Prevalence and Associated Factors of Postoperative Nausea and Vomiting Among Pediatric Patients Undergoing Elective Surgery Under General Anesthesia at Addis Ababa Public Hospital in 2021/22: a Multi-center Cross-sectional Study

Prevalence and Associated Factors of Postoperative Nausea and Vomiting Among Pediatric Patients Undergoing Elective Surgery Under General Anesthesia at Addis Ababa Public Hospital in 2021/22: a Multi-center Cross-sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and Associated Factors of Postoperative Nausea and Vomiting Among Pediatric Patients Undergoing Elective Surgery Under General Anesthesia at Addis Ababa Public Hospital in 2021/22: a Multi-center Cross-sectional Study Desta Waktasu, Lidya Haddis, Emebat Seyoum, Mistre Nigussie, Molla Amsalu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4818176/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Postoperative nausea and vomiting (PONV) is a common and distressing complication following surgical procedures, affecting up to 70% of paediatric patients. PONV can lead to delayed recovery, increased hospital stay, and reduced patient satisfaction, posing a significant burden on healthcare systems. In the paediatric population, PONV is particularly concerning due to the potential risk of aspiration, dehydration, and electrolyte imbalances Methods: A multicentre cross-sectional study method was carried out, with study population of 186 surgical paediatrics patient populations from December 1, 2021 to May 30, 2022. The magnitude of Paediatrics population was evaluated according to specific criteria encompassing socio demographic and preoperative paediatrics characteristics, intraoperative, and postoperative characteristics of paediatrics PONV. Results: The magnitude of pediatrics PONV in PACU and Ward identified with their associated risk factors of perioperative anxiety, motion sickness and long duration of surgery and anaesthesia. Conclusion: The magnitude of paediatrics PONV at Addis Ababa Public Hospital is 12%.Using opioid for postoperative management is not related to paediatrics PONV in our study. Reduction strategy as well as prevention and treatment are vital for enhancing paediatrics patient safety and perioperative care quality. prevalence paediatrics postoperative nausea vomiting Figures Figure 1 Figure 2 INTRODUCTION Postoperative nausea and vomiting (PONV) is not a recent problem; in the early 1990s, it was seen as a minor one, but it has recently grown to be a serious issue( 1 ). PONV, which can persist for up to 24 hours following surgery, is a condition that causes nausea, vomiting, or retching in the post-anesthesia care unit (PACU) ( 2 ). The terrible feeling of nausea that comes along with the consciousness of wanting to vomit is called nausea. Vomiting is the violent, involuntary evacuation of stomach contents through the mouth ( 3 ). This study focused on postoperative vomiting (PONV) in children between the ages of 4 and 17 because it is difficult to report nausea in young children ( 4 ). The vomiting area, situated in the dorsal part of the lateral reticular formation, is where vomiting occurs. Acetylcholine (ACh) and histamine (H1) receptors are the most prevalent in the vomiting center ( 5 ). The nucleus tractussolitarius (NTS), the chemoreceptor trigger zone (CTZ), and the cerebral cortex ( 6 ) all provide information. The cerebral cortex receives afferent CNS input from circuits that mediate pain, smell, sight, emotion (fear/anxiety), and biological abnormalities. Children are affected by PONV twice as frequently as adults, and it can result in complications such extended PACU stays, aspiration, wound bleeding, and unanticipated readmissions, all of which place a significant financial burden on the patients( 7 ). Children are twice as prone as adults to outsource PONV ( 8 ). PONV is a frighteningly common complication among children, with estimates ranging from 33.2 percent to 82 percent depending on the patient's risk factors ( 7 ). PONV is a dangerous complication that