What are the factors affecting postoperative nausea and vomiting following breast cancer surgery with inhalation anesthesia?

Abstract

Background: The incidence and risk factors of postoperative nausea and vomiting (PONV) and early PONV (ePONV) was evaluated in patients who underwent breast surgery with volatile anesthesia.

Methods: In this retrospective study, we used a multivariate logistic regression to investigate the incidence and risk factors of PONV.

Results: Among 928 patients, 166 (18%) and 220 (24%) had ePONV and PONV, respectively. In the multivariate analysis, the anesthesia duration and the use of desflurane were independent risk factors for ePONV. For PONV, the anesthesia duration and Apfel score were the independent risk factors.

Conclusions: Although many previous studies have shown that PONV is a multifactorial event, our results indicate that desflurane use can be considered a main cause of ePONV. However, in the delayed phase, a higher Apfel score was the main predictor. In the early and delayed phases, a long duration of anesthesia was related to a high risk of PONV. Accordingly, avoiding a long duration of anesthesia and desflurane use is recommended for patients at a high risk of developing PONV, particularly for those with high Apfel scores.