Investigation of the incidence of early and delayed postoperative nausea and vomiting (PONV) in different surgical specialties

Postoperative nausea and vomiting (PONV) can be classified as: a) early PONV (occurring within the first 2 hours postoperatively), and b) delayed PONV (occurring between 2 and 24 hours postoperatively). Objectives of this study were: to examine the incidence of early and delayed PONV; to determine which risk factors contribute significantly to the occurrence of PONV and to develop an appropriate strategy for the prophylaxis of PONV. A prospective cohort study included 431 adult patients undergoing elective surgery. The risk factors were classified into four categories: patient-related (individual) factors, surgery-related factors, anaesthesia- and drug-related factors, and postoperative factors. In our study main contributors to early PONV were female gender, BMI over 25 kg/m², history of motion sickness, the presence of chronic renal insufficiency, postoperative opioid use, and postoperative hypotension. Factors contributing to delayed PONV included female gender and history of motion sickness. Gynaecological procedures were associated with the highest risk for both early and delayed PONV. Prophylaxis of early PONV must be carried out through careful individualized drug dosing and measures to support hemodynamic stability. Prophylaxis of delayed PONV needs to be implemented through optimal postoperative pain control with minimal use of opioid analgesics. This study was not registered in a Clinical Trials Registry Platform because it is a prospective observational study. Ethical approval was obtained from the Institutional Ethics Committee (Ref. No. 19/1/2022, dated 20/12/2022) of the CHC Zemun.