has been linked to an increased mortality risk in both adults and children. PONV's negative effects range from patient distress to surgical morbidity ( 7 ). While it is difficult to eliminate PONV in many cases completely, the risk can be reduced by using multimodal nonopioid analgesic regimens, whole intravenous medicines rather than volatile anesthetics, and a proper prophylactic medication regimen ( 6 ). Identifying the prevalence and prevention of pediatric postoperative nausea and vomiting (PONV) is thought to improve patient satisfaction and provide cost-effective care while caring for patients ( 7 ). Many studies indicate that the higher prevalence of pediatric postoperative nausea and vomiting is due to associated patient factors, anesthesia factors, and surgical factors ( 9 ). PONV has detrimental effects on the patient, surgical recovery, the healthcare professional, and the institution ( 10 ). Children should be stratified to receive appropriate management of risk factors and antiemetic therapy ( 11 ).Wherever possible, strategies to decrease exposure to emetogenic substances should be used. By decreasing baseline risk factors and correctly treating those at risk, we can provide better perioperative care to children ( 12 ). This study aimed to know the magnitude and associated factors of PONV among pediatrics. We also compared the magnitude in OR, PACU, and Ward. We hypothesized that postoperative pain management in pediatrics with opioids is not a major concern like other factors. METHODS Study Design A multicentre cross-sectional study of 186 patients was examined for PONV at three selected Addis Ababa Public Hospitals, Black Lion Specialized Hospital, Paulus Specialized Hospital and Menilik II Specialized Hospital Sample size determination The sample size is calculated by using single population proportion formula. Previously, the prevalence of pediatric PONV for pediatrics age of 6–11 in Baghdad is 30%( 13 ). using a single population proportion formula with 95% confidence interval or 5% level of significance and 5% margin of error, the sample size calculated as follow as: N= \(\:\frac{{(\text{Z}\:{\alpha\:}/2)\:\:}^{2}\:\text{P}(1-\text{p})\:}{{d}^{2}}\) Where; n is minimum sample size required⎫ Z 1- α/2 is the standard normal variable at (1-α) % confidence level and α (level of⎫ significance), Usually 95% confidence level is used = 1.96; P is taken to be 0.3⎫ q = 1-p = 0.7⎫ d = is the margin of sampling error tolerated, assumed to be 0.05.⎫ n = (〖1.962 ×0.3×0.7)/〖0.05〗2 ≈ 323………………………………( 13 ) By using correction formula for finite population since source population is below 10,000, nf = n/(1 + n/N),where is n is the minimum sample size and N is the total number of pediatric patients operated per three month at three hospitals is 450 from situational analysis, and using adjusted sample size formula for small population, 323/(1+(323/450)) ≈ 188.Therefore, the estimate sample size of the study will be 188. By taking 10% non-response rate the total sample will be ≈ 207.From the three hospitals of 450 total number of patient per three month ,TASH,NTASH = 220,MIIRH,NMIIRH = 80 and SPMHC,NSPMHC = 150,the Total N = 450,so sample size for each hospital will calculated as follow using this formula: nj = n/N *NJ nTASH = 92,nMIIRH = 33,nSPMHC = 63,where j = 1, 2, 3……k n = total sample size for the three hospitals k is the number of strata n j = is the sample size of each hospital allocation nj = is the source population size of each hospital. nTASH,is sample size for Tikur Anbesa Specialized Hospital nMIIRH,is sample size for Menilik II Referral Hospital nSPMHC,is sample size for St.paulos hospital medical college Sampling technique Simple random sampling technique was used after labelling the record chart during the study period. Data Type and Method of Data Collection Primary as well as secondary data information was used to conduct this study. The primary data included respondent’s socio economic, demographic, intra as well as immediate post-operative conditions. For collection