The Study of Clinical Practice Guideline for Prevention of Postoperative Nausea and Vomiting (PONV) in Lopburi Cancer Hospital
Keywords:
Postoperative nausea and vomiting, Clinical practice guideline, Ondansetron, MetoclopramideAbstract
Postoperative nausea and vomiting (PONV) are one of the most common complications after anesthesia that causes patient discomfort and may lead to a prolonged hospital stay. Therefore, Lopburi Cancer Hospital developed the clinical practice guideline (CPG) for PONV prophylaxis, but the effectiveness has not been investigated. This study aimed to determine the incidence of PONV based on PONV prophylaxis guidelines.The PONV in patients receiving ondansetron and metoclopramide were compared.This retrospective cohort study enrolled 365 patients undergoing general anesthesia for surgical procedures in Lopburi Cancer Hospital from August 2018 – May 2020. Retrospective data were collected from anesthetic records and medical records. According to the CPG, each patient was assessed for PONV risk by the simplified risk score and received prophylaxis medications. The overall incidence of PONV was 15.9%. In relation to PONV prophylaxis guideline, 91.3% received optimal prophylaxis. The incidence of PONV was 16.2% with optimal prophylaxis, which was no significant difference compared with the suboptimal & suboptimal prophylaxis groups. No significant difference in PONV prophylactic effect between ondansetron and metoclopramide was observed (OR 0.91, 95% CI 0.56-1.48). The incidence of PONV in Lopburi Cancer Hospital was high despite PONV prophylaxis usage following guidelines.This PONV prophylaxis guideline should be adjusted to improve PONV outcomes and suit our context.
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