PONV Prophylaxis Failure Disproportionately Affects Female Patients, Despite Intraoperative Computerized Decision Support Guidance

Authors

Karl A. Krieser, University of MichiganFollow
John B. Riley III, University of Nebraska Medical CenterFollow
Jospeh E. Baus, University of Nebraska Medical CenterFollow
Julie T. Hoffman, University of Nebraska Medical CenterFollow
James N. Sullivan MD, University of Nebraska Medical CenterFollow
Robert L. Lobato, University of Nebraska Medical CenterFollow

Document Type

Original Report

Disciplines

Anesthesia and Analgesia | Anesthesiology

Abstract

Objectives: To compare postoperative nausea and vomiting (PONV) prophylaxis treatment and outcomes based on patients’ sex, using a retrospective cohort. The setting was the operating room and post-anesthesia care unit of a tertiary care university medical center.

Patients: A total of 678 adult male and female patients with American Society of Anesthesiologist (ASA) scores of 1-4 underwent surgery with general anesthesia. All patients received preoperative PONV risk assessment. PONV prophylaxis was administered at the discretion of the anesthesia care team members with guidance from a computerized decision support system.

Measurements: Adequacy of prophylaxis was retrospectively determined based on individual patient risk factors and the observed treatment received, compared with guideline-based prophylaxis recommendations. Patient outcome was measured by diagnosis of PONV in recovery.

Results: Comparing patients who received fewer than the guideline-recommended number of prophylactic antiemetics by sex, 94.6% were female and 5.4% were males (p < 0.001). Patients who received fewer than guideline-recommended number of antiemetics had significantly higher rates of nausea or vomiting in the post-anesthesia care unit (30.4% vs 17.5%, p < 0.001).

Conclusion: This retrospective cohort study shows that female patients receiving general anesthesia are disproportionately affected by failure to adhere to PONV prevention guidelines.

DOI

10.32873/unmc.dc.gmerj.2.1.091

Embedded Media

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Recommended Citation

Krieser, K. A., Riley, J. B., Baus, J. E., Hoffman, J. T., Sullivan, J. N., , Lobato, R. L. PONV Prophylaxis Failure Disproportionately Affects Female Patients, Despite Intraoperative Computerized Decision Support Guidance. Graduate Medical Education Research Journal. 2020 Sep 29; 2(1).
https://digitalcommons.unmc.edu/gmerj/vol2/iss1/6