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Therapeutic suggestions during general anesthesia reduce postoperative nausea and vomiting in high-risk patients

  • 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 \(\textit {post hoc}\) 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 (\(\it n\) = 180) their incidence was nearly halved, 17.2 vs. 31.2% (\(\it p\) = 0.030) and 20.7 vs. 34.4% (\(\it p\) = 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.

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Author:Hartmuth Sebastian Burkhard NowakORCiDGND, Alexander WolfORCiDGND, Tim RahmelORCiDGND, Günther OpreaGND, Lisa GrauseGND, Manuela MöllerGND, Katharina GyarmatiGND, Corinna MittlerGND, Alexandra ZaglerGND, Katrin LutzGND, Johannes LoeserGND, Thomas SallerGND, Michael TrybaORCiDGND, Michael AdamzikORCiDGND, Ernil HansenORCiDGND, Nina ZechGND
Parent Title (English):Frontiers in psychology
Subtitle (English):a \(\textit post hoc}\) analysis of a randomized controlled trial
Publisher:Frontiers Research Foundation
Place of publication:Lausanne, Schweiz
Document Type:Article
Date of Publication (online):2023/10/17
Date of first Publication:2022/07/15
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Open Access Fonds
general anesthesia; hypnotherapy; patient communication; postoperative nausea and vomiting; therapeutic suggestions
Issue:13, Article 898326
First Page:898326-1
Last Page:898326-11
Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum.
Institutes/Facilities:Knappschaftskrankenhaus Bochum, Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International