A study of the knowledge, perceptions, and practices of anaesthetists towards paediatric post-operative nausea and vomiting management

Abstract

Background Postoperative nausea and vomiting (PONV) is a common adverse event after surgery and anaesthesia in European paediatric patients. Despite advances in PONV management, there remains inadequate adherence by anaesthetists to consensus guidelines. South Africa has a unique profile of paediatric PONV and limited literature on this topic could be identified. The aim of this study was to describe the knowledge, perceptions, and practices of anaesthetists in the University of Witwatersrand’s Department of Anaesthesiology towards the management of paediatric PONV. Methods A cross-sectional, contextual, descriptive study was done in the form of a structured self-administered electronic questionnaire. Data was collected on respondents’ practices, knowledge, and perceptions of paediatric PONV and its management. Results Data was collected from May 2022 to September 2022. A total of 149 questionnaires were analysed. 6% of respondents reported having patients who had experienced PONV in the last month. Less than half of anaesthetists reported assessing for risk factors (48%) or using clinical prediction tools (42%) for PONV. Despite this, 54% of respondents used prophylaxis for PONV in all patients. There was a 57% pass rate for the knowledge section of the questionnaire. Most anaesthetists (89%) appreciated the seriousness of PONV as a side effect, but just over half (50.3%) felt confident in managing it. Conclusion South African anaesthetists surveyed had limited experience of paediatric PONV. Respondents’ knowledge of PONV guidelines and management was poor and there was limited preoperative screening for PONV. However, many anaesthetists had adopted a liberal antiemetic prophylaxis strategy. This approach may be beneficial as it simplifies the management of an unfamiliar problem. However, this may also represent over treatment of a comparatively rare complication of anaesthesia. iv Integration of the global consensus on PONV management into the South African setting could be of great benefit to our paediatric population.