The effect of Apfel risk score and fasting times on postoperative nausea and vomiting: Post-Operative Nausea and Vomiting

Background: Postoperative nausea and vomiting (PONV) is an undesirable problem with many adverse effects on the patient. The first step toward effective treatment and prevention is to identify the patient's risk factors for PONV. This descriptive, cross-sectional study was conducted in the General Surgery Clinic between August 2017 and August 2018 to evaluate the effect of Apfel risk score and fasting duration on PONV and draw attention to this issue. Methods: A total of 283 patients who were scheduled for elective surgery were included in the study. The patients were evaluated using the Patient Evaluation Form created by the researcher by scanning the literature, and the Apfel Risk Scoring System. Results: The solid fasting time of the patients was 18.9 ± 28.9 h, the mean fluid fasting time was 13.9 ± 7.4 h, the mean operation time was 133 ± 76 min, the perceived hunger score was 3.1 ± 3.2, and the mean thirst score was 4.3 ± 3.2 and 16.8 ± 18.5. When the Apfel Risk Score and the incidence of all-time postoperative nausea and vomiting (PONV) were compared, a significant correlation was found between the patients' solid food fasting times and the incidences of the 2nd, 4th, 8th, and 24th hours. PONV incidence (p ˂ 0.01). Conclusion: The fasting times of the patients are longer than recommended. There is a parallel relationship between both long fasting times and the Apfel risk score and the incidence of PONV. It is recommended that institutions establish an evidence-based policy and take the necessary precautions in the preoperative evaluation of patients in terms of postoperative nausea and vomiting and during fasting periods.