of primary data, a paediatric parents/guards were interviewed. For the purpose of quality primary data collection, appropriate orientation and pre-test was given for data collectors (three graduate Degree anaesthesiology professionals). In addition, timely supervision was conducted by the principal investigator. Inclusion Criteria All pediatric patients of 4–17 years old enrolled to undergo elective surgery under GA with Endotracheal Intubation and have consent from their family/guardian to participate in the study were included. Exclusion criteria Pediatric Patients Admitted to ICU Data processing and analysis For generation of valuable result from this study, descriptive statistics as well as econometric model was applied. Data was checked manually for completeness and clarity. After this, it was coded, entered, cleaned and analyzed using SPSS version 24 software program. Descriptive statistics was used to explore the socio-demographic characteristics of patients, and the results were summarized as frequencies and percentage. Bivariate and multivariate analysis was used to see the effect of independent variable on outcome variable. Variables, which were significant on bivariate analysis is at p-value less than or equals to 0.25was taken to multivariate analysis. The strength of association was measured by 95% confidence interval and P-value of 0.05 was used as statistically significant in all cases. RESULTS The magnitude of PONV among pediatrics population was 12% (Fig. 2 ), while the associated factors are anxiety,duration (Table 5 ). Sociodemeographic Characteristics of Addis Ababa Public Hospital pediatric patientsTable 1 Table 1 Socio-demographic characteristics of Pediatrics PONV at Addis Ababa Public Hospitals from December 1, 2021 to May 30, 2022 (n = 186) Intraoperative characteristics of Paediatrics PONV at Addis Ababa Public Hospitals Table 2 Variables Responses Frequency (n) Percentage (%) Sex Male 105 56.5 Female 81 43.5 Age (years) 4–10 132 71.0 11–17 54 29.0 BMI (kg/m2) < 18 40 21.5 18–25 129 69.4 < 26 17 9.1 Preoperative Anxiety Yes 81 43.5 No 105 56.5 ASA Physical Status I 102 54.8 II 73 39.2 III 8 4.3 IV and Above 3 1.6 Comorbidity No Comorbidity 65 35 Has comorbidity 121 65 Type Of Comorbidity Non-Critical 40 21.5 Critical 146 78.5 History of surgery Yes 20 11 No 166 89 History of PONV Yes 44 23.7 No 142 76.6 History motion sickness Yes 159 85.5 No 27 14.5 Family history of smoking Yes 48 25.8 No 138 74.2 Table 2 Intraoperative Pediatrics PONV characteristics at Addis Ababa Public Hospitals from December 1, 2021 to May 30, 2022 (n = 186) Variables Responses Frequency (n) Percent (%) Induction used IV induction 159 87.5 IH induction 27 12.5 Maintenance used IV induction 164 90.2 IH induction 22 9.2 Types of surgery Ophthalmic 169 92.7 Non ophthalmic 17 7.3 Total Blood Loss Below allowable 14 7.3 Normal 167 90 Above allowable 5 2.7 Total Fluid Given Below allowable 30 16.2 Normal 156 79.4 Above allowable 10 5.4 Intra-operative analgesic Opoid 166 90.2 Non-opoid 10 9.8 Duration of Surgery 35 minute 173 93 Duration of Anesthesia 45 minute 172 92.5 Table 3 Postoperative Table 3 Variables Responses Frequency (n) Percent (%) PON in PACU Yes 38 8.1 No 148 91.9 POV in PACU Yes 26 14 No 160 86 PONV IN PACU Yes 24 12.9 No 162 87.1 PON in PACU Yes 23 12.4 No 163 87.6 POV in PACU Yes 15 8.1 No 171 91.9 PONV in PACU Yes 13 7 No 173 93 Postoperative Pain Mild 115 61.8 Moderate 52 28 Severe 19 10.2 Analgesia given in PACU Opoids 46 25 Non opoids 142 75 Analgesia given in WARD Opoids 24 12.6 Non opoids 164 87.4 Time ponv occurs 0–6 hours 53 28.5 6–12 hours 20 10.8 Table 3 Postoperative Pediatrics PONV characteristics at different setting of PACU and ward at Addis Ababa Public Hospitals from December 1, 2021 to May 30, 2022 (n = 186) Bar graph shows summary of a higher incidence of postoperative nausea in the PACU setting, but a lower incidence of both nausea and vomiting in the WARD of Addis Ababa Public Hospitals setting for paediatric patientsFigure 1 The pie chart shows that