Prevalence and factors associated with post-operative nausea and vomiting in patients after neurosurgery at Muhimbili Orthopaedic Institute

Abstract

ABSTRACT Background: There is a frequent occurrence of postoperative nausea and vomiting (PONV) as a complication that is mostly seen after surgery, which is related to a range of factors including those that are patient-related, anaesthesia and surgical in nature. The prevalence of PONV in neurosurgical procedures ranges from 30% in low-risk groups to 80% in high-risk groups globally. despite anaesthetic techniques advances and improvement in PONV recognition, prevention, treatment and management strategies. Such cases may cause complications that can delay healing. Objective: The aim of this study was to assess the prevalence and factors associated with PONV in patients after neurosurgery at Muhimbili Orthopaedic Institute (MOI). Methodology: This cross-sectional study at MOI ICU involved 72 participants. Data were collected using a checklist, covering consent, patient factors (age, sex, history of PONV, motion sickness, smoking status), anaesthetic factors (type of anesthesia, drugs used, inhalation agents, fasting time), surgical factors (type of operation, anatomical location, duration), and PONV events within the first 48 hours. Data were entered, cleaned, coded, and analyzed using SPSS Version 27. Descriptive statistics summarized continuous variables with median and interquartile range (IQR) and categorical variables with frequency tables. Associations were analyzed using chi-square tests with p-values ≤ 0.05 considered significant. Logistic regression (bivariate and multivariate) was used to assess relationships and effects. Result: The study included 72 patients with a median age of 44 years (IQR: 35–60). The prevalence of PONV was 52.8%. Significant independent predictors of PONV included: a history of motion sickness (OR = 2.96, 95% CI: 1.14–8.11, p = 0.029), a history of PONV (OR = 2.77, 95% CI: 1.08–7.37, p = 0.037), and smoking (OR = 3.09, 95% CI: 1.17–8.63, p = 0.006). Female patients experienced PONV more frequently than males (OR = 0.32, 95% CI: 0.12–0.84, p = 0.022). Fentanyl showed a nearly significant association with PONV (OR = 0.27, 95% CI: 0.06–0.99, p = 0.065). Conclusion and recommendation: Prevalence of PONV in neurosurgical patients at MOI is high at 52.8% associated with patient factors of history of motion sickness, sex, history of PONV, and smoking. MOI should formulate effective assessment, prevention, management, and treatment strategies focusing on patient factors to reduce PONV prevalence and related adverse outcomes.