A Prospective Study of Nausea and Vomiting After Breast Cancer Surgery.
Susan W Wesmiller, Catherine M Bender, Yvette P Conley and 4 others
PMID 28527544WHAT IT FOUND
Nausea was common after breast cancer surgery: 29.8% in recovery and 35.1% in the first 48 hours after surgery.
History of PONV, higher pain and more opioids were more common with PONV. Thirteen women had no PONV but nausea or vomiting after discharge.
Key findings
01In the PACU, 29.8% of women experienced nausea and 9% experienced nausea and vomiting.
02Forty-eight hours after surgery, 35.1% reported nausea and 8.2% reported vomiting; 13 women had no PONV but reported nausea or vomiting after discharge.
03Women with PONV had higher pain scores, received more opioids, and more often had a history of PONV; smoking levels were similar between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at one centre, and local practice with preoperative and postoperative medications may have influenced nausea and vomiting. The sample was mostly white, with only seven African American women, so findings cannot be generalised to other racial or ethnic groups. Only 12 current smokers were included, so smoking findings were limited. The study observed what happened and compared groups after nausea or vomiting occurred; it did not randomise treatment, so it cannot show that any medication or risk factor caused the symptoms. All patients received ondansetron, all but five also received dexamethasone, and some received scopolamine or an oral substance-p antagonist, so the effect of any single antiemetic cannot be separated.
The easy way to misread this
Do not read these results as proof that ondansetron, dexamethasone, scopolamine or the oral substance-p antagonist caused or failed to prevent nausea. All women received ondansetron, all but five also received dexamethasone, and some received additional antiemetics, so this study did not test the effect of any single medication.