General anesthesia in elective surgery, factors for the occurrence of late postoperative nausea and vomiting
Keywords:
late postoperative nausea and vomiting; motion sickness; risk factorsAbstract
Introduction: Late postoperative nausea and vomiting represent unpleasant and bothersome adverse effects that increase postoperative morbidity and mortality. Objectives: To identify the factors that influence the occurrence of late postoperative nausea and vomiting in patients treated with general anesthesia for elective surgery.
Methods: A cross-sectional analytical study was conducted at the “Celestino Hernández Robau” University Hospital in Santa Clara, Villa Clara Province. From a population of 2186 patients treated with general anesthesia for elective surgery between 2021 and 2023, 400 were selected using non-probability, purposive sampling. The primary empirical method was the documentary analysis of individual medical records for data collection.
Results: The overall prevalence of late postoperative nausea and vomiting was 9.25%. Stratified, it was higher in patients with: age <50 years (9.52%), female (9.41%), non-smoker history (9.36%), history of nausea and vomiting/motion sickness (18.29%; OR=3.01), non-ambulatory surgery (11.64%; OR=1.74), abdominal surgery (10.00%), endotracheal general anesthesia (10.10%), surgical time ≥2 hours (11.64%; OR=4.62), postoperative pain (11.64%; OR=3.17), nausea and vomiting (13.29%; OR=2.17), and treatment with halogenated agents (9.38%) and opioids (9.52%).
Conclusions: The prevalence of late postoperative nausea and vomiting in patients treated with The use of general anesthesia for elective surgery was low. Factors contributing to this included: a history of nausea and vomiting/motion sickness, abdominal and non-ambulatory surgeries, surgical time of two hours or more, and pain, nausea, and vomiting in the immediate postoperative period.
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1. Artevia Sevilla RE, Chacón JR, Vargas Castillo SM. Revisión bibliográfica de náuseas y vómitos en postoperatorio en la población adulta. Rev Electrónica de Portales Médicos [Internet]. 2023 [citado 31/01/2025]; XVIII(9): [aprox. 2p.]. Disponible en: https://www.revista-portalesmedicos.com/revista-medica/revision-bibliografica-de-nauseas-y-vomitos-en-postoperatorio-en-la-poblacion-adulta/
2. Álvarez Hurtado LM, Nieto Monteagudo CG, Pérez Caballero D, Nieto Martínez GE, Salgado Carbajal D, Cruz García O. Incidencia de náuseas y vómitos postoperatorios en anestesia general para cirugía electiva. Medicentro Electrónica [Internet]. 2021 [citado 31/01/2025]; 25(1): [aprox. 2p.]. Disponible en: https://medicentro.sld.cu/index.php/medicentro/article/view/3083
3. Pérez Caballero D, Nieto Monteagudo CG. Náuseas y vómitos postoperatorios en anestesia general para intervención quirúrgica electiva. Acta Méd Centro [Internet]. 2017 [citado 31/01/2025]; 11(3):[aprox. 3p.]. Disponible en: https://revactamedicacentro.sld.cu/index.php/amc/article/download/845/1050?inline=1
4. Nieto Monteagudo CG, Pérez Caballero D, Santiago Pérez A, Álvarez Hurtado LM, Cruz García O. Incidencia de náuseas y vómitos posoperatorios en anestesia espinal para cirugía electiva. Acta Méd Centro [Internet]. 2022 [citado 30/01/2025]; 16(1):[aprox. 3p.] Disponible en: http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S2709-79272022000100058
5. von Peltz CA, Baber C, Nou SL. Australian perspective on fourth Consensus Guidelines for the management of postoperative nausea and vomiting. Anaesth Intensive Care [Internet]. 2021 [citado 30/01/2025]; 49(4): [aprox. 2p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34369811/
https://doi.org/10.1177/0310057x211030518
6. Veiga-Gil L, Pueyo J, López-Olaondo L. NVPO: Fisiopatología, factores de riesgo, profilaxis y tratamiento. Rev Esp Anestesiol Reanim [Internet]. 2017 [citado 30/01/2025]; 64(4):[aprox. 2p.]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S003493561630189X
https://doi.org/10.1016/j.redar.2016.10.001
7. Ishikawa E, Iwamoto R, Hojo T, Teshirogi T, Hashimoto K, Shibuya M, et al. Cross-sectional study of PONV risk factors for oral surgery after intubated general anesthesia with total intravenous anesthesia. Anesth Prog [Internet]. 2022 [citado 29/012025]; 69(1):[aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35377932/
http://dx.doi.org/10.2344/anpr-68-03-12
