Is PONV still a problem in pediatric surgery: a prospective study of what children tell us.

analgesics antiemetic pediatrics postoperative nausea and vomiting prevalence risk factors

Journal

Frontiers in pediatrics
ISSN: 2296-2360
Titre abrégé: Front Pediatr
Pays: Switzerland
ID NLM: 101615492

Informations de publication

Date de publication:
2023
Historique:
received: 16 06 2023
accepted: 09 10 2023
medline: 15 11 2023
pubmed: 15 11 2023
entrez: 15 11 2023
Statut: epublish

Résumé

Postoperative nausea and vomiting (PONV) is an unpleasant complication after surgery that commonly co-occurs with pain. Considering the high prevalence among pediatric patients, it is important to explore the main risk factors leading to PONV in order to optimize treatment strategies. The objectives of this study are as follows: (1) to determine the prevalence of PONV on the day of surgery by conducting interviews with pediatric patients, (2) to assess PONV prevalence in the recovery room and on the ward by analyzing nursing records, and (3) to collect information on PONV risk factors on the day of surgery and the following postoperative days. We wanted to investigate real-life scenarios rather than relying on artificially designed studies. A prospective analysis [according to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines] of PONV on the day of surgery and the following postoperative days was conducted by evaluating demographic and procedural parameters, as well as conducting interviews with the children under study. A total of 626 children and adolescents, ranging in age from 4 to 18 years, were interviewed on the ward following their surgery. The interviews were conducted using a questionnaire, as children aged 4 and above can participate in an outcome-based survey. On the day of surgery, several multivariable independent predictors were identified for PONV. The type of surgery was found to be a significant factor ( The main risk factors for PONV include the intraoperative administration of opioids during the recovery room stay and at the ward, the intraoperative use of non-opioids (diclofenac), and the specific type of surgical procedure. Real-life data demonstrated that in clinical praxis, there is a gap between the adherence to established guidelines and the use of antiemetic prophylaxis in surgeries that are generally not associated with a high PONV prevalence. Further efforts are needed to improve the existing procedures and thus improve the overall outcome.

Sections du résumé

Background UNASSIGNED
Postoperative nausea and vomiting (PONV) is an unpleasant complication after surgery that commonly co-occurs with pain. Considering the high prevalence among pediatric patients, it is important to explore the main risk factors leading to PONV in order to optimize treatment strategies. The objectives of this study are as follows: (1) to determine the prevalence of PONV on the day of surgery by conducting interviews with pediatric patients, (2) to assess PONV prevalence in the recovery room and on the ward by analyzing nursing records, and (3) to collect information on PONV risk factors on the day of surgery and the following postoperative days. We wanted to investigate real-life scenarios rather than relying on artificially designed studies.
Methods UNASSIGNED
A prospective analysis [according to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines] of PONV on the day of surgery and the following postoperative days was conducted by evaluating demographic and procedural parameters, as well as conducting interviews with the children under study. A total of 626 children and adolescents, ranging in age from 4 to 18 years, were interviewed on the ward following their surgery. The interviews were conducted using a questionnaire, as children aged 4 and above can participate in an outcome-based survey.
Results UNASSIGNED
On the day of surgery, several multivariable independent predictors were identified for PONV. The type of surgery was found to be a significant factor (
Conclusions UNASSIGNED
The main risk factors for PONV include the intraoperative administration of opioids during the recovery room stay and at the ward, the intraoperative use of non-opioids (diclofenac), and the specific type of surgical procedure. Real-life data demonstrated that in clinical praxis, there is a gap between the adherence to established guidelines and the use of antiemetic prophylaxis in surgeries that are generally not associated with a high PONV prevalence. Further efforts are needed to improve the existing procedures and thus improve the overall outcome.

Identifiants

pubmed: 37964809
doi: 10.3389/fped.2023.1241304
pmc: PMC10642485
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1241304

Informations de copyright

© 2023 Messerer, Stijic, Sandner-Kiesling, Brillinger, Helm, Scheer, Strohmeier and Avian.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Brigitte Messerer (B)

Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.

Marko Stijic (M)

Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
University Clinic for Neurology, Clinical Department for Neurogeriatrics, Medical University of Graz, Graz, Austria.

Andreas Sandner-Kiesling (A)

Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.

Johanna M Brillinger (JM)

Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.

Jasmin Helm (J)

Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.

Jacqueline Scheer (J)

Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.

Christof Stefan Strohmeier (CS)

Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.

Alexander Avian (A)

Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.

Classifications MeSH