Abstract: The effectiveness of propofol infusion on postoperative nausea and vomiting (PONV) is poorly understood in relation to various patient and procedure characteristics. This retrospective cohort study aimed to quantify the effectiveness of propofol infusion when administered either via total intravenous administration (TIVA) or combined intravenous anesthesia (CIVA) with inhalational agents on PONV. The relationship between propofol infusion and PONV was characterized controlling for patient demographics, procedure characteristics, PONV risk factors, and antiemetic drugs in adult patients (age ≥18 years) undergoing general anesthesia. Learned coefficients from multivariate regression models were reported as "lift" which represents the percentage change in the base likelihood of observing PONV if a variable is present versus absent. In a total of 41,490 patients, models showed that propofol infusion has a naive effect on PONV with a lift of -41% ( P < .001) when using TIVA and -17% ( P < .001) when using CIVA. Adding interaction terms to the model resulted in the loss of statistical significance in these relationships (lift of -30%, P = .23, when using TIVA, and -42%, P = .36, when using CIVA). It was further found that CIVA/TIVA are ineffective in short cases (CIVA * short surgery duration: lift = 49%, P < .001 and TIVA * short surgery duration: lift = 56%, P < .001).
Competing Interests: Name: Edward Hoornstra, MHA, MSN, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Nishant Velagapudi, MS Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: John T. Bryant, MD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Douglas Roberts, MSN, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Lakshmana Behara, MS Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None Name: Ravitheja Venigandla, MS Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None Name: Prakash Mani, BS Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Bala G. Nair, PhD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None The authors did not discuss off-label use within the article. Disclosure statements are available upon request.
(Copyright © by the American Association of Nurse Anesthetists.)
Processing Request
No Comments.