Examining the Use of the Transdermal Scopolamine Patch in the Prevention of Postdischarge Nausea and/or Vomiting: A Secondary Analysis

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Hdl Handle:
http://hdl.handle.net/10755/603158
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Title:
Examining the Use of the Transdermal Scopolamine Patch in the Prevention of Postdischarge Nausea and/or Vomiting: A Secondary Analysis
Other Titles:
The Aftermath of Operative Prodedures: Research Pertaining to Operative Outcomes [Session]
Author(s):
Masiongale, James I.; Garvin, Jane; Murphy, Marguerite J.; Looney, Stephen W.; Garvin, Jane; Murphy, Marguerite J.; Looney, Stephen W.
Lead Author STTI Affiliation:
Beta Omicron
Author Details:
James I. Masiongale, CRNA, jmasiong@gru.edu; Jane Garvin, RN; Marguerite J. Murphy, RN; Stephen W. Looney
Abstract:
Session presented on Sunday, November 8, 2015: Postdischarge nausea and/or vomiting (PDNV) is estimated to affect up to 50% of patients undergoing general anesthesia.  New guidelines recommend long acting antiemetics for those considered to be at risk for PDNV.  Therefore, the purpose of this study was to examine the use of the long acting antiemetic, transdermal scopolamine patch (TDS), and the subsequent incidence of nausea and vomiting among ambulatory surgical patients.  From the multicenter observational cohort study of 2170 adult ambulatory surgical patients collected from 2007-2008, data were analyzed from 2098 participants with sufficient information to calculate risk scores.  The parent study contained variables of interest that were recoded for this study.  Descriptive statistics were used to characterize participants in terms of demographics, risk for nausea and/or vomiting, surgical procedure, TDS use (none, during anesthesia, or following the operation in the postanesthesia care unit), and incidence of nausea and/or vomiting.  On average, participants were overweight (body mass index = 28.3, SD = 6.9), approximately 50 years of age (M = 49.7, SD = 15.4) and primarily female (65%).  Common surgical procedures were general surgery (N = 426, 20%), gynecologic (N = 230, 11%), knee arthroscopy (N = 222, 11%), and breast (N = 219, 10%).  TDS was used in less than 4% of the participants; no TDS (N = 2020, 96%), TDS during anesthesia (N = 71, 3.4%), and TDS in PACU (N = 7, <1%).  For those qualified to receive a long acting antiemetic based on risk scores, less than 1% received TDS.  Over 90% (N = 64) of those receiving TDS during anesthesia had a PDNV Risk Score of ≥ 3; 86% (N = 6) of those receiving TDS in PACU had a PDNV Risk Score of ≥ 3.  Given the expected PDNV incidence of 20,30,50,60, and 80% for a risk score of 1,2,3,4,5, respectively, those not receiving TDS experienced PDNV at the expected incidence based on PDNV risk score (18,31,49,61,and 82% respectively).  Those receiving TDS during anesthesia generally had an incidence of PDNV less than expected (0, 40, 37, 53,and 71% respectively).  Six of the seven receiving TDS in PACU had a postoperative nausea and/or vomiting risk score ≥ 3.  Five of the seven receiving TDS in PACU had nausea and/or vomiting while in the PACU.  Those with a PDNV risk score of 3, 4, or 5 receiving TDS in PACU had higher incidence of PDNV than expected (67, 100, and 100%); this was likely due to providers reserving TDS for those with the highest risk scores and those already experiencing nausea or vomiting in the PACU.  Findings from this study highlight the limited use of TDS as a long acting antiemetic in ambulatory surgical settings and the potential value when given during anesthesia. While this cohort study has limitations, further study is needed to examine the effect of TDS on the individual components of PDNV (nausea, vomiting, nausea or vomiting, and nausea and vomiting), as well as severity of PDNV, using a randomized controlled trial to examine TDS across all levels of PDNV risk score.
