Risk factors for postoperative nausea and vomiting after general anesthesia: a systematic review and meta-analysis
Abstract
Objective: This systematic review and meta-analysis aimed to quantitatively analyze and summarize the risk factors of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia.
Methods: Literature screening, data extraction, and statistical analysis were conducted by an independent investigator. Meta-analyses were conducted for included studies using a random-effects method and generic inverse variance. All risk factors analyzed in the multifactorial regression models of the included studies were included in the meta-analysis to calculate the combined OR and 95% CI.
Results: We included 31 studies (n = 355,117). Patient-specific factors included female gender (OR 2.39), motion sickness (2.08), non-smoking (1.70), migraine (1.38), BMI (1.06), age (0.98), ASA II (0.97) and ASA III (0.84). Anesthetic factors included patient-controlled analgesia (1.51), volatile anesthetics (1.46), postoperative-opioids (1.32), duration of anesthesia (1.31), intraoperative-opioids (1.22), N2O (1.12), intravenous-anesthesia (1.12), fentanyl (1.07), preventive antiemetic (0.84), and hormone medications (0.81). Of the 16 surgical factors, breast surgery (2.13), cholecystectomy (2.07), abdominal surgery (1.37), gynecology surgery (1.34), and surgical duration (1.13) were statistically significant. The remaining surgical factors, namely plastic (2.01), ophthalmologic surgery (2.0), neurosurgery (1.71), head/neck surgery (1.38), ear/nose/throat surgery (1.34), orthopedics…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 355,117 participants or records.
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