Incidence and Factors Associated with Postoperative Nausea and Vomiting Following Elective Surgery Under General Anaesthesia: A Retrospective Observational Study

Abstract

Background: Postoperative nausea and vomiting (PONV) remains a frequent perioperative problem despite routine antiemetic use. Risk varies according to patient characteristics, operative exposure and postoperative analgesic requirements.

Objectives: To determine the incidence and severity of PONV after elective surgery under general anaesthesia and to examine associations with routinely documented perioperative risk factors.

Methods: Records of 40 adults undergoing elective surgery under general anaesthesia were analysed retrospectively. Demographic characteristics, ASA physical status, smoking status, previous PONV or motion sickness, type and duration of surgery, antiemetic prophylaxis, postoperative opioid use and documented PONV were extracted. The Apfel score was recalculated from its four standard components because the original score field was internally inconsistent. Categorical associations were examined using Fisher's exact test, and continuous variables using the Mann-Whitney U test.

Results: PONV occurred in 15/40 patients (37.5%). Among affected patients, mild, moderate and severe symptoms were recorded in 2, 8 and 5 patients, respectively. PONV was more frequent in women (13/21 vs 2/19; p=0.001), non-smokers (15/32 vs 0/8; p=0.016), patients with previous PONV/motion sickness (13/13 vs 2/27; p<0.001), those receiving postoperative opioids (15/23 vs 0/17; p<0.001), and those undergoing laparoscopic procedures (13/21 vs 2/19; p=0.001). Median operative duration was also longer in patients with PONV (155 vs 115 min; p<0.001). Antiemetic prophylaxis was not significantly associated with lower observed PONV in this small retrospective cohort (p=0.101).

Conclusion: PONV affected more than one-third of the cohort and clustered strongly among patients with recognised risk characteristics, particularly previous PONV or motion sickness, postoperative opioid exposure, female sex and laparoscopic surgery. The findings support structured preoperative risk assessment and risk-adapted multimodal prevention rather than reliance on routine prophylaxis alone.