Keywords:
Transdermal scopolamine patch; Postdischarge nausea and/or vomiting; Postdischarge nausea and/or vomiting risk factors
Repository Posting Date:
21-Mar-2016
Date of Publication:
21-Mar-2016
Other Identifiers:
CONV15C17
Conference Date:
2015
Conference Name:
43rd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Las Vegas, Nevada, USA
Description:
43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.titleExamining the Use of the Transdermal Scopolamine Patch in the Prevention of Postdischarge Nausea and/or Vomiting: A Secondary Analysisen
dc.title.alternativeThe Aftermath of Operative Prodedures: Research Pertaining to Operative Outcomes [Session]en
dc.contributor.authorMasiongale, James I.en
dc.contributor.authorGarvin, Janeen
dc.contributor.authorMurphy, Marguerite J.en
dc.contributor.authorLooney, Stephen W.en
dc.contributor.authorGarvin, Janeen
dc.contributor.authorMurphy, Marguerite J.en
dc.contributor.authorLooney, Stephen W.en
dc.contributor.departmentBeta Omicronen
dc.author.detailsJames I. Masiongale, CRNA, jmasiong@gru.edu; Jane Garvin, RN; Marguerite J. Murphy, RN; Stephen W. Looneyen
dc.identifier.urihttp://hdl.handle.net/10755/603158en
dc.description.abstractSession presented on Sunday, November 8, 2015: Postdischarge nausea and/or vomiting (PDNV) is estimated to affect up to 50% of patients undergoing general anesthesia.  New guidelines recommend long acting antiemetics for those considered to be at risk for PDNV.  Therefore, the purpose of this study was to examine the use of the long acting antiemetic, transdermal scopolamine patch (TDS), and the subsequent incidence of nausea and vomiting among ambulatory surgical patients.  From the multicenter observational cohort study of 2170 adult ambulatory surgical patients collected from 2007-2008, data were analyzed from 2098 participants with sufficient information to calculate risk scores.  The parent study contained variables of interest that were recoded for this study.  Descriptive statistics were used to characterize participants in terms of demographics, risk for nausea and/or vomiting, surgical procedure, TDS use (none, during anesthesia, or following the operation in the postanesthesia care unit), and incidence of nausea and/or vomiting.  On average, participants were overweight (body mass index = 28.3, SD = 6.9), approximately 50 years of age (M = 49.7, SD = 15.4) and primarily female (65%).  Common surgical procedures were general surgery (N = 426, 20%), gynecologic (N = 230, 11%), knee arthroscopy (N = 222, 11%), and breast (N = 219, 10%).  TDS was used in less than 4% of the participants; no TDS (N = 2020, 96%), TDS during anesthesia (N = 71, 3.4%), and TDS in PACU (N = 7, <1%).  For those qualified to receive a long acting antiemetic based on risk scores, less than 1% received TDS.  Over 90% (N = 64) of those receiving TDS during anesthesia had a PDNV Risk Score of ≥ 3; 86% (N = 6) of those receiving TDS in PACU had a PDNV Risk Score of ≥ 3.  Given the expected PDNV incidence of 20,30,50,60, and 80% for a risk score of 1,2,3,4,5, respectively, those not receiving TDS experienced PDNV at the expected incidence based on PDNV risk score (18,31,49,61,and 82% respectively).  Those receiving TDS during anesthesia generally had an incidence of PDNV less than expected (0, 40, 37, 53,and 71% respectively).  Six of the seven receiving TDS in PACU had a postoperative nausea and/or vomiting risk score ≥ 3.  Five of the seven receiving TDS in PACU had nausea and/or vomiting while in the PACU.  Those with a PDNV risk score of 3, 4, or 5 receiving TDS in PACU had higher incidence of PDNV than expected (67, 100, and 100%); this was likely due to providers reserving TDS for those with the highest risk scores and those already experiencing nausea or vomiting in the PACU.  Findings from this study highlight the limited use of TDS as a long acting antiemetic in ambulatory surgical settings and the potential value when given during anesthesia. While this cohort study has limitations, further study is needed to examine the effect of TDS on the individual components of PDNV (nausea, vomiting, nausea or vomiting, and nausea and vomiting), as well as severity of PDNV, using a randomized controlled trial to examine TDS across all levels of PDNV risk score.en
dc.subjectTransdermal scopolamine patchen
dc.subjectPostdischarge nausea and/or vomitingen
dc.subjectPostdischarge nausea and/or vomiting risk factorsen
dc.date.available2016-03-21T16:44:33Zen
dc.date.issued2016-03-21en
dc.date.accessioned2016-03-21T16:44:33Zen
dc.conference.date2015en
dc.conference.name43rd Biennial Conventionen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationLas Vegas, Nevada, USAen
dc.description43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`en
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