-Original-

Factors Associated with Postoperative Nausea and Vomiting after Breast Cancer Surgery with Inhalation Anesthesia

Tomonori Morita, Makiko Yamamoto and Atsuhiro Sakamoto

Department of Anesthesiology, Nippon Medical School, Tokyo, Japan

Background: The incidence and risk factors of postoperative nausea and vomiting (PONV) and early PONV (ePONV) were evaluated in patients who underwent breast surgery with volatile anesthesia.
Methods: In this retrospective study, multivariate logistic regression was used to determine incidence and identify risk factors for PONV.
Results: Among 928 patients, 166 (18%) and 220 (24%) had ePONV and PONV, respectively. In multivariate analysis, anesthesia duration and use of desflurane were independent risk factors for ePONV. For PONV, anesthesia duration and Apfel score were independent risk factors.
Conclusions: Our results indicate that desflurane was the main cause of ePONV. However, during the delayed phase, a higher Apfel score was the strongest predictor. In the early and delayed phases, long anesthesia duration was associated with high risk of PONV. Thus, prolonged anesthesia and desflurane use should be avoided for patients at high risk of PONV, particularly those with high Apfel scores.

J Nippon Med Sch 2021; 88: 418-422

Keywords
PONV, sevoflurane, desflurane, anesthesia

Correspondence to
Tomonori Morita, Department of Anesthesiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
t-morit@nms.ac.jp

Received, August 14, 2020
Accepted, October 28, 2020