Background: Postoperative nausea and vomiting (PONV) can have significant consequences on postoperative recovery and quality of care. The aim of our study was to investigate the association between anesthetic agents, antiemetic prophylaxis with dexamethasone (APD), and the occurrence of postoperative nausea and vomiting. Method: We conducted a case-control study (Cases: patients who received APD; Controls: patients who did not receive APD) including 108 patients who underwent surgery in the ENT, traumatology, and gynecology departments of Laquintinie Hospital in Douala. Sociodemographic data and the frequency of PONV within 48 hours post-surgery were collected in both groups and analyzed using R software. Fisher’s exact test was used to assess the association between anesthetic agents, APD, and the occurrence of PONV (95% CI, alpha = 5%). Results: The mean age of patients was 39.8 ± 10.2 years, with a male predominance (54.6%). PONV occurred in 7 (13%) patients in the case group and in 19 (35.2%) in the control group. Fentanyl (p = 0.012) and Halothane (p = 0.008) were significantly associated with the occurrence of PONV, while no significant association was found with Thiopental (p = 0.174), Propofol (p = 0.245), Ketamine (p = 0.108), or Isoflurane (p = 0.604). Conclusion: Anesthetic agents such as thiopental, propofol, ketamine, and isoflurane, when combined with DAP, may have effects on reducing the frequency of PONV.
References
[1]
Meyer, T.A., Hutson, L.R., Morris, P.M. and McAllister, R.K. (2023) A Postoperative Nausea and Vomiting Update: Current Information on New Drugs, Old Drugs, Res-cue/Treatment, Combination Therapies and Nontraditional Modalities. Advances in Anesthesia, 41, 17-38. https://doi.org/10.1016/j.aan.2023.05.002
[2]
Gan, T.J., Meyer, T., Apfel, C.C., Chung, F., Davis, P.J., Eubanks, S., et al. (2003) Consensus Guidelines for Managing Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 97, 62-71. https://doi.org/10.1213/01.ane.0000068580.00245.95
[3]
Williams, B.A., Schumacher, C.A., Choragudi, R., Garbelotti, K.E., Ludden, J.M. and Hall, D.E. (2025) Historical Perspectives Supporting the Ambitious Anesthetist Aiming for Zero Nausea/Vomiting: Should One Trust Every Consensus Statement Every Time? Frontiers in Anesthesiology, 3, Article 1525030. https://doi.org/10.3389/fanes.2024.1525030
[4]
Uribe, A.A., Stoicea, N., Echeverria-Villalobos, M., Todeschini, A.B., Esparza Gutierrez, A., Folea, A.R., et al. (2019) Postoperative Nausea and Vomiting after Craniotomy: An Evidence-Based Review of General Considerations, Risk Factors, and Management. Journal of Neurosurgical Anesthesiology, 33, 212-220. https://doi.org/10.1097/ana.0000000000000667
[5]
Kovac, A.L. (2000) Prevention and Treatment of Postoperative Nausea and Vomiting. Drugs, 59, 213-243. https://doi.org/10.2165/00003495-200059020-00005
[6]
Eberhart, L.H.J., Morin, A.M., Wulf, H. and Geldner, G. (2002) Patient Preferences for Immediate Postoperative Recovery. British Journal of Anaesthesia, 89, 760-761. https://doi.org/10.1093/bja/89.5.760
[7]
Gan, T.J., Belani, K.G., Bergese, S., Chung, F., Diemunsch, P., Habib, A.S., et al. (2020) Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesthesia & Analgesia, 131, 411-448. https://doi.org/10.1213/ane.0000000000004833
[8]
De Oliveira, G.S., Castro-Alves, L.J.S., Ahmad, S., Kendall, M.C. and McCarthy, R.J. (2013) Dexamethasone to Prevent Postoperative Nausea and Vomiting: An Updated Meta-Analysis of Randomized Controlled Trials. Anesthesia & Analgesia, 116, 58-74. https://doi.org/10.1213/ane.0b013e31826f0a0a
[9]
Apfel, C.C., Korttila, K., Abdalla, M., Kerger, H., Turan, A., Vedder, I., et al. (2004) A Factorial Trial of Six Interventions for the Prevention of Postoperative Nausea and Vomiting. New England Journal of Medicine, 350, 2441-2451. https://doi.org/10.1056/nejmoa032196
[10]
Smith, J.A. (2005) A Factorial Trial of Six Interventions for the Prevention of Postoperative Nausea and Vomiting. Journal of Urology, 173, 887-887. https://doi.org/10.1097/00005392-200503000-00072
[11]
Chen, C., Siddiqui, F.J., Chen, T., Chan, E.S. and Tam, K. (2011) Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Thyroidectomy: Meta-Analysis of Randomized Controlled Trials. World Journal of Surgery, 36, 61-68. https://doi.org/10.1007/s00268-011-1343-9
[12]
Wang, X., Zhou, Q., Pan, D., Deng, H., Zhou, A., Huang, F., et al. (2015) Dexamethasone versus Ondansetron in the Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Surgery: A Meta-Analysis of Randomized Controlled Trials. BMC Anesthesiology, 15, Article No. 118. https://doi.org/10.1186/s12871-015-0100-2
[13]
Sanger, G.J. and Andrews, P.L.R. (2018) A History of Drug Discovery for Treatment of Nausea and Vomiting and the Implications for Future Research. Frontiers in Pharmacology, 9, Article 913. https://doi.org/10.3389/fphar.2018.00913
[14]
Kianian, S., Bansal, J., Lee, C., Zhang, K. and Bergese, S.D. (2024) Perioperative Multimodal Analgesia: A Review of Efficacy and Safety of the Treatment Options. Anesthesiology and Perioperative Science, 2, Article No. 9. https://doi.org/10.1007/s44254-023-00043-1
[15]
Stoops, S. and Kovac, A. (2020) New Insights into the Pathophysiology and Risk Factors for PONV. Best Practice & Research Clinical Anaesthesiology, 34, 667-679. https://doi.org/10.1016/j.bpa.2020.06.001
