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Anaesthesia
Article
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Anaesthesia
Article . 2019 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
Anaesthesia
Article . 2020
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Dynamic predictive model for postoperative nausea and vomiting for intravenous fentanyl patient‐controlled analgesia

Authors: D, Chae; S Y, Kim; Y, Song; W, Baek; H, Shin; K, Park; D W, Han;

Dynamic predictive model for postoperative nausea and vomiting for intravenous fentanyl patient‐controlled analgesia

Abstract

Summary Postoperative nausea and vomiting is the most common side‐effect of opioid‐based intravenous patient‐controlled analgesia. Apfel's simplified risk score is popular but it has some limitations. We developed and validated a dynamic predictive model for nausea or vomiting up to 48 postoperative hours, available as an online web application. Fentanyl was used by 22,144 adult patients for analgesia after non‐cardiac surgery under general anaesthesia: we randomly divided them into development (80%) and validation (20%) cohorts, repeated 100 times. We used linear discriminant analysis to select variables for multivariate logistic regression. The incidences of postoperative nausea or vomiting were: 0–48 h, 5691/22,144 (26%); 0–6 h, 2749/22,144 (12%); 6–12 h, 2687/22,144 (12%); 12–18 h, 2624/22,144 (12%); 18–24 h, 1884/22,144 (9%); and 24–48 h, 1082/22,144 (5%). The median (95%CI) area under the receiver operating characteristic curve was 0.72 (0.71–0.73) up to 48 postoperative hours compared with 0.65 (0.64–0.66) for the Apfel model, p < 0.001. The equivalent areas for 0–6 h, 6–12 h, 12–18 h, 18–24 h and 24–48 h were: 0.70 (0.69–0.72); 0.71 (0.69–0.73); 0.69 (0.68–0.71); 0.70 (0.67–0.72); and 0.69 (0.66–0.71), respectively. Our web application allows clinicians to calculate incidences of nausea and vomiting in patients receiving intravenous fentanyl for patient‐controlled analgesia.

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Keywords

Male, Postoperative Nausea and Vomiting/epidemiology, Motion Sickness, Motion Sickness/epidemiology, postoperative nausea and vomiting, 610, Opioid, Comorbidity, fentanyl, predictive model, Sex Factors, Patient-Controlled/adverse effects*, Risk Factors, Surveys and Questionnaires, 617, Humans, Anesthetics, Analgesics, Smoking, Surveys and Questionnaires*, Analgesia, Patient-Controlled, Smoking/epidemiology, Postoperative Nausea and Vomiting/diagnosis*, Middle Aged, intravenous patient-controlled analgesia, Intravenous/adverse effects*, Analgesics, Opioid, Fentanyl, Fentanyl/adverse effects*, Postoperative Nausea and Vomiting, Female, Analgesia, Anesthetics, Intravenous

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    popularity
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    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
17
Top 10%
Top 10%
Top 10%
Green
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