Retrospective Analysis of the Incidence and Predictors of Postoperative Nausea and Vomiting After Spinal Anaesthesia

Postoperative nausea and vomiting (PONV) continues to be a concern even after spinal anaesthesia, a technique traditionally considered to have low emetogenic potential. This retrospective study evaluated the incidence of PONV within 24 hours of surgery and identified patient- and treatment-related predictors using electronic medical records from a tertiary care hospital. Records of 500 ASA I and II adult patients who underwent surgery under spinal anaesthesia between March and December 2024 were analysed. The overall PONV incidence was 26.8% (n = 134), with nausea alone occurring in 18.8%, vomiting ± nausea in 8.0%, and rescue antiemetic use in 10.6%. The 95% confidence interval for overall PONV was 23.0–30.9%. On multivariable logistic regression, female sex (aOR 1.91; p = 0.001), history of prior PONV or motion sickness (aOR 2.29; p < 0.001), and postoperative opioid use (aOR 1.58; p = 0.026) were independently associated with PONV. Non-smoking status did not retain significance after adjustment. These findings reinforce the continued relevance of simplified risk models in peri operative populations and highlight the importance of opioid-sparing postoperative analgesia and individualized prophylaxis strategies.