in the overall summary, the majority (88%) of pediatric patients in Addis Ababa public hospitals do not experience postoperative nausea and vomiting, while a smaller percentage (12%) do experience PONVFigure 2 Binary Logistic Regression showing the significance of associated factors with a significance value of < 0.02 Table 4 Table 4 Binary Logistic Regression of Pediatrics PONV at Addis Ababa Public Hospitals from Decemeber1, 2021 to May 30, 2022(n=186) Variables Sig. Exp(B) 95% C.I for EXP(B) Lower Upper Age .637 .789 .294 2.117 Sex .510 .748 .315 1.777 BMI .755 .880 .395 1.963 Anxiety .025 1.333 .552 3.223 ASAClass .457 1.374 .595 3.174 Preoperative Fasting .330 1.540 .646 3.671 Comorbidity .512 1.084 .852 1.380 History of Surgry .608 1.347 .431 4.206 History of PONV .018 .526 .126 2.205 Motion Sickness .022 .914 .185 4.507 Opoid Premedication .039 3.851 1.072 13.831 Premedication Used .391 .539 .131 2.210 Smoking .016 .145 .030 .701 Premedication Used .208 1.424 .821 2.470 Types of Induction .253 2.607 .504 13.476 IV Used .847 1.049 .646 1.702 IH maintanance .000 .148 .234 .910 Caudal Anesthesia .170 .507 .192 1.338 Types of Surgery .0125 .789 .574 1.086 Total Blood Loss .416 1.407 .618 3.202 Fluid Given .078 .466 .199 1.089 Intraoperative Analgesia .322 1.683 .601 4.712 Duration of Surgery .012 .000 .000 . Duration of Anesthesia .015 15.846 .000 . PostOperative Fluid .921 .486 .000 755945.452 Pain .114 .000 .000 7.681 PACU analgesia .886 1.295 .038 44.315 Ward Analgesia .223 313.446 .030 3.117 A significance value of <0.02 from Binary Logistic Regression re-entered to Multiple logistic regression and re analysed as below, then a significant value of < 0.05 from multiple logistic regression are assumed to be associated risk factors of PONVTable 5 Table 5 Multiple Logistic Regression of Pediatrics PONV at Addis Ababa Public Hospitals from Decemeber1, 2021 to May 30, 2022 (n=186) Variables Sig. Exp(B) 95% C.I for EXP(B) Lower Upper Anxiety .000 .771 .551 1.81 Previous Motion Sickness .021 .381 .000 . History of PONV .015 .627 .019 21.215 Inhalational anesthesia .910 . . . Surgery Duration>30min .019 .42 .601 1.302 [Anesthesia Duration>45min .001 .12 1.02 3.7 Opoid Analgesia .223 .446 .030 32.117 DISCUSSION The main results of the present study were as follows: (i) the overall paediatrics PONV level did not differ from the existing data except the case of using opioid for pain management in our case; (ii) there was a significance in anxiety in paediatrics in to resulting PONV; (iii) there was a PONV from Previous Motion Sickness; (iv) there was PONV if there is previous history of PONV; (v) Increment of duration of surgery and anaesthesia both results in PONV. In contrast to study done in different areas of the world ,our research states opioid postoperative analgesia do not result in PONV providing ( 7 ) the odds ratio for opioid analgesia is 0.446, indicating that the use of opioid analgesia is associated with 55.4% lower odds of the outcome, compared to not using opioid analgesia, holding all other variables constant. However, the confidence interval is extremely wide, ranging from 0.030 to over 3 million, suggesting that the estimate is highly imprecise and the effect is not statistically significant. Maintaining a vigilant approach to identifying and addressing PONV risk factors can ensure that the majority of paediatric patients continue to have a smooth and comfortable recovery ( 14 ). Sex is not a significant predictor of the outcome, as the p-value of 0.510 is greater than 0.05 in our study. The odds ratio of 0.748 indicates that the odds of the outcome are 25.2% lower for males compared to females, but this effect is not statistically significant ( 8 ). BMI is not a significant predictor of the outcome, as the p-value of 0.755 is greater than 0.05. The odds ratio of 0.880 suggests that for every one-unit increase in BMI, the odds of the outcome decrease by 12%, but this effect is not statistically significant ( 15 ). These researches suggest that the medical teams in Addis