PDF(Pubmed)
Abstract：
UNASSIGNED: Post-operative nausea and vomiting (PONV) is common, undesirable, and stressful following surgery. By focusing attention and resources on those groups of patients most likely to develop PONV, the quality of care provided to the patients can be improved. The primary objective was to compare the incidence of PONV after implementation of the Apfel scoring system with the control group receiving prophylaxis for every surgery. The secondary objective was to identify the effect on the patient\'s expenditure/savings with respect to management of PONV.
UNASSIGNED: This prospective randomized controlled double-blinded study enrolled 70 patients undergoing surgeries under general anesthesia. Patients were randomized to group A (control group - all received PONV prophylaxis) and group B (Apfel stratification performed for PONV prophylaxis). Based on the Apfel system, the risk of PONV was classified as the grades low, moderate, and high risk. Patients at moderate and high risk received PONV prophylaxis in group B. Patients were monitored for PONV during 24 h after surgery and rescue medication given as required. The effect of implementing Apfel risk stratification on the incidence of PONV (primary outcome measure) and on patient expenditure was compared.
UNASSIGNED: Compared to administering prophylaxis for all patients, the incidence of PONV [group A-5 patients (14.3%)] did not increase (P = 0.428) after implementing the Apfel scoring system [group B-2 patients (5.7%)]. The number of patients spending on prophylaxis for PONV in group A [35 (100%)] was higher than that in group B [17 (48%)], without increasing expenditure on PONV treatment.
UNASSIGNED: Withholding prophylaxis on the basis of the Apfel scoring system did not increase the incidence of PONV compared to providing prophylaxis for all the patients. The overall cost of prevention and treatment of PONV is less when the Apfel scoring system is used.
UNASSIGNED: This prospective randomized controlled double-blinded study enrolled 70 patients undergoing surgeries under general anesthesia. Patients were randomized to group A (control group - all received PONV prophylaxis) and group B (Apfel stratification performed for PONV prophylaxis). Based on the Apfel system, the risk of PONV was classified as the grades low, moderate, and high risk. Patients at moderate and high risk received PONV prophylaxis in group B. Patients were monitored for PONV during 24 h after surgery and rescue medication given as required. The effect of implementing Apfel risk stratification on the incidence of PONV (primary outcome measure) and on patient expenditure was compared.
UNASSIGNED: Compared to administering prophylaxis for all patients, the incidence of PONV [group A-5 patients (14.3%)] did not increase (P = 0.428) after implementing the Apfel scoring system [group B-2 patients (5.7%)]. The number of patients spending on prophylaxis for PONV in group A [35 (100%)] was higher than that in group B [17 (48%)], without increasing expenditure on PONV treatment.
UNASSIGNED: Withholding prophylaxis on the basis of the Apfel scoring system did not increase the incidence of PONV compared to providing prophylaxis for all the patients. The overall cost of prevention and treatment of PONV is less when the Apfel scoring system is used.
摘要：
■术后恶心和呕吐（PONV）很常见，不受欢迎的，手术后压力很大.通过将注意力和资源集中在那些最有可能发生PONV的患者群体上，可以提高向患者提供的护理质量。主要目的是比较实施Apfel评分系统后的PONV发生率与接受每次手术预防的对照组。次要目标是确定PONV管理对患者支出/节省的影响。
■这项前瞻性随机对照双盲研究招募了70名在全身麻醉下进行手术的患者。患者被随机分为A组（对照组-均接受PONV预防）和B组（进行PONV预防的Apfel分层）。基于Apfel系统,PONV的风险被归类为低等级，中度,和高风险。B组中高危患者接受PONV预防，术后24小时监测患者PONV，并根据需要给予抢救药物。比较了实施Apfel风险分层对PONV发生率（主要结果指标）和患者支出的影响。
■与对所有患者进行预防相比，实施Apfel评分系统[B-2组患者(5.7%)]后,PONV[A-5组患者(14.3%)]的发生率没有增加(P=0.428).A组预防PONV的患者人数[35（100％）]高于B组[17（48％）]，在不增加PONV治疗支出的情况下。
■与为所有患者提供预防相比，基于Apfel评分系统的保留预防并未增加PONV的发生率。使用Apfel评分系统时，预防和治疗PONV的总成本较低。
■这项前瞻性随机对照双盲研究招募了70名在全身麻醉下进行手术的患者。患者被随机分为A组（对照组-均接受PONV预防）和B组（进行PONV预防的Apfel分层）。基于Apfel系统,PONV的风险被归类为低等级，中度,和高风险。B组中高危患者接受PONV预防，术后24小时监测患者PONV，并根据需要给予抢救药物。比较了实施Apfel风险分层对PONV发生率（主要结果指标）和患者支出的影响。
■与对所有患者进行预防相比，实施Apfel评分系统[B-2组患者(5.7%)]后,PONV[A-5组患者(14.3%)]的发生率没有增加(P=0.428).A组预防PONV的患者人数[35（100％）]高于B组[17（48％）]，在不增加PONV治疗支出的情况下。
■与为所有患者提供预防相比，基于Apfel评分系统的保留预防并未增加PONV的发生率。使用Apfel评分系统时，预防和治疗PONV的总成本较低。
