-71.
http://dx.doi.org/10.1213/01.ANE.0000068580.00245.95 [2] Kovac, A.L. (2000) Prevention and Treatment of Postoperative Nausea and Vomiting. Drugs, 59, 213-243.
http://dx.doi.org/10.2165/00003495-200059020-00005 [3] Van Den Bosch, J.E., Kalkman, C.J., Vergouwe, Y., Van Klei, W.A., Bonsel, G.J., Grobbee, D.E., et al. (2005) Assessing the Applicability of Scoring Systems for Predicting Postoperative Nausea and Vomiting. Anaesthesia, 60, 323-331. http://dx.doi.org/10.1111/j.1365-2044.2005.04121.x [4] Amponsah, G. (2007) Postoperative Nausea and Vomiting in Korlebu Teaching Hospital. Ghana Medical Journal, 41, 181-185. [5] Ugochukwu, O., Adaobi, A., Ewah, R. and Obioma, O. (2010) Postoperative Nausea and Vomiting in a Gynecological and Obstetrical Population in South Eastern Nigeria. Pan African Medical Journal, 7, 6. [6] Rodseth, R.N., Gopalan, P.D., Cassimjee, H.M. and Goga, S. (2010) Reduced Incidence of Postoperative Nausea and Vomiting in Black South Africans and Its Utility for a Modified Risk Scoring System. Anesthesia & Analgesia, 110, 1591-1594. http://dx.doi.org/10.1213/ANE.0b013e3181da9005 [7] Ssebuufu, R., Kakande, I. and Okello, M. (2009) Post-Operative Nausea and Vomiting at Mulago Hospital. East and Central African Journal of Surgery, 14, 50-57. [8] Candiotti, K.A., Birnbach, D.J., Lubarsky, D.A., Nhuch, F., Kamat, A., Koch, W.H. and Andrews, D. (2005) The Impact of Pharmacogenomics on Postoperative Nausea and Vomiting: Do CYP2D6 Allele Copy Number and Polymorphisms Affect the Success. Anesthesiology, 102, 543-549. http://dx.doi.org/10.1097/00000542-200503000-00011 [9] Carruthers, J. (2010) The Changing Shape and Scope of Southern African Historical Studies. South African Historical Journal, 62, 384-393. http://dx.doi.org/10.1080/02582473.2010.493009 [10] Koivuranta, M., Läärä, E., Snåre, L. and Alahuhta, S. (1997) A Survey of Postoperative Nausea and Vomiting. Anaesthesia, 52, 443-449. http://dx.doi.org/10.1111/j.1365-2044.1997.117-az0113.x [11] Gan, T.J. (2006) Risk Factors for Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 102, 1884-1898.
http://dx.doi.org/10.1213/01.ANE.0000219597.16143.4D [12] Chimbira, W. and Sweeney, B.P. (2000) The Effect of Smoking on Postoperative Nausea and Vomiting. Anaesthesia, 55, 540-544. http://dx.doi.org/10.1046/j.1365-2044.2000.01474.x [13] Apfel, C.C., et al. (1999) A Simplified Risk Score for Predicting Postoperative Nausea and Vomiting: Conclusions from Cross-Validations between Two Centers. Anesthesiology, 91, 693-700.
http://dx.doi.org/10.1097/00000542-199909000-00022 [14] Sinclair, D.R., Chung, F. and Mezei, G. (1999) Can Postoperative Nausea and Vomiting Be Predicted? Anesthesiology, 91, 109-118. http://dx.doi.org/10.1097/00000542-199907000-00018 [15] Cepeda, M.S., et al. (2003) Side Effects of Opioids during Short-Term Administration: Effect of Age, Gender, and Race & Ast. Therapeutics, 74, 102-112. [16] Pusch, F., Berger, A., Wildling, E., Tiefenthaler, W. and Krafft, P. (2002) The Effects of Systolic Arterial Blood Pressure Variations on Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 94, 1652-1655.
