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Risk Assessment of Postoperative Nausea and Vomiting in the Intravenous Patient-Controlled Analgesia Environment: Predictive Values of the Apfel's Simplified Risk Score for Identification of High-Risk Patients

DC FieldValueLanguage
dc.contributor.author김신형-
dc.contributor.author신양식-
dc.contributor.author오영준-
dc.contributor.author이정림-
dc.contributor.author최용선-
dc.date.accessioned2014-12-18T09:06:37Z-
dc.date.available2014-12-18T09:06:37Z-
dc.date.issued2013-
dc.identifier.issn0513-5796-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/87552-
dc.description.abstractPURPOSE: Opioid-based intravenous patient-controlled analgesia (IV PCA) is popular method of postoperative pain control, but many patients suffer from IV PCA-related postoperative nausea and vomiting (PONV). In this retrospective observational study, we have determined independent predictors of IV PCA-related PONV and predictive values of the Apfel's simplified risk score in pursuance of identifying high-risk patients. MATERIALS AND METHODS: We analyzed 7000 patients who received IV PCA with background infusion after elective surgery. Patients who maintained IV PCA for a postoperative period of 48 hr (completion group, n=6128) were compared with those who have discontinued IV PCA within 48 hr of surgery due to intractable PONV (cessation group, n=872). Patients, anesthetics, and surgical factors known for predicting PONV were evaluated by logistic regression analysis to identify independent predictors of IV PCA related intractable PONV. RESULTS: In a stepwise multivariate analysis, weight, background infusion dose of fentanyl, addition of ketolorac to PCA, duration of anesthesia, general anesthesia, head and neck surgery, and Apfel's simplified risk score were revealed as independent risk factors for intractable PONV followed by the cessation of IV PCA. In addition, Apfel's simplified risk score, which demonstrated the highest odds ratio among the predictors, was strongly correlated with the cessation rate of IV PCA. CONCLUSION: Multimodal prophylactic antiemetic strategies and dose reduction of opioids may be considered as strategies for the prevention of PONV with the use of IV PCA, especially in patients with high Apfel's simplified risk scores.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfYonsei Medical Journal-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAnalgesia, Patient-Controlled/adverse effects*-
dc.subject.MESHAnesthetics, Intravenous/administration & dosage-
dc.subject.MESHAnesthetics, Intravenous/adverse effects-
dc.subject.MESHAnesthetics, Intravenous/therapeutic use-
dc.subject.MESHAntiemetics/administration & dosage-
dc.subject.MESHAntiemetics/therapeutic use-
dc.subject.MESHFemale-
dc.subject.MESHFentanyl/administration & dosage-
dc.subject.MESHFentanyl/adverse effects-
dc.subject.MESHFentanyl/therapeutic use-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMultivariate Analysis-
dc.subject.MESHOdds Ratio-
dc.subject.MESHPostoperative Nausea and Vomiting/drug therapy*-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Assessment/methods-
dc.subject.MESHRisk Factors-
dc.titleRisk Assessment of Postoperative Nausea and Vomiting in the Intravenous Patient-Controlled Analgesia Environment: Predictive Values of the Apfel's Simplified Risk Score for Identification of High-Risk Patients-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Anesthesiology (마취통증의학)-
dc.contributor.googleauthorShin Hyung Kim-
dc.contributor.googleauthorYang-Sik Shin-
dc.contributor.googleauthorYoung Jun Oh-
dc.contributor.googleauthorJeong Rim Lee-
dc.contributor.googleauthorSung Chan Chung-
dc.contributor.googleauthorYong Seon Choi-
dc.identifier.doi10.3349/ymj.2013.54.5.1273-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00676-
dc.contributor.localIdA02123-
dc.contributor.localIdA02389-
dc.contributor.localIdA03098-
dc.contributor.localIdA04119-
dc.relation.journalcodeJ02813-
dc.identifier.pmid23918581-
dc.subject.keywordApfel’s simplified risk score-
dc.subject.keywordpatient-controlled analgesia-
dc.subject.keywordpostoperative nausea and vomiting-
dc.contributor.alternativeNameKim, Shin Hyung-
dc.contributor.alternativeNameShin, Yang Sik-
dc.contributor.alternativeNameOh, Young Jun-
dc.contributor.alternativeNameLee, Jeong Rim-
dc.contributor.alternativeNameChoi, Yong Seon-
dc.contributor.affiliatedAuthorKim, Shin Hyung-
dc.contributor.affiliatedAuthorShin, Yang Sik-
dc.contributor.affiliatedAuthorOh, Young Jun-
dc.contributor.affiliatedAuthorLee, Jeong Rim-
dc.contributor.affiliatedAuthorChoi, Yong Seon-
dc.rights.accessRightsfree-
dc.citation.volume54-
dc.citation.number5-
dc.citation.startPage1273-
dc.citation.endPage1281-
dc.identifier.bibliographicCitationYonsei Medical Journal, Vol.54(5) : 1273-1281, 2013-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers

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