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Impact of an antiemetic protocol on postoperative nausea and vomiting in children
Author(s) -
Drake R.,
Anderson B.J.,
Persson M.A.,
Thompson J.M.D.
Publication year - 2001
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2001.00594.x
Subject(s) - medicine , antiemetic , nausea , vomiting , anesthesia , postoperative nausea and vomiting , perioperative , incidence (geometry) , physics , optics
The objective of the study was to demonstrate a decreased incidence of postoperative nausea and vomiting (PONV) in children through the use of an antiemetic protocol. PONV was recorded in children (1.5–15 years) after inpatient surgery under general anaesthesia in a prospective, interview based survey. Group 1 consisted of children having surgery 1 month before the introduction of a formalized antiemetic protocol and group 2, 2 months after its introduction. Data were collected over a 1‐month period in each group. Outcome measures of nausea, emesis, antiemetic requirement and patient satisfaction were monitored for the first 24‐h postoperative period. There were 272 children enrolled: 138 in group 1 and 134 in group 2. There was a difference between the two groups for gender ( P =0.03), type of surgery ( P =0.017), perioperative opioid ( P =0.003) and perioperative antiemetic use ( P =0.024). However, multivariate analysis did not demonstrate an impact on outcome from these factors. The incidence of postoperative nausea (PON) and postoperative vomiting (POV) following the introduction of the protocol was 36% and 34%, respectively. Moderate to severe nausea was decreased after introduction of the protocol (18% versus 9%, P =0.028) but moderate to severe vomiting failed to reach significance (19% versus 11%, P =0.078). The proportion of children who had repeated nausea decreased after the introduction of the protocol (17% versus 8%, P =0.02) but repeated episodes of vomiting remained unchanged (19% versus 14%). This was attributed to a significant increase in antiemetic prescribing by protocol in group 2 (10% versus 59%, P < 0.001). Patient satisfaction was high in both groups (85% versus 90%). The introduction of a postoperative antiemetic protocol improved prescribing frequency. This resulted in a decreased incidence of moderate to severe PON and a reduction in the number of patients with repeated nausea.