Evaluation of Post-Operative and Post-Discharge Nausea Vomiting and Associated Risk Factors Among Patients Undergoing Ambulatory Laparoscopic Cholecystectomy in Tertiary Care Hospital

Abstract

Post-operative nausea and vomiting (PONV)may lead to dehydration, bleeding, wound dehiscence, aspiration pneumonitis, and esophageal rupture. Post-discharge nausea and vomiting (PDNV) is acondition occurred during 24-72 hours of discharge. Both conditions have almost the same risk factors. Objective: To determine the frequency of post-operative and post-discharge nausea and vomiting and its associated factors among patients undergoing ambulatory laparoscopic surgery in a Tertiary Care Hospital. Methods: Total 106 patientsrequiring ambulatory laparoscopic surgery were included. Patient was kept under observation for at least 12 hourstill discharge. Post-discharge time of first incidence of nausea and/or vomiting was recorded. Normality was checked through Shapiro-Wilk test. To compare qualitative variables, chi-square test was used. If following Gaussian distribution, quantitative variables were compared using t-test; otherwise, Mann-Whitney U test was used. Logistic regression was applied to get Odd ratios. P-value ≤0.05 was taken as statistically significant. Results: Ketorolac was given to 104(98.1%) patients and only 2(1.9%) received tramadol. The most common complication was excessive bleeding 4(3.8%). Intraoperative opioids were given to 22(20.8%) patients. Post-operative vomiting and nausea among patients were found as 42(39.6%) and 20(18.9%) respectively. Post-discharge nausea and vomiting in patients were found as 14(13.2%) and 6(5.7%) respectively. Conclusions: Highprevalence of PONV and low prevalence of PDNV among patients who underwent ambulatory surgeries were reported. After ambulatory surgery the risk factors for PONV are observed as operation time>1h, female gender, postoperative pain during activitie, and postoperative pain at rest.