[1] Gan, T.J., Meyer, T., Apfel, C.C., Chung, F., Davis, P.J., Eubanks, S. and Watcha, M. (2003) Consensus Guidelines for Managing Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 97, 62-71.
http://dx.doi.org/10.1213/01.ANE.0000068580.00245.95 [2] Kovac, A.L. (2000) Prevention and Treatment of Postoperative Nausea and Vomiting. Drugs, 59, 213-243.
http://dx.doi.org/10.2165/00003495-200059020-00005 [3] Van Den Bosch, J.E., Kalkman, C.J., Vergouwe, Y., Van Klei, W.A., Bonsel, G.J., Grobbee, D.E., et al. (2005) Assessing the Applicability of Scoring Systems for Predicting Postoperative Nausea and Vomiting. Anaesthesia, 60, 323-331. http://dx.doi.org/10.1111/j.1365-2044.2005.04121.x [4] Amponsah, G. (2007) Postoperative Nausea and Vomiting in Korlebu Teaching Hospital. Ghana Medical Journal, 41, 181-185. [5] Ugochukwu, O., Adaobi, A., Ewah, R. and Obioma, O. (2010) Postoperative Nausea and Vomiting in a Gynecological and Obstetrical Population in South Eastern Nigeria. Pan African Medical Journal, 7, 6. [6] Rodseth, R.N., Gopalan, P.D., Cassimjee, H.M. and Goga, S. (2010) Reduced Incidence of Postoperative Nausea and Vomiting in Black South Africans and Its Utility for a Modified Risk Scoring System. Anesthesia & Analgesia, 110, 1591-1594. http://dx.doi.org/10.1213/ANE.0b013e3181da9005 [7] Ssebuufu, R., Kakande, I. and Okello, M. (2009) Post-Operative Nausea and Vomiting at Mulago Hospital. East and Central African Journal of Surgery, 14, 50-57. [8] Candiotti, K.A., Birnbach, D.J., Lubarsky, D.A., Nhuch, F., Kamat, A., Koch, W.H. and Andrews, D. (2005) The Impact of Pharmacogenomics on Postoperative Nausea and Vomiting: Do CYP2D6 Allele Copy Number and Polymorphisms Affect the Success. Anesthesiology, 102, 543-549. http://dx.doi.org/10.1097/00000542-200503000-00011 [9] Carruthers, J. (2010) The Changing Shape and Scope of Southern African Historical Studies. South African Historical Journal, 62, 384-393. http://dx.doi.org/10.1080/02582473.2010.493009 [10] Koivuranta, M., Läärä, E., Snåre, L. and Alahuhta, S. (1997) A Survey of Postoperative Nausea and Vomiting. Anaesthesia, 52, 443-449. http://dx.doi.org/10.1111/j.1365-2044.1997.117-az0113.x [11] Gan, T.J. (2006) Risk Factors for Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 102, 1884-1898.
http://dx.doi.org/10.1213/01.ANE.0000219597.16143.4D [12] Chimbira, W. and Sweeney, B.P. (2000) The Effect of Smoking on Postoperative Nausea and Vomiting. Anaesthesia, 55, 540-544. http://dx.doi.org/10.1046/j.1365-2044.2000.01474.x [13] Apfel, C.C., et al. (1999) A Simplified Risk Score for Predicting Postoperative Nausea and Vomiting: Conclusions from Cross-Validations between Two Centers. Anesthesiology, 91, 693-700.
http://dx.doi.org/10.1097/00000542-199909000-00022 [14] Sinclair, D.R., Chung, F. and Mezei, G. (1999) Can Postoperative Nausea and Vomiting Be Predicted? Anesthesiology, 91, 109-118. http://dx.doi.org/10.1097/00000542-199907000-00018 [15] Cepeda, M.S., et al. (2003) Side Effects of Opioids during Short-Term Administration: Effect of Age, Gender, and Race & Ast. Therapeutics, 74, 102-112. [16] Pusch, F., Berger, A., Wildling, E., Tiefenthaler, W. and Krafft, P. (2002) The Effects of Systolic Arterial Blood Pressure Variations on Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 94, 1652-1655.