An exploratory study of the relationship between post‐operative nausea and vomiting and post discharge nausea and vomiting in children undergoing ambulatory surgery

Abstract

Background

The factors contributing to postoperative nausea and vomiting in children have been identified, but there have been no reported studies that have studied pediatric post‐discharge nausea and vomiting .

Aims

A preliminary study of the factors affecting post discharge nausea and vomiting in ambulatory children, specifically whether postoperative nausea and vomiting factors are contributory.

Methods

122 pediatric patients aged 5‐10 years undergoing elective ambulatory surgery participated in this institution‐approved study. After obtaining written parental consent and patient assent when indicated, child self‐ratings of nausea and pain were completed pre‐operatively and at discharge, and for 3 days post‐discharge. Questionnaires were returned by mail, with a 64% return rate. Using stepwise logistic regression with backward elimination, three separate analyses were undertaken to predict the following outcomes: nausea present in recovery; nausea present on postoperative day 1 and emesis on day of surgery.

Results

Nearly half (47%) of our cohort experienced nausea at the time of discharge; 11% had emesis on day of surgery. On postoperative day 1 there was a 15% incidence of nausea with a 3% incidence of emesis. In the multiple logistic regression analyses, nausea at discharge was predicted by male gender (odds ratio 2.5, 95% CI: 1.0–6.2) and presence of pain on discharge (odds ratio 3.0, 95% CI: 1.0–9.2). Emesis on day of surgery was predicted by presence of nausea at discharge (odds ratio 16.9, 95% CI: 1.8–159.3) and having a family history of nausea/vomiting (odds ratio 8.3, 95% CI: 1.6–43.4). Presence of nausea on postoperative day 1 was predicted only by presence of nausea on discharge (odds ratio 3.7, 95% CI: 1.2–11.1).

Conclusions

Our preliminary data indicate that post‐operative nausea and vomiting may persist into the post‐discharge period and pain may be a contributing factor.

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