Ababa public hospitals are effective at managing postoperative vomiting, but may need to focus more on addressing nausea, particularly in the PACU setting (21). Investigating factors contributing to nausea, such as anaesthetic management, pain control, or patient-specific risk factors, could help inform targeted interventions to further improve PONV outcomes (22). The Presence of comorbidities is not a significant predictor of the outcome, as the p-value of 0.512 is greater than 0.05 ( 16 ).History of Motion sickness have been suggested to be associated with paediatrics PONV, as the p-value of 0.022 is less than 0.05. The odds ratio of 0.914 suggests that the odds of the outcome are 8.6% lower for individuals with a history of motion sickness, and this effect is statistically significant ( 4 ). In recent public health research, the anxiety reduction method with family of children has been used as an important term separate from motion sickness ( 1 ). Both have been considered independent risk factors for several risk factors, such as long duration of surgery and anaesthesia ( 1 ). Finally, the use of inhalational induction do not associated with paediatrics PONV in our setting contradicting research done by Kenny GNC ( 14 ) Limitations The limitations of this study were, we face financial problem since it is multicenter CONCLUSION The overall prevalence of postoperative nausea and vomiting was 12% .It was moderate compared with most studies conducted in Africa and other parts of the world. History of motion sickness/PONV/anxiety and duration of surgery and anesthesia above 45/30 minute respectively were the major factors associated with postoperative nausea and vomiting /PONV/ in pediatrics. We recommend that since medicine is ever dynamic science further research is necessary on magnitude and associated factors of pediatrics postoperative nausea and vomiting. Declarations Acknowledgements First, I would like to praise Lord for everything and then my deep gratitude and appreciation goes to my advisor Lidya Haddis for her continuous encouragement, suggestions and valuable advice to develop this thesis Secondly. I would like to thanks Addis Ababa University for being sponsorship and approval of my research to conduct this study Thirdly I would like to thank Debre Berhan University for giving me chance to learn Master of Science in anesthesia. Finally my special thanks go to the writer of the literatures I used for citations. Disclosure Author Contributions Advisor: Lidya Haddis Principal Invigilator: Desta Waktasu (MSc Student) The authors confirm contribution to the paper as follows: Study conception and design: Desta Waktasu and Lidya Haddis Data collection: Desta Waktasu Analysis and interpretation of results: Desta Waktasu,Lidya Haddis,Emebat Seyoum and Mistre Nigussie Draft manuscript preparation: Desta Waktasu and Molla Amsalu All authors reviewed the results and approved the final version of the manuscript Funding: This research received no external funding. Institutional Review Board Statement: All experimental procedures were approved by the Human Research Ethics Committee of the AAU and conformed to the principles outlined in the Declaration of Helsinki (approval number approval number (Ames /17/2021/2022). This study was guided by ethical standards and national and international laws. All pediatrics Guards/family signed the consent form after receiving instructions regarding the possible risks and benefits and was granted privacy, confidentiality, and anonymity rights. The participant’s guards were free to stop participating any stage of the experiment without giving reasons for their decision. Informed Consent Statement: Informed consent was obtained from all subjects involved in the study to publish this paper. Data Availability Statement: Data supporting the study results can be provided followed by request sent to the corresponding author’s e-mail Conflicts of Interest: None. References Kocaturk O, Keles S, Omurlu IK. Risk factors for postoperative nausea and vomiting in pediatric patients undergoing ambulatory dental treatment. Niger J Clin Pract. 