Q: 34 year old female is admitted to ICU after video-assisted thoracoscopic surgery(VATS) due to persistent severe nausea and an episode of vomiting in recovery area. All of the following are predictor of Postoperative Nausea and Vomiting  (PONV) except?

A) complain of nausea and vomiting prior to the surgery 
B) Female gender 
C) Smoking status 
D) Young age
E) History of motion sickness


Answer: C

It may be of interest to know that non-smoking status is an independent risk factor for PONV. As expected, all other choices in the question are good predictors of PONV. 

Female gender is considered to be the strongest overall predictor for PONV.



References:

1. Cohen MM, Duncan PG, DeBoer DP, Tweed WA. The postoperative interview: assessing risk factors for nausea and vomiting. Anesth Analg 1994; 78:7.

2. Stadler M, Bardiau F, Seidel L, et al. Difference in risk factors for postoperative nausea and vomiting. Anesthesiology 2003; 98:46.

3.  Apfel CC, Heidrich FM, Jukar-Rao S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth 2012; 109:742.

4. Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted? Anesthesiology 1999; 91:109.

5. Palazzo M, Evans R. Logistic regression analysis of fixed patient factors for postoperative sickness: a model for risk assessment. Br J Anaesth 1993; 70:135.