Risk Factors of Postoperative Nausea and Vomiting on General Anesthesia in RSUD Abdul Wahab Sjahranie Samarinda

  • Christopher Kevin Susanto Medical Program, Faculty of Medicine, Universitas Mulawarman, Samarinda, Indonesia
  • Eva Rachmi Department of Anatomy, Faculty of Medicine, Universitas Mulawarman, Samarinda, Indonesia
  • Muhammad Rizqan Khalidi Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Mulawarman, Samarinda, Indonesia


Postoperative Nausea and Vomiting (PONV) is the nauseous feeling within 24 hours after surgery. PONV increases the risk of fluid and electrolyte imbalance, re-opening of the surgical wound, and aspiration of gastric fluid. This study aimed to analyze the effect of postoperative opioid administration, duration of anesthesia, type of surgery, and BMI on the incidence of nausea and vomiting after surgery under general anesthesia, at Abdul Wahab Sjahranie Hospital, Samarinda. The research design employed in this research was a retrospective cohort study. The number of samples was 92 patients. The results of the analysis showed an increased risk of PONV in underweight – normal BMI patients (1.45 times higher risk; p=0.035), patients who received postoperative opioids (1.64 times higher risk; p=0.005), patients who underwent surgery that was potentially stimulating the vagus nerve (1.52 times riskier; p=0.02), and patients with anesthetic duration of more than 2 hours (1.93 times greater risk; p=0.007). Therefore, it could be concluded that BMI, postoperative opioid use, type of surgery, and duration of anesthesia influenced PONV incident on the use of general anesthesia at RSUD Abdul Wahab Sjahranie, Samarinda.

Keywords: postoperative nausea and vomiting, BMI, opioid after surgery, type of surgery, anesthesia duration


Alli, A., Omar, S., Tsang, S., & Naik, B. I. (2017). The Effect f Ethnicity on the Incidence of Postoperative Nausea and Vomiting in Moderate to High Risk Patients undergoing general Anesthesia in South Africa, A Controlles Observational Study. Middle East J Anaesthesiol., 24(2), 119–129. PMID: 30140116; PMCID: PMC6103314

Amirshahi, M., Behnamfar, N., Badakhsh, M., Rafiemanesh, H., Keikhaie, K., Sheyback, M., & Sari, M. (2020). Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis. Saudi Journal of Anaesthesia, 14(1), 48–56. https://doi.org/10.4103/sja.SJA_401_19

Apfel, C. C., Heidrich, F. M., Jukar-Rao, S., Jalota, L., Hornuss, C., Whelan, R. P., Zhang, K., & Cakmakkaya, O. S. (2012). Evidence-based analysis of risk factors for postoperative nausea and vomiting. British Journal of Anaesthesia, 109(5), 742–753. https://doi.org/10.1093/bja/aes276https://doi.org/10.1093/bja/aes276

Apipan, B., Rummasak, D., & Wongsirichat, N. (2016). Postoperative nausea and vomiting after general anesthesia for oral and maxillofacial surgery. Journal of Dental Anesthesia and Pain Medicine, 16(4), 273. https://doi.org/10.17245/jdapm.2016.16.4.273

Bhakta, P., Ghosh, B. R., Singh, U., Govind, P. S., Gupta, A., Kapoor, K. S., Jain, R. K., Nag, T., Mitra, D., Ray, M., Singh, V., & Mukherjee, G. (2016). Incidence of postoperative nausea and vomiting following gynecological laparoscopy: A comparison of standard anesthetic technique and propofol infusion. Acta Anaesthesiologica Taiwanica, 54(4), 108–113. https://doi.org/10.1016/j.aat.2016.10.002

Chatterjee, S., Rudra, A., & Sengupta, S. (2011). Current concepts in the management of postoperative nausea and vomiting. Anesthesiology Research and Practice, 2011. https://doi.org/10.1155/2011/748031

DiLorenzo, A. N., & Schell, R. M. (2014). Morgan & Mikhail’s Clinical Anesthesiology, 5th Edition. Anesthesia & Analgesia, 119(2), 495–496. https://doi.org/10.1213/ane.0000000000000298

Gan, T. J., Habib, A. S., Miller, T. E., White, W., & Apfelbaum, J. L. (2014). Incidence, patient satisfaction, and perceptions of post-surgical pain: Results from a US national survey. Current Medical Research and Opinion, 30(1), 149–160. https://doi.org/10.1185/03007995.2013.860019

Hanley, M. J., Abernethy, D. R., & Greenblatt, D. J. (2010). Effect of Obesity on the Pharmacokinetics of Drugs in Humans. Clinical Pharmacokinetics, 49(2), 71–87. doi: 10.2165/11318100-000000000-00000.

Hendrickx, J. F. A., Van Zundert, T., & De Wolf, A. M. (2020). End of year summary 2019: anaesthesia and airway management. Journal of Clinical Monitoring and Computing, 34(1), 3–7. https://doi.org/10.1007/s10877-019-00453-2

Iqbal, I. M., & Spencer, R. (2012). Postoperative nausea and vomiting. Anaesthesia and Intensive Care Medicine, 13(12), 613–616. https://doi.org/10.1016/j.mpaic.2012.09.012

Katzung, B. G., Masters, S. B., & Trevor, A. J. (2014). Farmakologi dasar dan klinik. In EGC (12th ed., Vol. 1).

