Examining the Predictors of Postoperative Nausea and Vomiting in Women Following Cesarean Delivery

Objective: To answer the following research questions: What is the incidence and severity of postoperative nausea and vomiting (PONV) for women during the 24‐hour period following surgery? What are the relationships between sociodemographics, obstetric/gynecologic (OB‐GYN) history and antiemetic received (e.g., type(s), timing, and frequency) and incidence and severity of PONV? Does the timing, type, and frequency of antiemetic use predict the incidence and severity of PONV when other known predictors are considered? Design: Retrospective descriptive correlational design. Setting: A 600‐bed community hospital in Southern California. Sample: Sixty women: White (61.7%), African American (1.7%), Hispanic (11.7%), Asian (18.3%), and nonspecified (6.6%) who had cesarean delivery. Methods: Information related to sociodemographic characteristics, medical and OB‐GYN history, treatment received during cesarean delivery, incidence and severity of PONV, and treatment measures received and outcomes were abstracted from the medical records following receipt of Institutional Review Board approval. Results: Thirty women (50%) complained of PONV during the 24‐hour period after surgery. The use of antiemetic during and after surgery immediately and the use of multimodal versus single therapy were associated with decreased incidence and severity of PONV (p < .001 and p = .018, respectively). In a multivariate model, these two variables accounted for 48% of the variance in PONV while age, type of anesthesia used, history of PONV, and gravidity and parity were controlled for. Conclusion/Implications for Nursing Practice: PONV is a common complaint of women who receive intrathecal morphine for analgesia during cesarean delivery. There is a paucity of evidence to support implementation of strategies to reduce PONV and minimize the negative outcomes associated with PONV following cesarean delivery. Findings show that the use of multimodal antiemetics during and after cesarean delivery immediately reduces the incidence and severity of PONV. Prospective studies examining the predictors of PONV in women after cesarean delivery are warranted to better explain this phenomenon and to guide clinical nurses into the development of policies and pathways to help reduce PONV in specified populations and to collaborate mother–infant care with other healthcare providers.