McKenzie, S., & Halavan, J. (1987). An investigation into post-anesthesia nausea and vomiting in a community hospital-based anesthesiology practice. AANA Journal, 55(5), 427-433
A study investigating the incidence of nausea and vomiting among post-anesthesia patients in a private, community hospital anesthesiology practice was undertaken. A total of 826 patients were semi-sequentially sampled and evaluated using the Chi-square statistic. Findings supported many widely held beliefs about the problem of nausea and vomiting (for example, it appears to be related to age and sex). The most significant information obtained was that recovery room nausea and vomiting were closely related to the patients’ immediate post-anesthesia experience of pain (p < 0.0001). This relationship presents some interesting ideas in the search for a better understanding of this difficult clinical problem, as well as some alternatives for treatment.
An investigation was undertaken to determine i£ there has been an increase in the number of patients suffering from nausea and/or vomiting following anesthesia. This report will basically review the anatomy, physiology, and pharmacology of vomiting to provide a foundation for better understanding of this complex clinical problem. It is interesting that in spite of how frequent and commonplace the problem of nausea and vomiting is in every clinical setting, there is little available information about what actually happens in the brain to create this problem or what kinds of stimulation can cause this response in the body. The design of this project was quasi-experimental. There was no specific treatment group identified and manipulated by the authors, and the data were collected by the respective anesthetists rendering the anesthesia care. The purpose of this study is to provide surgeons, physician and nurse anesthetists, and recovery room nurses with statistical data concerning the incidence of nausea and vomiting present in the patient population currently, and to investigate factors that may cause this problem. It is presumed that in identifying contributing factors to this problem, methods and practices to decrease the incidence of postoperative nausea and vomiting may also be identified, enabling anesthesia and recovery room personnel to provide better care for the perioperative patient.
Hypothesis: The incidence of nausea and vomiting following anesthesia among the patients studied is lower than that of the currently reported incidence within the anesthesia community. Additionally it is believed that there is a difference in post-anesthesia nausea and vomiting among different drug techniques.
Thompson, H. (1999). Themanagement of post-operative nausea and vomiting. Journal Of Advanced Nursing, 29(5), 1130-1136. doi:10.1046/j.1365-2648.1999.00998.x
Despite the advent of new technology and pharmacological agents, post-operative nausea and vomiting (PONV) continues to have an incidence of 20-30% today. Development of PONV can lead to serious complications such as aspiration, dehydration, electrolyte disturbances and disruption of the surgical site. PONV leads to increased cost of treatment, and may be associated with increased anxiety, dissatisfaction with the surgical experience and anticipatory nausea in the future. The mechanisms of PONV are examined with associated risk factors. A review of the literature of PONV management is included covering pharmacological, dietary and behavioural interventions; culminating in the development of assessment and management guidelines and identification of areas for further study.
Hambridge, K. (2013). Assessing the risk of post-operative nausea and vomiting. Nursing Standard, 27(18), 35-43.
Post-operative nausea and vomiting (PONV) is a common complication for many surgical patients, causing anxiety and distress. Evidence suggests that nursing practice in this area is inconsistent and that nurses’ knowledge needs to improve, to promote better patient outcomes. This article provides a review of the incidence of PONV, associated complications and risk factors. Examples of risk assessment tools that could be used to identify patients at risk of developing PONV are described to ensure timely and appropriate treatment.
Waterman, H., Leatherbarrow, B., Slater, R., & Waterman, C. (1999). Post-operative pain, nausea and vomiting: qualitative perspectives from telephone interviews. Journal Of Advanced Nursing, 29(3), 690-696. doi:10.1046/j.1365-2648.1999.00938.x
Previous studies on post-operative pain, nausea and vomiting tend to be quantitative in method and focus on in-patient or day case surgery. The objectives of this study carried out in one specialist eye hospital in England were to consider post-operative pain, nausea and vomiting from a qualitative perspective. Fifty-five patients undergoing general anaesthetic short-stay ophthalmic surgery (orbital hydroxyapatite implantation) consented to participate in telephone interviews 8 days post-surgery. The interviews lasted between 20 and 60 minutes. Data were analysed thematically and offer insight into varying experiences of pain, nausea and vomiting in hospital, on discharge and at home. Results indicate that not all patients were discharged home in optimum condition. The needs of post-operative short-stay patients should come before financial imperatives to vacate beds. Patient education and information giving is discussed in the light of the findings.
Sakellaris, G., Georgogianaki, P., Astyrakaki, E., Michalakis, M., Dede, O., Alegakis, A., & … Charissis, G. (2008). Prevention of post-operative nausea and vomiting in children – a prospective randomized double-blind study. Acta Paediatrica, 97(6), 801-804
Background/Purpose: Post-operative nausea and vomiting (PONV) are common complications related to surgery and anesthesia. The aim of this study was to assess whether sevoﬂurane, with or without the use of an antiemetic such as ondansetron, increases or not the incidence of PONV in children. Methods: One hundred and ten children, 2 months to 14 years undergoing inguinal hernia, hypospadias and penile deformity repair, were randomly allocated into one of two groups, according to whether they received ondansetron or placebo (47 vs. 63). Induction and maintenance of anesthesia was with Sevoﬂurane in both groups. Regional anesthesia was performed on all children (inguinal nerve, penile or caudal block). No opioids were used. In post-operative period, children were assessed for PONV, every 4 h for the ﬁrst 24 h. Results: Vomiting was very low in both groups (8 cases: 7.3%). No signiﬁcant statistical difference of post-operative nausea (p=0.296) and vomiting (p=0.462) (Fisher’s exact test) was found between the group that received ondansetron and the placebo group.
Ming, J., Kuo, B., Lin, J., & Lin, L. (2002). The efficacy of acupressure to prevent nausea and vomiting in post-operative patients. Journal Of Advanced Nursing, 39(4), 343-351. doi:10.1046/j.1365-2648.2002.02295.x
BACKGROUND: Post-operative nausea and vomiting is a common complication following general anesthesia. Traditional Chinese medicine indicates that acupressure therapy may reduce nausea and vomiting in certain ailments. AIM(S) OF THE STUDY: The aim of this study was to examine the effect of stimulating two acupressure points on prevention of post-operative nausea andvomiting. DESIGN AND METHODS: A randomized block experimental design was used. The Rhodes Index of Nausea, Vomitingand Retching (INVR) questionnaire was used as a tool to measure incidence. To control the motion sickness variable, the subjects who underwent functional endoscopic sinus surgery (FESS) under general anesthesia were randomly assigned to a finger-pressing group, a wrist-band group, and a control group. There were 150 subjects in total with each group consisting of 50 subjects. The acupoints and treatment times were similar in the finger-pressing group and wrist-band pressing group, whereas only conversation was employed in the control group. RESULTS: Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure, wrist-band, and control groups, with a reduction in the incidence rate of nausea from 73.0% to 43.2% and vomiting incidence rate from 90.5% to 42.9% in the former. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the former group. CONCLUSION: In view of the total absence of side-effects in acupressure, its application is worthy of use. This study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting.
The weaknessess of these and most probably all of the articles to be found for my topic are the unbelieveable number of variables and combinations of variables for this issue – the different catagories of data are overwhelming – thus making it extreamly difficult to suggest a solution comprehensive of all of the potential patients and their “list of factors”
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