Evaluation of Preoperative Anxiety Sensitivity as a Risk Factor for Postoperative Nausea and Vomiting

Background and Aims: Psychological factors such as anxiety sensitivity may influence the risk of postoperative nausea and vomiting (PONV). We evaluated the effect of preoperative anxiety sensitivity on the incidence (primary objective) and severity of PONV. Predictive value of anxiety sensitivity and of other established risk factors for PONV was also determined. Methods: This prospective and observational study was performed in 121 adults undergoing elective surgery under general anesthesia. Preoperative anxiety sensitivity was assessed using the Anxiety Sensitivity Index-3 (ASI-3). The Visual Analog Scale (VAS) score was used to assess preoperative anxiety and occurrence of PONV in the first 24 h. Statistical analysis was performed using the SPSS software version 21 program for Windows. Results: The incidence of PONV in the first 24 h was 59.5% (72 of 121 patients). The median (interquartile range [IQR]) ASI-3 scores (5 [2–13] and 4 [1–8]; [ P = 0.068]) and median (IQR) VAS anxiety scores (2.8 [1.4–4.9] and 2 [1.4–3)]; P = 0.137) were comparable in patients with and without PONV. A statistically significant correlation was noted between VAS anxiety score and ASI-3 score, rho = 0.18, P = 0.044. Female gender ( P < 0.001), postoperative opioids (0.035), previous history of motion sickness or PONV ( P = 0.041), and intraoperative bradycardia ( P = 0.003) were found to be significant risk factors for PONV. Conclusion: Preoperative anxiety sensitivity as assessed by ASI-3 score does not increase PONV in adult patients undergoing elective surgery under general anesthesia. Female gender, postoperative opioids, intraoperative bradycardia, and previous history of PONV or motion sickness were found to be significant risk factors for PONV.