Kim, J. H., Hong, M., Kim, Y. J., Lee, H. S., Kwon, Y. S., & Lee, J. J. (2020). Effect of body mass index on postoperative nausea and vomiting: Propensity analysis. Journal of Clinical Medicine, 9(6), 17–19. https://doi.org/10.3390/jcm9061612

Kranke, P., Apfel, C. C., Papenfuss, T., Rauch, S., Löbmann, U., Rübsam, B., Greim, C. A., & Roewer, N. (2001). An increased body mass index is no risk factor for postoperative nausea and vomiting. A systematic review and results of original data. Acta Anaesthesiologica Scandinavica, 45(2), 160–166. https://doi.org/10.1034/j.1399-6576.2001.450205.x

Leong, X. Y. A., Kwa, X. W. C., Ng, S. H. E., & Koh, L. K. D. (2015). Singapore General Hospital Experience on Ethnicity and the Incidence of Postoperative Nausea and Vomiting after Elective Orthopaedic Surgeries. Journal of Anesthesiology, 2015, 1–7. https://doi.org/10.1155/2015/952302

Look, X., Mok, M. U. S., Tay, Y. S., & Abdullah, H. R. (2018). How do Singapore patients view post-anaesthesia adverse outcomes? A single-centre willingness-to-pay study. Singapore Medical Journal, 59(5), 264–270. https://doi.org/10.11622/smedj.2017078

MacDougall, M. R., & Sharma, S. (2021). Chemoreceptor Trigger Zone. 2021 Aug 9. In: StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing; 2022 Jan–. PMID: 30725818.

Mauermann, E., Clamer, D., Ruppen, W., & Bandschapp, O. (2019). Association between intra-operative fentanyl dosing and postoperative nausea/vomiting and pain: A prospective cohort study. European Journal of Anaesthesiology, 36(11), 871–880. https://doi.org/10.1097/EJA.0000000000001081

Morino, R., Ozaki, M., Nagata, O., & Yokota, M. (2013). Incidence of and risk factors for postoperative nausea and vomiting at a Japanese Cancer Center: First large-scale study in Japan. Journal of Anesthesia, 27(1), 18–24. https://doi.org/10.1007/s00540-012-1468-5

Pasternak, G. W. (2014). Opiate pharmacology and relief of pain. Journal of Clinical Oncology, 32(16), 1655–1661. https://doi.org/10.1200/JCO.2013.53.1079

Seyni-Boureima, R., Zhang, Z., Antoine, M. M. L. K., & Antoine-Frank, C. D. (2022). A review on the anesthetic management of obese patients undergoing surgery. BMC Anesthesiology, 22(1), 1–13. https://doi.org/10.1186/s12871-022-01579-8

Shaikh, S., Nagarekha, D., Hegade, G., & Marutheesh, M. (2016). Postoperative nausea and vomiting: A simple yet complex problem. Anesthesia: Essays and Researches, 10(3), 388. https://doi.org/10.4103/0259-1162.179310

Silbernagl, S., & Lang, F. (2009). Color Atlas Pathophysiology. Thieme Flexibook. http://corporate.arcelormittal.com/who-we-are/at-a-glance

Stadler, M., Bardiau, F., Seidel, L., Albert, A., & Boogaerts, J. G. (2003). Difference in risk factors for postoperative nausea and vomiting. Anesthesiology, 98(1), 46–52. https://doi.org/10.1097/00000542-200301000-00011

Sudjito, M. H., Mulyata, & Setyawati, T. (2018). Kejadian Mual Muntah Pasca-Laparatomi ( PONV ) setelah Pemberian Granisetron Dibandingkan setelah Pemberian Kombinasi Ondansetron - Deksametason. Cermin Dunia Kedokteran, 45(3), 172–175.

Torabi Khah, M., Yousefi, H., Monazami Ansari, A. H., & Musarezaie, A. (2020). Prevalence of Postoperative Nausea and Vomiting and Pain in Patients Undergoing Elective Orthopaedic Surgery in Iran. Journal of Perianesthesia Nursing, 35(3), 294–297. https://doi.org/10.1016/j.jopan.2019.07.006

Vaughns, J. D., Ziesenitz, V. C., Williams, E. F., Mushtaq, A., Bachmann, R., Skopp, G., Weiss, J., Mikus, G., & Anker, J. N. van den. (2017). Use of Fentanyl in Adolescents with Clinically Severe Obesity Undergoing Bariatric Surgery - a Pilot Study. Paediatric Drugs, 19(3), 251–257. https://doi.org/10.1007/s40272-017-0216-6.Use
How to Cite
SUSANTO, Christopher Kevin; RACHMI, Eva; KHALIDI, Muhammad Rizqan. Risk Factors of Postoperative Nausea and Vomiting on General Anesthesia in RSUD Abdul Wahab Sjahranie Samarinda. Journal of Agromedicine and Medical Sciences, [S.l.], v. 8, n. 2, p. 96-101, june 2022. ISSN 2714-5654. Available at: <https://jurnal.unej.ac.id/index.php/JAMS/article/view/29227>. Date accessed: 23 may 2024. doi: https://doi.org/10.19184/ams.v8i2.29227.
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