8. Nieto Monteagudo CG, Cruz García O, Álvarez Hurtado LM, López de la Cruz F, Cruz Hernández M, Cruz Hernández Y. Náuseas y vómitos postoperatorios en pacientes pediátricos sometidos a anestesia general para cirugía electiva. Acta Méd Centro [Internet]. 2021 [citado 29/01/2025]; 15(1): [aprox. 3p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2709-79272021000100042
9. Bueno Fernández C, Blasco Muñoz L, Sainz Pardo A, Nasarre Puyuelo M, Tejedor Bosqued A, Muñoz Cáceres J. Náuseas y vómitos postoperatorios. Revista Sanitaria de Investigación [Internet]. 2022 [citado 12/02/2025]; 3(3): Disponible en: https://revistasanitariadeinvestigacion.com/nauseas-y-vomitos-postoperatorios/
10. Schwartz J, Gan TJ. Management of postoperative nausea and vomiting in the context of an Enhanced Recovery After Surgery program. Best Pract Res Clin Anaesthesiol [Internet]. 2020 [citado 30/01/2025]; 34(4):[aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33288119/
https://doi.org/10.1016/j.bpa.2020.07.011
11. Diaz Campanero P, Petrus Rubio S, Morales Cayuela MA, Mariscal Flores ML. Actualización en náuseas y vómitos posoperatorios. Rev Electrónica AnestesiaR [Internet]. 2022 [citado 31/05/2025]; 14(3): Disponible en: https://anestesiar.org/2021/actualizacion-en-nauseas-y-vomitos-postoperatorios/
https://doi.org/10.30445/rear.v14i3.1069
12. Apfel CC. Nauseas y vómitos postoperatorios En: Miller RD. Miller Anestesia. 8va ed. Barcelona: Elsevier; 2016;
13. Arance García M. Analgesia posoperatoria. Manejo de náuseas y vómitos posoperatorios. Cir Andal [Internet]. 2022 [citado 27/02/2025]; 33(4):[aprox. 2p.]. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=8910887
14. Chacón Medina M, Ortiz Sánchez Y, Rosabal Sadin MR, Rodríguez Hernández I, Trenal Barrero M. Efectividad de la profilaxis antiemétiva en el posoperatorio de pacientes operados por cirugía de minimo acceso. Multimed [Internet]. 2023 [citado 27/02/2025]; 27:[aprox. 3p.] Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1028-2023000100014&Ing=es.
15. Koivuranta M, Laara E, Snare L, Alahuhta S. A survey of postoperative nausea and vomiting. Anaesthesia [Internet]. 1997 [citado 27/02/2025]; 52(5):[aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/9165963/
https://doi.org/10.1111/j.1365-2044.1997.117-az0113.x
16. Szachnowicz B, Pawasauskas J, Brothers T. An analysis of the management and incidence of postoperative nausea and vomiting. J Perioper Pract [Internet]. 2021 [citado 14/02/2025]; 31(10):[aprox. 2p.]. Disponible en: https://journals.sagepub.com/doi/10.1177/1750458920950659
https://doi.org/10.1177/1750458920950659
17. Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg [Internet]. 2020 [citado 19/02/2025]; 131(2):[aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/41237407/
https://doi.org/10.1213/ANE.0000000000004833
18. Meyer MJ, George EE. La unidad de cuidados postanestésicos. En: Pino RM. Manual de procedimientos de anestesia clínica del Massachusetts General Hospital. 9a ed. Philadelphia: Wolters Kluwer; 2016.
19. Maraş G, Bulut H. Prevalence of Nausea-Vomiting and Coping Strategies in Patients Undergoing Outpatient Surgery. J. Perianesth Nursing [Internet]. 2021 [citado 19/02/2025]; 36(5):[aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34167895/
https://doi.org/10.1016/j.jopan.2020.10.004
20. Butterworth JF. Postanesthesia care. Morgan & Mikhail´s Clinical Anesthesiology. 7a ed. New York: McGraw Hill; 2022.
21. Jin Z, Kowa CY, Gan S, Lin J, Gan TJ. Efficacy of palonosetron-dexamethasone combination compared to palonosetron alone for prophylaxis against postoperative nausea and vomiting. Curr Med Res Opin [Internet]. 2021 [citado 25/02/2025]; 8: [aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33617380/
https://doi.org/10.1080/03007995.2021.1893677
22. Wahid M, Ali S, Yasin B, Farhat K, Noor M, Syed FT. Granisetrón versus Ondansetrón: Comparison of 5-HT3 antagonists in preventing spinal anaesthesia induced hemodynamic inestability in obstetric patients. Pak J Med Sci Q [Internet]. 2022 [citado 10/02/2025]; 38(7):[aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36246694/
https://dx.doi.org/10.12669/pjms.38.7.5585
23. Tusher DS, Saha DP, Chowdhury DM, Hossain DM, Ara DN, Biswas DS, et al. Gabapentin and prevention of post-operative nausea and vomiting (PONV). Sch J Appl Med Sci [Internet]. 2022 [citado 10/02/2025]; 9(11):[aprox. 3p.]. Disponible en: https://saspublishers.com/media/articles/SJAMS_911_1691-1697.pdf
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Copyright (c) 2026 Carlos Gilberto Nieto Monteagudo, Miguel Alejandro Guerra Hernández , Diane Gómez Lima, Osmany Cruz García
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