Postoperative nausea and vomiting at a tertiary care hospital in north-western Tanzania

Abstract

Background: Postoperative nausea and vomiting is one of the most distressing morbidities associated with surgery. This descriptive prospective study was conducted to determine the incidence, predictors and management of postoperative nausea and vomiting among patients attending a tertiary hospital in north-western Tanzania.

Methods: The study was conducted in the surgical wards and intensive care unit of Bugando Medical Centre in Mwanza, Tanzania between January 2013 and December 2013. The study population included adult patients aged ≥18 years, classified as ASA I and who were scheduled for elective surgeries under general or region anaesthesia. Patients were assessed preoperatively, intraoperatively and postoperatively.  A questionnaire was administered to each patient in order to collect the information on demographic characteristics, estimated patient’s body mass index, smoking  status, prior history of motion sickness or post-operative nausea and vomiting (PONV), type and duration of surgery/anaesthesia, intraoperative pethidine use, postoperative pain and timing of oral intake.

Results: A total of 348 patients (age=18-76 years) were included in the study. The male to female ratio was 1.4: 1. The incidence of postoperative nausea and vomiting was 41.4%. Age group 21-30, female gender, history of PONV, general anaesthesia and intraoperative pethidine were the main predictors of PONV (p < 0.001). Only forty-five (31.3%) out of the 144 patients who reported their episodes of PONV received any medications.

Conclusion: The incidence of PONV among surgical patients at Bugando Medical Centre is unacceptably high and the predictors of postoperative nausea and vomiting within 24 hours included being a young adult, female, having history of PONV, been under general anaesthesia and intraoperative pethidine. It is recommended that patients with increased likelihood of developing postoperative nausea and vomiting should be given anti-emetic prophylaxis and other preventive measures.