A Prospective Study of Postoperative Vomiting in Children Undergoing Different Surgical Procedures under General Anaesthesia

2008 
To identify the risk factors associated with postoperative vomiting (POV) in paediatric population undergoing common surgeries. The risk factors studied for association with POV were age >5 years, female gender, previous history of POV/motion sickness, type of surgery and duration of anaesthesia >45 min. A total of 100 ASA grade I and II patients of either sex aged between 2-12 years undergoing elective surgical procedures were screened for the study. All patients underwent similar anaesthe­sia protocol and received two antiemetic agents (ondansetron 0.05mg.kg -1 and dexamethasone 0.15mg.kg -1 ) in premedication. The patients were observed for 24 hours postoperatively for the incidence of vomiting, number of times rescue antiemetic given and any adverse reaction to antiemetic.Overall 34% patients (34/100) developed POV of which 26 had only one episode and 8 patients had 2 episodes during first 24 h. Incidence of POV was 13% (13/100) in first 4 h whereas it was 29% (29/100) in late postoperative period. In early post operative period, POV was not associated significantly with any predicted risk factors. However, age>5years, duration of anaesthesia>45 minutes and history of motion sickness/POV were significantly associated in late postoperative period(4-24h). Female gender and type of surgery were not associated with increased POV. The combination antiemetic effectively prevented POV in early postoperative period (0-4h) only but not in late postoperative period(0-24h).
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