Analysis of PONV incidence in gynaecology patients

Dorota Ćwiek, Arleta Wojciechowska, Katarzyna Szymoniak, Dorota Fryc, Marta Stanisz, Janusz Menkiszak


Introduction: Postoperative nausea and vomiting (PONV) is the most common side effect of anaesthesia, as reported by patients in the postoperative period. The overall incidence of PONV, according to various authors, is in the 8–92% range. The latest research on the pathophysiology of vomit reflexes has played an important role in changing the perception of PONV and introduction of PONV prevention, which significantly improves patient comfort by reducing the number of complications and shortening the length of the hospital stay.

The aim of the study was to analyse the incidence of PONV
in gynaecological patients.

Materials and methods: The study was conducted among 300 women, patients of the Surgical Gynaecology and Gynaecological Oncology Clinic for Adults and Girls at the Independent Public Clinical Hospital No. 2 of the Pomeranian Medical University in Szczecin, who underwent surgery due to a variety of gynaecological conditions in the period from May to October 2015. The research tool was the author’s own questionnaire containing 22 closed-ended questions. The questionnaire included demographics as well as an assessment of the state of the women’s health in terms of complications (nausea, vomiting), and substance use (tobacco, alcohol). Patient medical records were also analysed.

Results: The results demonstrated: 1) no relationship between the socio-demographic variables and the incidence of nausea and vomiting in the postoperative period; 2) no relationship between PONV and specific medical variables, such as alcohol use, body mass index (BMI), administration of opioids such as fentanyl and fentanyl plus morphine; 3) a relationship between the type of surgery, anaesthesia used, smoking, and the incidence of nausea and vomiting; 4) a high risk of nausea and vomiting in patients after administration of spinal morphine into the subarachnoid space; 5) metabolic diseases, diseases of the lower digestive tract, respiratory conditions, and motion sickness had a negative influence on the incidence of PONV.

Conclusions: 1. The type and duration of surgery as well as the type of anaesthesia and opioids used affected the incidence of nausea and vomiting in the postoperative period. If possible, every effort should be made to shorten the duration of surgery, perform surgery laparoscopically and administer drugs, which do not affect the incidence of nausea and vomiting. 2. There is a need for organisational changes in hospitals regarding the introduction and compliance with ERAS, in particular, with regard to the withdrawal of food and drink before surgery.
3. The use of chewing gum strongly reduced the incidence of nausea and vomiting. Therefore, it would be important to introduce, as a standard practice, this non-pharmacological prevention method in the postoperative period.


nausea; vomiting; PONV; prevention; gynaecology; risk factors

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