Incidence and predictors of postoperative nausea and vomiting in children undergoing electrophysiology ablation procedures. Issue 2 (14th January 2020)

• Record Type: Journal Article
• Authors: Lee, Ye; Banooni, Andrew; Yuki, Koichi; Staffa, Steven J.; DiNardo, James A.; Brown, Morgan L.
• Editors: Veyckemans, Francis
• Is Part Of: Paediatric anaesthesia. Volume 30:Issue 2(2020:Feb.)
• Page Start: 147
• Page End: 152
• Publication Date: 2020-01-14
• Subjects: anesthesia -- children -- electrophysiology -- hypnotics and sedatives -- postoperative nausea and vomiting -- propofol; Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.13797
• Languages: English
• ISSNs: 1155-5645

Abstract

Abstract: Background: Postoperative nausea and vomiting remains a significant concern for patients undergoing general anesthesia for percutaneous radiofrequency catheter ablation and cryoablation for tachyarrhythmias. Aim: Our objective was to examine the incidence and risk factors for nausea and vomiting in the recovery room. Methods: Children aged > 2 and ≤ 18 years who underwent general anesthesia for a percutaneous radiofrequency catheter ablation or cryoablation for a tachyarrhythmia between January 1, 2013, and January 1, 2016, were retrospectively reviewed. Outcomes included postoperative nausea, vomiting, and a composite of postoperative nausea and vomiting in the recovery room. Results: We identified 611 patients with a mean age of 13.3 ± 3.9 years, 54.5% male, and a mean length of anesthesia was 3.9 ± 1.0 hours. Vomiting or retching in the postanesthesia care unit occurred in 7.4% of patients and nausea in an additional 12.4%. A composite of nausea and vomiting occurred in 95 patients (15.5%). On multivariable analysis, a subhypnotic propofol infusion (OR 0.45, 95% CI 0.23‐0.88, P = .019) and shorter anesthetic duration (OR 0.81 per 30 minutes, 95% CI 0.70‐0.94, P = .006) were independently associated with less vomiting in the recovery room. A history of PONV (OR 2.24, 95% CI 1.24‐4.05, P = .007) was independently associated with a composite of nausea and vomiting in the recovery room. Conclusions: A shorter anesthetic time and a subhypnotic propofol infusion were predictive of a lower rate of postoperative vomiting in patients undergoing general anesthesia for electrophysiologic ablation procedures.