Postoperative Opioid Associated Nausea, Vomiting Risks Examined
|The following article features coverage from PAINWeek 2017 in Las Vegas, Nevada. Click here to read more of MPR's conference coverage.|
LAS VEGAS — Opioid treatment of acute postoperative pain was shown to cause high rates of postoperative nausea and vomiting, particularly in women and younger patients, according to research presented at PAINWeek 2017, held September 5 to 9, in Las Vegas, Nevada.1
To evaluate predictors of postoperative nausea and vomiting in patients receiving parenteral opioids, researchers retrospectively reviewed 592,127 adult patients from the Premier Perspective Database who underwent non-trauma surgery and received >1 dose of parenteral fentanyl, morphine, or hydromorphone for acute postoperative pain. Surgical procedures were categorized as general/colorectal, orthopedic, obstetric/gynecologic, cardiothoracic/vascular, and urologic. Researchers evaluated female gender, age, severity of illness, and average total daily morphine equivalent opioid dosing as risk factors for postoperative nausea and vomiting.
The rate of postoperative nausea and vomiting ranged from 44% for obstetrics/gynecology hospital stays to 72% for general/colorectal hospital stays, with an average rate across all surgical groups of 59%. Compared with men, women had a 1.5- to 1.8-fold increased risk for postoperative nausea and vomiting. Patients younger than 44 had an increased risk for nausea and vomiting compared with patients 55 to 64 for all surgical groups except obstetrics/gynecology.
The risk for nausea and vomiting increased in patients with higher all patient refined-diagnosis related group illness severity. Patients with the highest disease severity had a 3.6- (general/colorectal) to 5.6-fold (cardiothoracic/vascular) increased risk of postoperative vomiting compared with patients with minor illness severity.
The investigators concluded that their data were "consistent with the published literature." Based on these results, they suggested that alternatives to opioids for acute postoperative pain "can reduce the clinical burden of [postoperative nausea and vomiting] and improve patient-centered care in high-risk patients."
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- Senagore AJ, Habib AS, Morland K, et al. Predictors of post-operative nausea or vomiting associated with opioid treated acute postoperative pain. Presented at: PAINWeek 2017; September 5-9; Las Vegas, Nevada.