Incidence and risk factor evaluation for postoperative nausea and vomiting in cesarean section under general anesthesia compared to the gynecologic surgery: A retrospective study

Aim

This retrospective study sought to investigate the incidence of postoperative nausea and vomiting (PONV) and its associated risk factors in patients undergoing cesarean section under general anesthesia.

Methods

Patients who underwent cesarean section under general anesthesia or who underwent open gynecologic surgery were assigned to the OB group (n = 291) or the GY group (n = 225), respectively. The primary outcome was the incidence of PONV. Multivariable logistic regression analysis was performed to identify independent risk factors for PONV in the OB group. Propensity score matching was additionally conducted to facilitate a comparison of PONV incidence between the OB and GY groups (n = 66 in each group).

Results

In the OB group, 21 patients (7.2%) experienced PONV, which was significantly lower than the 68 patients (30.2%) in the GY group (p < 0.001). This difference remained statistically significant after propensity score matching (15.2% in the OB group vs. 31.8% in the GY group; p = 0.019). In multivariable logistic regression analysis of the OB group, abdominal surgical history (p = 0.032), longer surgical duration (p = 0.017), lower fluid intake (p = 0.011), and higher estimated blood loss (p = 0.009) were associated with PONV.

Conclusions

PONV may occur less frequently in patients undergoing cesarean section under general anesthesia than in those undergoing gynecologic surgery. In obstetric patients, substantial intraoperative blood loss with inadequate fluid replacement, prolonged surgical duration, and a history of abdominal surgery may represent additional risk factor for PONV.