Universität zu Köln

Nowak, Hartmuth, Wolf, Alexander ORCID: 0000-0001-8875-586X, Rahmel, Tim, Oprea, Guenther, Grause, Lisa, Moeller, Manuela, Gyarmati, Katharina, Mittler, Corinna, Zagler, Alexandra, Lutz, Katrin, Loeser, Johannes, Saller, Thomas, Tryba, Michael, Adamzik, Michael, Hansen, Ernil and Zech, Nina (2022). Therapeutic Suggestions During General Anesthesia Reduce Postoperative Nausea and Vomiting in High-Risk Patients - A Post hoc Analysis of a Randomized Controlled Trial. Front. Psychol., 13. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-1078

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Abstract

Postoperative nausea and vomiting (PONV) are one of the most adverse events after general anesthesia, a distressing experience, and pose a risk to the patient. Despite advances in drug prophylaxis and PONV treatment, the incidence remains high and additional non-pharmacological treatments are needed. In this post hoc analysis of a recently published double-blind multicenter randomized controlled trial on the efficacy of intraoperative therapeutic suggestions on postoperative opioid dosage, we analyzed the effects of intraoperative therapeutic suggestions on PONV. We focus on patients with a high risk of PONV (Apfel risk score of 3-4) and distinguished early (first two postoperative hours) and delayed PONV (2-24 h). A total of 385 patients with a moderate or high risk for PONV were included. The incidence of early and delayed PONV was reduced (22.7-18.3 and 29.9-24.1%, respectively), without statistical significance, whereas in high-risk patients (n = 180) their incidence was nearly halved, 17.2 vs. 31.2% (p = 0.030) and 20.7 vs. 34.4% (p = 0.040), corresponding to a number needed to treat of 7 to avoid PONV. In addition, there was a significant reduction in PONV severity. In a multivariate logistic regression model, assignment to the control group (OR 2.2; 95% CI: 1.1-4.8) was identified as an independent predictor of the occurrence of early PONV. Our results indicate that intraoperative therapeutic suggestions can significantly reduce the incidence of PONV in high-risk patients. This encourages the expansion of therapeutic suggestions under general anesthesia, which are inexpensive and virtually free of side effects.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nowak, Hartmuth UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Alexander UNSPECIFIED orcid.org/0000-0001-8875-586X UNSPECIFIED Rahmel, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Oprea, Guenther UNSPECIFIED UNSPECIFIED UNSPECIFIED Grause, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Moeller, Manuela UNSPECIFIED UNSPECIFIED UNSPECIFIED Gyarmati, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Mittler, Corinna UNSPECIFIED UNSPECIFIED UNSPECIFIED Zagler, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Lutz, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Loeser, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Saller, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Tryba, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Adamzik, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Hansen, Ernil UNSPECIFIED UNSPECIFIED UNSPECIFIED Zech, Nina UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-682956
DOI:	10.3389/fpsyg.2022.898326
Journal or Publication Title:	Front. Psychol.
Volume:	13
Date:	2022
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-1078
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NITROUS-OXIDE; PREVENTION; SURGERY; INTERVENTIONS; METAANALYSIS; ISOFLURANE; EMPHYSEMA; ANXIETY; MEMORY; MUSIC Multiple languages Psychology, Multidisciplinary Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68295