Incidence and risk stratification of post-operative nausea and vomiting in patients who underwent laparoscopic cholecystectomy at the Zamboanga City Medical Center.

INTRODUCTION: Post-operative nausea and vomiting (PONV )remains to be one of the most common complications after laparoscopic cholecystectomy. PONV is a clinical issue that should be addressed by the physicians because it does not only prolong the patient's stay at the PACU, but is also lengthens hospital stay, there by, increasing hospital costs. More so, it may also increase morbidity rate, adversely affect recovery and sense of well- being post-operatively.

OBJECTIVES: This study determines the overall incidence of PONV and its rate according to the established variables such age, sex, BMI, smoking history and intra-abdominal pressure. 

METHODS: Utilizing an observation case-cohort design, all patients who underwent laparoscopic cholecystectomy between January 1, 2015 until September 30, 2015 are included in the study. Excluded are patients who are currently taking maintenance medication with known anti-emetic property, emergency cases and the conversion of a previous procedure to open cholecystectomy. A monitoring sheet is used in the recording of post-op vomiting and other related data.

RESULTS: Of the 43 patients who undergo cholecystectomy, 30% develop PONV. Among those who develop PONV, 62% of are females, 84% belongs to the middle-aged group (36-55 years old); 62% are overweight (BMI 25-29.9) and 77% are non-smokers. In the study intra-abdominal pressure is maintained to a desirable limit of less than 15mmHg. 

CONCLUSION: Post-operative nausea and vomiting (PONV) is indeed one of the complications of laparoscopic cholecystectomy. With a 30% incidence of PONV among post-laparoscopic cholecystectomy patients in our institution it is just prudent to address this adverse reaction perioperatively. Female gender is a risk factor for PONV based on this study. Although this study does not confirm association of age, obesity and non-smoking status to higher incidence of PONV, knowledge of these factors  should warrant the anesthesiologist efforts to alleviate PONV after every post-laparoscopic cholecystectomy procedure.