Academic Board of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Australia.
Br J Anaesth. 2010 Feb;104(2):158-66. doi: 10.1093/bja/aep370. Epub 2009 Dec 26.
Postoperative nausea and vomiting (PONV) is common and of concern to patients and clinicians. The effect of PONV can range from trivial and transient to major clinical importance, and it is unclear which of its characteristics lead to discomfort and distress.
We first enrolled 180 participants (patients, family members, nurses, doctors) to identify the characteristics of clinically important PONV, and from these data developed a measurement scale. We then evaluated the scale in a further 163 patients reporting PONV. Validity, reliability, and responsiveness of the PONV Intensity Scale were tested using psychometric techniques.
Most participants agreed that three or more vomits, and greater nausea severity and duration, were key factors in defining clinically important PONV. These data were used to derive a PONV Intensity Scale and a score to define clinically important PONV. The scale identified 29 patients (18%) as having clinically important PONV. Patients with clinically important PONV had a poorer quality of recovery (P<0.0005) and needed twice as much antiemetic treatment (P<0.0005). The scale was strongly associated with PONV consequences and complications, with odds ratios ranging from 6.0 to 31 (all P<0.0005). The scale had excellent reproducibility (intraclass correlation 0.99, P<0.0005). The scale could reliably reflect a clinically important change in health status (effect size 0.82, P<0.0005).
The PONV Intensity Scale is a valid, reliable, and responsive measure of clinically important PONV.
术后恶心和呕吐（PONV）很常见，令患者和临床医生担忧。PONV 的影响范围从微不足道且短暂到具有重要临床意义不等，目前尚不清楚其哪些特征会导致不适和痛苦。
我们首先招募了 180 名参与者（患者、家属、护士和医生）来确定临床上重要的 PONV 的特征，并根据这些数据开发了一种测量量表。然后，我们在 163 名报告有 PONV 的患者中评估了该量表。使用心理测量技术测试 PONV 强度量表的有效性、可靠性和反应性。
大多数参与者都认为，呕吐 3 次以上，以及更严重和持续时间更长的恶心是定义临床上重要的 PONV 的关键因素。这些数据用于得出 PONV 强度量表和定义临床上重要的 PONV 的评分。该量表确定了 29 名（18%）患者存在临床上重要的 PONV。患有临床上重要的 PONV 的患者康复质量较差（P<0.0005），需要两倍剂量的止吐治疗（P<0.0005）。该量表与 PONV 的后果和并发症密切相关，优势比范围为 6.0 至 31（均 P<0.0005）。该量表具有极好的可重复性（组内相关系数 0.99，P<0.0005）。该量表可以可靠地反映健康状况的临床重要变化（效应大小 0.82，P<0.0005）。
PONV 强度量表是一种有效、可靠且敏感的临床上重要的 PONV 测量工具。
