Risk factors of postoperative nausea and vomiting in catheter ablation under general anesthesia：A single-center retrospective study

Abstract

Background : In recent years, catheter ablation(ABL)under general anesthesia has been increasingly used to improve the success rate of ABL by minimizing pain and the risk of patient movement during the procedure. To date, the incidence of perioperative anesthesia-related complications related to ABL is not known in Japan. We retrospectively examined the incidence and risk factors of postoperative nausea and vomiting(PONV)in following ABL under general anesthesia.
Methods : Of 161 patients who underwent ABL under general anesthesia between October 1, 2018, and September 14, 2020 at our hospital, 159 patients who did not undergo emergency surgery were included. We divided the patients into PONV and non-PONV groups according to the presence or absence of PONV within 24 h after surgery. The main outcome was the incidence of PONV within 24 h after surgery. We also retrospectively compared patient background and perioperative factors before surgery.
Results : PONV was observed in 30 of the 159 patients(18.9%). Significant demographic differences between the PONV and non-PONV groups were identified. These included non-smoking(66.7% vs 37.2%, p = 0.005), non-habitual drinking(86.7% vs 49.6%, p <0.0001), female sex(60% vs 19.4%, p <0.0001), total infusion volume(7.0 mL/kg/h vs 6.1 mL/kg/h, p = 0.0397), and crystalline liquid use(6.8 mL/kg/h vs 5.8 mL/kg/h, p = 0.0350). No significant differences were found in the other explanatory variables. Multivariate analysis revealed that female sex(odds ratio : 3.03 ; 95% CI : 1.11-8.29, p = 0.0305)and non-habitual drinking(odds ratio : 4.31 ; 95% CI : 1.33-13.94, p = 0.0149)were independently associated with PONV. In addition to PONV, gastrointestinal symptoms such as gastric discomfort and heartburn were observed in 21 patients(13.2%).
Conclusion : Female sex and non-habitual drinking were risk factors for PONV in ABLs under general anesthesia. It is necessary to pay attention to the same PONV risk factors in ABL as those in conventional general anesthesia surgery.