Keywords
Vómito
Período post-operatorio
Paciente ambulatorio
Adherencia guía
Profilaxis
Antiemético Nausea
Vomiting
Post-operative period
Outpatient
Guideline compliance
Prophylaxis
And antiemetic agents
How to Cite
Abstract
Introduction: this observational trial assesses the compliance with our Clinical Practice Guidelines for the Prophylaxis of PONV (CPGPPONV). Methodology: our guidelines were based on the number of risk factors for developing PONV (female, non-smoker, previous PONV and post-operative administration of opioids), where the number of antiemetic prophylactic interventions = number of risk factors – 1. The population included adult patients at risk of PONV undergoing ambulatory surgery under general anesthesia. The PONV was documented at 2, 6, 24, 48, and 72 hours after surgery, as well as the compliance with the Guidelines (C versus non-compliance [NC]). NC was defined as a lower (NC-) or higher (NC+) of interventions versus the Guidelines. Total control (TC) was defined as the absence of emesis, no requirement for postoperative antiemetic agents, and absence of moderate nausea. Results: 39% of the 294 patients included received antiemetic prophylaxis in accordance with the Guidelines (CPGPPONV) (C). The NC- was 35% and NC+ was 26%. Despite the compliance (C), the TC rate was 65%; and 64% were NC-. Interestingly, with NC+ the TC rate was 85% (p <0.01 versus C and NC). Conclusions: compliance with our Guidelines (CPGPPONV) resulted in a decline in the antiemetic prophylactic effectiveness (as compared against the NC+), leading us to conclude that a more liberal preventive strategy (number of antiemetic prophylactic interventions = number of risk factors), may reduce the incidence of PONV in this type of patients.
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