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Abstract

Background: Postoperative nausea and vomiting (PONV) are among the most frequent and distressing complications following surgeries performed under general anesthesia. Although often perceived as minor, PONV can significantly delay recovery, prolong hospital stays, and reduce patient satisfaction. Female patients undergoing laparoscopic cholecystectomy are particularly vulnerable due to several established risk factors. Effective identification and management of PONV are essential to improving perioperative care and patient outcomes.
Objective: To determine the prevalence and Apfel risk factors of PONV in female patients undergoing laparoscopic cholecystectomy.
Methods: This descriptive cross-sectional study was conducted at Lady Reading Hospital, Peshawar, from June to December 2023. A total of 200 ASA class I and II female patients aged above 18 years scheduled for elective laparoscopic cholecystectomy were enrolled through convenience sampling. Ethical approval was obtained, and written informed consent was taken from each participant. All patients received standardized general anesthesia with ondansetron 4 mg administered prophylactically. PONV was assessed at 4, 6, and 24 hours postoperatively. Data were analyzed using SPSS version 27, and results were presented as means, frequencies, and percentages.
Results: Out of 200 patients, 40 (20%) experienced PONV. Among these, 29 (72.5%) reported nausea, and 11 (27.5%) reported vomiting. The highest incidence occurred at 4 hours postoperatively, with 19 (68%) patients experiencing nausea and 11 (32%) vomiting. At 6 hours, 10 (20.8%) patients had nausea, and no vomiting was observed. No symptoms were recorded at 24 hours. Risk factor analysis revealed that non-smoking status, prior history of PONV or motion sickness, and postoperative opioid use were significantly associated with increased PONV incidence. The Apfel scoring system demonstrated strong predictive value.
Conclusion: PONV is a prevalent early postoperative complication in female patients undergoing laparoscopic cholecystectomy. The Apfel score proved to be an effective tool for identifying high-risk individuals. Early recognition and individualized prophylactic strategies are crucial for enhancing recovery and patient comfort.