Prevalence and determinants of postoperative nausea and vomiting following opioid-based anesthesia in laparoscopic gynecological surgery: a cross-sectional study in a Sri Lankan cohort

Abstract

Background & objective: Postoperative nausea and vomiting (PONV) is a frustrating and uncomfortable experience for many patients after surgery, especially women undergoing laparoscopic gynecological procedures. Despite the widespread use of risk prediction techniques such as the Apfel score, little is known about how well these predictions apply to South Asian populations, especially women from Sri Lanka. This study evaluated prevalence and determinants of postoperative nausea and vomiting following opioid-based anesthesia in laparoscopic gynecological surgery.

Methodology: This project was carried out as a cross-sectional study at the Teaching Hospital of Peradeniya from October 2024 to March 2025. 276 women aged 18 to 65 years who underwent opioid anesthesia for elective laparoscopic gynecological procedures were included in the study. Every patient received the same anesthetic treatment. In this study, PONV symptoms were captured over 48 hours post-surgery, which were further utilized to investigate PONV contributing factors using advanced statistical tools.

Results: About one in four women (25.7%) developed PONV, which was lower than expected based on Apfel score predictions. Significant risk factors included a past history of motion sickness, previous PONV, and higher morphine use. Surgical complexity and duration had no clear link to PONV.

Conclusions: PONV remains a significant issue, but patient-specific factors, more than surgical ones, play the biggest role. Risk prediction tools may need local tailoring for better accuracy.

Abbreviations: IAP: intra-abdominal pressure, PONV: Postoperative nausea and vomiting,  

Keywords: Postoperative Nausea and Vomiting (PONV); Laparoscopic Gynecological Surgery; Sri Lankan Cohort; Risk Factors; Opioid Based Anaesthesia

Citation: Ratnayake A, Gnanarathne S, Kumarasiri G, Isurindi U. Prevalence and determinants of postoperative nausea and vomiting following opioid-based anesthesia in laparoscopic gynecological surgery: a cross-sectional study in a Sri Lankan cohort. Anaesth. pain intensive care 2025;29(8):905-911.

DOI: 10.35975/apic.v29i8.3017.

Received: July 18, 2025; Revised: August 05, 2025; Accepted: August 06, 2025