The influence of anxiety as a potential cause of postoperative nausea and vomiting (PONV) has not been explored. After conducting an observational study at a university hospital, researchers concluded that anxiety-sensitive patients were at an increased risk for experiencing PONV. The results were published in the European Journal of Anaesthesiology.

Non-smoking women age 18 to 75 years who underwent elective interventions in surgery and received general anesthesia were included in the study (N=135). Risk factors for PONV (female sex, non-smoking status, expected postoperative administration of opioids, and a history of PONV or motion sickness) were assessed and recorded. Patients completed a preoperative anxiety-sensitivity questionnaire that assessed 3 subscales: somatic concerns, cognitive concerns, and social concerns. PONV prophylaxis (dexamethasone, 5 to 10 mg before anesthesia; ondansetron, 4 mg after surgery) was administered, and the incidence of PONV within the first 24 hours after surgery was evaluated.

The majority of surgical interventions occurred in 3 subspecialties of general surgery (n=77), gynecologic surgery (n=39), and urologic surgery (n=19). A total of 56 patients (41.5%) were found to have PONV within the first 24 hours following surgery. Significantly higher anxiety sensitivity scores were found in patients with PONV compared with patients without PONV (87.5% vs 65.8%, respectively), suggesting that anxiety sensitivity can contribute to the estimation of an individual’s risk for PONV. Patients with PONV were younger, less likely to have received PONV prophylaxis, had received opioids for postoperative analgesia more often, and had undergone laparoscopic surgery more frequently.

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“The current study reveals that psychological factors such as anxiety sensitivity help to predict the risk of PONV in a selected group of nonsmoking women,” the researchers concluded.

Reference

Laufenberg-Feldmann R, Müller M, Ferner M, Engelhard K, Kappis B. Is ‘anxiety sensitivity’ predictive of postoperative nausea and vomiting?: A prospective observational study [published March 8, 2019]. Eur J Anaesthesiol. doi:10.1097/EJA.0000000000000979