POST OPERATIVE NAUSEA AND VOMITING COMPARISON OF GENERAL ANESTHESIA AND SUBARACHNOID BLOCK

Abstract

Background: Postoperative nausea and vomiting (PONV) are common complications following surgery, significantly affecting patient recovery and satisfaction. Multiple factors, including anesthesia type, patient history, and surgical characteristics, influence its occurrence. General anesthesia (GA) is frequently associated with a higher risk of PONV due to systemic exposure to emetogenic agents. In contrast, subarachnoid block (SAB), a regional anesthetic technique, is considered to have a more favorable postoperative profile with fewer gastrointestinal side effects.

Objective: To compare the incidence of postoperative nausea and vomiting among patients undergoing surgery under general anesthesia versus subarachnoid block.

Methods: A cross-sectional comparative study was conducted at Gulab Devi Teaching Hospital over six months. A total of 100 surgical patients aged 20 to 60 years were enrolled using purposive sampling and allocated into two groups: Group A (n=50) received general anesthesia, and Group B (n=50) received subarachnoid block. Inclusion criteria included ASA physical status I–III. Data on age, gender, motion sickness history, smoking, surgical type, opioid use, and PONV within 24 hours postoperatively were collected using a structured questionnaire. Statistical analysis was performed using SPSS version 26, applying Chi-square tests for associations.

Results: The incidence of PONV was significantly higher in the GA group, with 45 out of 50 patients (90%) experiencing PONV, compared to 20 out of 50 patients (40%) in the SAB group (p < 0.005). Among GA patients, 62% reported vomiting 1–2 times and 28% reported ≥3 episodes, while only 10% of SAB patients experienced vomiting ≥3 times. Nausea was constant in 34% of GA patients versus 18% in SAB patients. Risk factors such as motion sickness (60%), smoking (24%), and opioid use (76%) were also more prevalent in the GA group and significantly associated with PONV.

Conclusion: Subarachnoid block is associated with a substantially lower incidence of postoperative nausea and vomiting compared to general anesthesia, suggesting it as a preferable anesthetic technique, particularly in patients at higher risk of PONV.