Perioperative medicine & outcomes
Investigating the Association Between a Risk-Directed Prophylaxis Protocol and Postoperative Nausea and Vomiting: Validation in a Low-Income Setting
Main finding · PONV, level change at start of postintervention periodResult — go to the resultOdds ratio 0.23 95% CI 0.05–1.01Authors' conclusion
A risk-directed PONV prophylaxis protocol was associated with reduced vomiting and time to first oral intake after implementation. There was no substantial difference in the slopes of vomiting incidence and time to first oral intake before and after implementation.
Study context
- Population
- Adults undergoing elective open abdominal surgery at Kigali University Teaching Hospital, Rwanda
- Participants
- 116 adults
- Comparison
- Postintervention vs Preintervention
- Outcome
- Incidence of PONV
- Follow-up
- First 48 hours postoperatively
Methodological detailsbefore-after implementation, single-centre
- Before-after implementation
- Single-centre
Main finding
As reported in the abstract
PONV, level change at start of postintervention period
Odds ratio
0.23
95% CI 0.05–1.01
Postintervention vs Preintervention
OR 0.23 (95% CI 0.05–1.01)
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Nausea, slopeNo difference in slope | 1.48 (0.60–3.65) | ||
| Vomiting, monthly trend during preintervention periodPer month; no change | 1.01 (0.61–1.67) | ||
| Vomiting, beginning of postintervention period vs just beforevs just before; odds decreased | 0.10 (0.02–0.47) | P = 0.004 | |
| 0.050.21520Odds ratio (log scale) |
Nausea, monthly trend
- Decreasing trend in odds of nausea per month: OR
- 0.60 (95% CI 0.36-0.97)
- Interrupted time series
Nausea, immediately after implementation
- No difference in incidence of nausea immediately after implementation: OR
- 0.96 (95% CI 0.25-3.72)
Time to first oral intake
- Significant decrease in average time to first oral intake when protocol first implemented, adjusted for confounders: estimated hours less
- 14 (95% CI, −25 to −3)
- No difference in slope of average time to first oral intake between the 2 periods
- P = 0.44
Original publication
Investigating the Association Between a Risk-Directed Prophylaxis Protocol and Postoperative Nausea and Vomiting: Validation in a Low-Income Setting. Anesth Analg. Published 12 October 2022. doi:10.
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