Early Postoperative Nausea and Vomiting following General Anaesthesia in Patients Receiving Prophylactic Intravenous Ondansetron: A Retrospective Observational Study.

Abstract

Background: Postoperative nausea and vomiting (PONV) is a common complication following general anaesthesia. It causes patient discomfort, delays recovery, and can prolong discharge from the post-anaesthesia care unit. Ondansetron, a 5-hydroxytryptamine-3 (5-HT3) receptor antagonist, is widely used for PONV prophylaxis. This study examined the occurrence of early postoperative nausea and vomiting in patients who underwent surgery under general anaesthesia and received intravenous ondansetron before extubation.
Methods: This was a retrospective observational study based on review of the perioperative records of 50 patients who underwent surgery under general anaesthesia at the postoperative anaesthesia care unit of Mahatma Gandhi Medical College and Research Institute, Puducherry. Patient characteristics, documented PONV risk factors, timing of ondansetron administration, and postoperative vomiting were extracted from the records. Patients were categorised into low-, moderate-, and high-risk groups for PONV based on the number of established risk factors documented (0–1
factors: low risk; 2 factors: moderate risk; ≥3 factors: high risk).
Results: Of the 50 patient records reviewed, 15 patients (30%) experienced postoperative nausea and/or vomiting, while 35 patients (70%) did not. The study population comprised 33 male and 17 female patients. PONV occurred in 8 of 33 male patients (24.2%) and 7 of 17 female patients (41.2%). Risk stratification classified 35 patients (70%) as low risk, 12 (24%) as moderate risk, and 3 (6%) as high risk. All patients had received intravenous ondansetron before extubation; no untreated comparison group was available in the dataset.
Conclusions: Early PONV was documented in 30% of patients despite prophylactic intravenous ondansetron. These findings highlight the importance of systematic risk assessment and documentation of PONV before, during and after surgery. Because this study lacked a control group, the results cannot be used to draw conclusions about the comparative efficacy of ondansetron. Prospective studies using a standardised risk-assessment tool and a clearly defined antiemetic protocol are needed.