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Gravid status is not associated with postoperative nausea and vomiting: a matched case–control study

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Abstract

Background

Postoperative nausea and vomiting (PONV) is a common and unpleasant complication of general anesthesia. There are well-known risk factors that predispose a patient to develop PONV. While studies exist that explore PONV incidence in gravid and non-gravid women separately, limited studies exist to compare the two cohorts to identify if pregnancy is associated with increased risk for PONV or differences in PONV prophylaxis and treatment.

Methods

This is a retrospective case–control cohort study, with 1:2 matching based on age, year of surgery, and surgical procedure. Electronic medical records were abstracted for demographic information, predisposing risk factors, prophylactic antiemetics, PONV documentation, rescue antiemetics, PACU stay, and length of hospitalization. Analyses of risk factors for PONV were performed using logistic and multinomial logistic regression analyses.

Results

237 gravid women who underwent non-obstetric procedures with general anesthesia were identified and matched with 474 non-gravid women. PONV complicated the course of 51 (21.5%) gravid and 72 (15.2%) non-gravid women. The number of prophylactic antiemetics was fewer among gravid (median 2 [1, 2]) than non-gravid (3 [2, 3]) women (P < 0.001). No association was found between gravid status and risk for PONV (adjusted odds ratio 1.35 [95%CI 0.84, 2.17], P = 0.222). Gravid women had longer hospital lengths of stay (P < 0.001), despite having shorter surgical duration (P = 0.015).

Conclusions

The risk for PONV is similar between gravid and similarly aged women. However, anesthesiologists administer fewer prophylactic antiemetics to gravid women during non-obstetric surgery.

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Data availability

This is derived from our institutional internal database and is not available to be shared with third parties.

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Funding

This work was supported by the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic. The authors were responsible for data interpretation and preparation, review, and approval of the manuscript. The corresponding author had final responsibility for the decision to submit for publication.

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Author notes

  1. A. Deljou and A. Kanaparthi contributed to the manuscript equally and are co-first authors.

Authors and Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, 200 First St SW, Rochester, MN, 55905, USA

    A. Deljou, A. Kanaparthi, J. Soleimani, J. Sprung, T. N. Weingarten & A. N. Chalupka

  2. Department of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine and Science, Rochester, MN, USA

    D. R. Schroeder

Authors
  1. A. Deljou
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  2. A. Kanaparthi
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  3. J. Soleimani
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  4. J. Sprung
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  5. D. R. Schroeder
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  6. T. N. Weingarten
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  7. A. N. Chalupka
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Contributions

AD contributed to data collection and drafting and revising of the manuscript. AK contributed to data collection and drafting and revising of the manuscript. JS (Jalal Soleimani) contributed to data collection. JS (Juraj Sprung) contributed to revising the manuscript. DRS contributed to statistical analysis. TNW contributed to the study conception and design, data collection, and drafting and revising of the manuscript. ANC contributed to the study design, data collection, and drafting and revising of the manuscript.

Corresponding author

Correspondence to A. Deljou.

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Conflict of interest

TNW reports financial support from Medtronic and Merck and non-financial support from Respiratory Motion.

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Deljou, A., Kanaparthi, A., Soleimani, J. et al. Gravid status is not associated with postoperative nausea and vomiting: a matched case–control study. J Anesth 37, 681–686 (2023). https://doi.org/10.1007/s00540-023-03220-5

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  • DOI: https://doi.org/10.1007/s00540-023-03220-5

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