Abstract | PURPOSE: MATERIALS AND METHODS: We analyzed 7000 patients who received IV PCA with background infusion after elective surgery. Patients who maintained IV PCA for a postoperative period of 48 hr (completion group, n=6128) were compared with those who have discontinued IV PCA within 48 hr of surgery due to intractable PONV (cessation group, n=872). Patients, anesthetics, and surgical factors known for predicting PONV were evaluated by logistic regression analysis to identify independent predictors of IV PCA related intractable PONV. RESULTS: In a stepwise multivariate analysis, weight, background infusion dose of fentanyl, addition of ketolorac to PCA, duration of anesthesia, general anesthesia, head and neck surgery, and Apfel's simplified risk score were revealed as independent risk factors for intractable PONV followed by the cessation of IV PCA. In addition, Apfel's simplified risk score, which demonstrated the highest odds ratio among the predictors, was strongly correlated with the cessation rate of IV PCA. CONCLUSION: Multimodal prophylactic antiemetic strategies and dose reduction of opioids may be considered as strategies for the prevention of PONV with the use of IV PCA, especially in patients with high Apfel's simplified risk scores.
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Authors | Shin Hyung Kim, Yang-Sik Shin, Young Jun Oh, Jeong Rim Lee, Sung Chan Chung, Yong Seon Choi |
Journal | Yonsei medical journal
(Yonsei Med J)
Vol. 54
Issue 5
Pg. 1273-81
(Sep 2013)
ISSN: 1976-2437 [Electronic] Korea (South) |
PMID | 23918581
(Publication Type: Journal Article)
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Chemical References |
- Anesthetics, Intravenous
- Antiemetics
- Fentanyl
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Topics |
- Adult
- Analgesia, Patient-Controlled
(adverse effects)
- Anesthetics, Intravenous
(administration & dosage, adverse effects, therapeutic use)
- Antiemetics
(administration & dosage, therapeutic use)
- Female
- Fentanyl
(administration & dosage, adverse effects, therapeutic use)
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Odds Ratio
- Postoperative Nausea and Vomiting
(drug therapy)
- Retrospective Studies
- Risk Assessment
(methods)
- Risk Factors
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