Prevention of postoperative nausea and vomiting after cesarean delivery under neuraxial anesthesia and postpartum analgesia in Japan: A cross-sectional study

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2024-09-17 DOI:10.1111/jog.16087

Daisuke Sakamaki, Yuki Shiko, Yusuke Ikeda, Kaede Watanabe, Shohei Noguchi, Yohei Kawasaki, Yusuke Mazda

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引用次数: 0

Abstract

Aims

This study aims to investigate the clinical practice of physicians working in obstetric setting toward postoperative nausea and vomiting (PONV) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia.

Methods

We conducted this online survey to all active members of the Japan Society of Obstetric Anesthesiology and Perinatology (JSOAP), where leads academic society in obstetric anesthesia in Japan. The questionnaire was developed using the Delphi method. The survey included questions about routine practices for PONV prevention, the use of neuraxial opioids, optimal practices, and perceived obstacles. The email sent three times every 2 weeks as a reminder.

Results

A total of 1046 e-mails were sent, and 307 JSOAP members responded to the survey (29.3%). More than half of responders (62.7%) used neuraxial opioids with intrathecal morphine being the most frequent. They had a higher rate of multimodal PONV prophylaxis compared with who did not use neuraxial opioids for postoperative analgesia (19.9% vs 6.7%). Metoclopramide was the commonest medication for PONV prevention, and there was a significant difference in the use of 5-hydroxytryptamine receptor antagonists (19.9% vs. 8.6%, p = 0.012). We observed that 80% of physicians reported the routine administration of prophylaxis for PONV for CD. Among these, 20% indicated the use of two or more agents. Conversely, in the cohort not administering neuraxial opioids, only 6.7% reported the use of two or more agents.

Conclusion

The online survey showed that the physicians using neuraxial opioids for CD had a higher proportion of multimodal PONV management involving two or more agents.

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日本在神经麻醉和产后镇痛下预防剖宫产术后恶心和呕吐：横断面研究

方法我们对日本产科麻醉和围产医学会（JSOAP）的所有活跃会员进行了在线调查，该学会是日本产科麻醉领域的主要学术团体。调查问卷采用德尔菲法编制。调查内容包括预防 PONV 的常规做法、神经阿片类药物的使用、最佳做法和感知障碍等问题。结果共发送了 1046 封电子邮件，307 名 JSOAP 会员（29.3%）对调查做出了回复。超过一半的回复者（62.7%）使用神经阿片类药物，其中最常用的是鞘内吗啡。与不使用神经阿片类药物进行术后镇痛的人相比，他们使用多模式预防 PONV 的比例更高（19.9% 对 6.7%）。甲氧氯普胺是预防 PONV 的最常用药物，5-羟色胺受体拮抗剂的使用率存在显著差异（19.9% vs. 8.6%，p = 0.012）。我们观察到，80% 的医生报告说，他们对 CD 的 PONV 进行了常规预防。其中，20% 的医生表示使用了两种或两种以上的药物。结论在线调查显示，使用神经阿片类药物治疗 CD 的医生使用两种或两种以上药物进行多模式 PONV 管理的比例较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.