Journal of the Chinese Medical Association
Volume 72, Issue 4 , Pages 183-187, April 2009

Risk Factors of Vomiting Among Females on Patient-controlled Epidural Analgesia

  • Yu-Ju Chen

      Affiliations

    • Department of Anesthesiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • ,
  • Kuang-Yi Chang

      Affiliations

    • Department of Anesthesiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • Division of Biostatistics, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C.
    • ,
  • Mei-Yung Tsou

      Affiliations

    • Department of Anesthesiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • ,
  • Shih-Pin Lin

      Affiliations

    • Department of Anesthesiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • ,
  • Kwok-Hon Chan

      Affiliations

    • Department of Anesthesiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • ,
  • Chien-Kun Ting

      Affiliations

    • Department of Anesthesiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Chien-Kun Ting, Department of Anesthesiology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 10 September 2008; accepted 19 March 2009.

Article Outline

Background

Postoperative pain and postoperative vomiting (POV) are both sources of distress in the postoperative period. Patient-controlled epidural analgesia (PCEA) is used in patients undergoing lower extremity surgery to improve postoperative quality but is accompanied by a certain incidence of vomiting. We wanted to determine the risk factors of POV in patients using PCEA with the aim of improving the quality of the postoperative period.

Methods

We conducted a retrospective study to analyze the risk factors among patients using PCEA after lower-limb surgery under regional anesthesia. A total of 195 patients (91 males, 104 females) were enrolled. They were categorized into 2 groups: vomiting and non-vomiting. We found that female gender predominated in the vomiting group. Hence, we analyzed the female subgroup in order to find the risk factors of vomiting in the female PCEA population.

Results

Female gender was the most significant factor related to vomiting (crude OR, 11.55; 95% CI, 4.88–27.33). From analysis of the female subgroup, puncture site (OR, 4.07; 95% CI, 1.41–11.79), catheter length in the epidural space (OR, 0.28; 95% CI, 0.16–0.50) and patient's height (OR, 1.07; 95% CI, 1.00–1.14) were also factors for vomiting, i.e. higher epidural catheter puncture site, shorter length in the epidural space, and greater height caused a higher incidence of POV.

Conclusion

The most important risk factor for POV in patients using PCEA was female gender. Among the female subgroup, the risk factors for POV included higher epidural catheter puncture site, shorter length in the epidural space and greater body height.

Key Words:  epidural analgesia , epidural catheter , logistic regression model , patient-controlled analgesia , postoperative vomiting

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PII: S1726-4901(09)70051-6

doi:10.1016/S1726-4901(09)70051-6

Journal of the Chinese Medical Association
Volume 72, Issue 4 , Pages 183-187, April 2009

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