Incidence and Management of Postoperative Nausea and Vomiting in General Surgical Patients at University College Hospital, Ibadan

Postoperative nausea and vomiting (PONV) is among the most distressing patient-reported complications following general anaesthesia, contributing to prolonged hospital stay, aspiration risk, and patient dissatisfaction. This study determines the incidence and evaluates the antiemetic management of PONV in general surgical patients at University College Hospital (UCH), Ibadan, Oyo State, South West Nigeria, from 2022 to 2023. A prospective observational study enrolled 220 patients undergoing elective surgery under general anaesthesia. PONV was assessed at 2, 6, and 24 hours postoperatively using a validated four-item symptom scale. Apfel risk scoring was applied preoperatively. Antiemetic prescribing patterns were recorded. The overall PONV incidence was 32%, consistent with published international ranges. Female sex, non-smoking status, and opioid analgesia use were significant predictors. Only 44% of high-risk patients received prophylactic antiemetics, and combination antiemetic therapy was underused. Ondansetron was the predominantly prescribed agent. The study recommends routine preoperative Apfel risk stratification, adoption of a multimodal antiemetic protocol for high-risk patients, and training of anaesthesia teams at UCH Ibadan on current PONV prevention guidelines. Keywords: postoperative nausea, PONV, antiemetics, UCH Ibadan, anaesthesia