Anwendung von Prophylaxealgorithmen zur Prävention postoperativer Übelkeit und Erbrechens - eine Computersimulation

A number of algorithms to prevent postoperative nausea and vomiting (PONV) have already been proposed whose efficacy and efficiency remain unclear. By this study the suitability of 15 differing algorithms for the PONV prophylaxis on seven patient populations with different baseline risks has been researched by way of a computer simulation. The prophylaxis algorithms partially consisted of published and partially of hypothetically based algorithms. Among the seven populations examined three of them were data raised by this study at the Marburg university hospital. The four others were populations published by other clinics as well as hypothetically based populations with determined baseline risks. To evaluate the suitability of the individual algorithms within the various patient populations, different parameters as to efficacy and efficiency have been worked out. The so obtained findings permit the following conclusion for the clinical practice: To reach an optimal PONV-prophylaxis it is helpful to know the risk structure of one´s own clinic. The risk-adapted algorithms seem to be superior to the other ones. Despite an optimal prophylaxis the PONV-incidence still remains at about 20 percent.