Title: Arterial Hypotension During Induction of Anesthesia May Not Be a Risk Factor for Postoperative Nausea and Vomiting
Abstract: To the Editor: In the recently published report by Pusch et al. (1), the investigators concluded that a marked systolic blood pressure decrease >35% from preanesthetic baseline occurring during induction of anesthesia is associated with an increased incidence of postoperative nausea and vomiting (PONV). However, the association may be far weaker than the presented analysis suggests. Table 1 demonstrates that there is consistent bias with respect to proven risk factors for PONV between the hypotensive group (n = 54) and the cohort of patients classified as being normotensive (n = 246), namely the duration of anesthesia (114 min vs 97 min), nonsmokers (74% vs 60%), postoperative opioid administration (72% vs 58%), history of motion sickness (33% vs 26%) and PONV (44% vs 25%), the latter even being significantly different. Unfortunately the authors did not correct for these risk factors in their analysis. A logistic regression analysis that adjusts for the different “risk profiles” considering established risk scores (2) or potential confounding factors would have either provided a more convincing message or confirmed that we can rely on the already established risk factors for PONV that should be reported as minimal standard in trials on PONV (3). Peter Kranke, MD Norbert Roewer, MD, PhD Dirk Rüsch, MD Swen N. Piper, MD
Publication Year: 2003
Publication Date: 2003-01-01
Language: en
Type: letter
Indexed In: ['crossref', 'pubmed']
Access and Citation
Cited By Count: 2
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot