Pediatric anesthesia & critical care
Postoperative Nausea and Vomiting in Pediatrics: Incidence and Guideline Adherence—a Retrospective Cohort Study
Authors' conclusion
Our study revealed a lower-than-expected incidence of PONV in pediatric patients, highlighting the need for standardized definitions and improved reporting. Adherence to PONV guidelines was suboptimal, emphasizing the need for better implementation strategies.
Study context
- Population
- Pediatric patients (≤18 years) undergoing surgery, September 2020–March 2023median age 9.21 years
- Participants
- 3,772 patients
- Outcome
- Incidence of PONV and adherence to the Fourth Consensus Guidelines for PONV management
Methodological detailssingle-centre, tertiary medical center, multivariable logistic regression
- Single-centre
- Tertiary medical center
- Multivariable logistic regression
Main finding
As reported in the abstract
Incidence of PONV and guideline adherence
Early postoperative nausea and vomiting (PONV) incidence
1.0%
95% CI 0.7–1.4
Delayed PONV incidence
3.8%
95% CI 3.2–4.5
Adherence to fourth consensus guidelines
32.5%
95% CI 31.0–34.0
Observational data: associations, not effects.
Further findings
Predictors of guideline adherence
| OR | P value | |
|---|---|---|
| Intraoperative long-acting opioids | 2.711 | P < 0.001 |
| Age ≥3 years | 2.074 | P < 0.001 |
| Outcome | Nonadherence | Adherence | P value |
|---|---|---|---|
| PONV at 24 h postsurgery by guideline adherence | 4.4% (95% CI 3.6–5.2) | 2.7% (95% CI 1.9–3.8) | P = 0.012 |
- Predictors of guideline adherence — Specific high PONV risk surgeries also significant
- P = .001
- Predictors of guideline adherence — Maintenance with inhalational agents solely also significant
- P = .017
- Predictors of guideline adherence — Neostigmine use also significant
- P < .001
High PONV risk
- High risk of PONV
- 55.9% (95% CI 54.3-57.5)
- 3 risk factors, most common: 1151 patients
- 30.5% (95% CI 29.1-32.0)
Original publication
Postoperative Nausea and Vomiting in Pediatrics: Incidence and Guideline Adherence—a Retrospective Cohort Study. Anesth Analg. Published 19 November 2024. doi:10.
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