2018;21(5):597–602. Hung L wei, Chou M yueh, Liang C kuang, Liu K. Journal of Clinical Gerontology & Geriatrics Being older as a risk factor for vomiting in those undergoing spinal anesthesia. 2012;3:68–72. Moon YE. Postoperative nausea and vomiting. 2014;67(3):164–70. Martin S, Baines D, Holtby H, Carr AS. The Association of Paediatric Anaesthetists of Great Britain & Ireland. Guidelines on the Prevention of Post-operative Vomiting in Children. 2016;(Spring):1–36. Pierre S, Whelan R. Nausea and vomiting after surgery. Contin Educ Anaesthesia, Crit Care Pain. 2013;13(1):28–32. McCracken G, Houston P, Lefebvre G. Guideline for the Management of Postoperative Nausea and Vomiting. J Obstet Gynaecol Canada [Internet]. 2008;30(7):600–7. Available from: http://dx.doi.org/10.1016/S1701-2163(16)32895-X Urits I, Orhurhu V, Jones MR, Adamian L, Borchart M, Galasso A, et al. Postoperative nausea and vomiting in paediatric anaesthesia. Turkish J Anaesthesiol Reanim. 2020;48(2):88–95. Nurhussen A, Al’ferid F, Birhanu T. Prevalence and Associated Factors of Post-operative Nausea and Vomiting in Elective Surgical Patients Operated under Anesthesia at Tikur Anbesa Specialized Teaching Hospital. Anesthesiology. 2020;91(24):1693–700. Rose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth. 1999;83(1):104–17. Morrison C, Wilmshurst S. Postoperative vomiting in children. BJA Educ [Internet]. 2019;19(10):329–33. Available from: https://doi.org/10.1016/j.bjae.2019.05.006 Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Vol. 131, Anesthesia and Analgesia. 2020. 411–448 p. Guidelines C, Panel A, Trust T, Trust T, Guideline C. No Title. 2022;1–11. Ali ZT. Study of the Postoperative Nausea and Vomiting Incidence for Pediatric Surgery in Baghdad Educational Hospital. 2018;(7). Kenny GNC. Risk factors for postoperative nausea and vomiting. 1994;49:6–10. Morrison C, Wilmshurst S. Postoperative vomiting in children. BJA Educ. 2019;19(10):329–33. Russell AC. Development and Validation of a Nausea Severity Scale for Assessment of Nausea in Children with Abdominal Pain-Related Functional Gastrointestinal Disorders. Ali U, Tsang M, Igbeyi B, Balakrishnan S, Shackell K, Kotzer G, et al. RESEARCH REPORT A 4 year quality improvement initiative reducing post ‐ operative nausea and vomiting in children undergoing strabismus surgery at a quaternary paediatric hospital. 2019;(May):690–7. Additional Declarations Competing interest reported. we prefer Bmc Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4818176","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":348775407,"identity":"82925725-9131-428c-b5f6-68ee05afebb8","order_by":0,"name":"Desta Waktasu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7ElEQVRIiWNgGAWjYDACdsYGCRDNz96Q+ABI8/AR1MIM1mLAINlz4LEBSAsbYS0MDGAtBjcSn4GtI6iFn5m58caHP3/kJWckp1V+zbGTYWNgfvjoBh4tks2MzZYz2wwM+3mepd2W3ZYMdBibsXEOHi0GhxnbpHkbDBhntuek3ZbcxgzUwsMmTVDLnz8G9hsO5H8rltxWT6QWBjaDxA0nEtIYP247TFgL2C+9bcbJM3sOJEszbjvOw8ZMwC/87O0Pb/z4I2fbD4zKjz+3Vdvzszc/fIxPCwpg5gGTxCoHAcYfpKgeBaNgFIyCEQMAF01HligscRYAAAAASUVORK5CYII=","orcid":"","institution":"Debre Berhan University","correspondingAuthor":true,"prefix":"","firstName":"Desta","middleName":"","lastName":"Waktasu","suffix":""},{"id":348775408,"identity":"ebf46bc1-601e-4d84-a97f-51b0604b0b97","order_by":1,"name":"Lidya Haddis","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Lidya","middleName":"","lastName":"Haddis","suffix":""},{"id":348775409,"identity":"a78b19df-135c-454d-a9a9-322759d1d5d9","order_by":2,"name":"Emebat Seyoum","email":"","orcid":"","institution":"Debre Berhan University","correspondingAuthor":false,"prefix":"","firstName":"Emebat","middleName":"","lastName":"Seyoum","suffix":""},{"id":348775410,"identity":"2dcdecc4-7a72-45b9-8d31-1d3cfae5dd71","order_by":3,"name":"Mistre Nigussie","email":"","orcid":"","institution":"Debre Berhan University","correspondingAuthor":false,"prefix":"","firstName":"Mistre","middleName":"","lastName":"Nigussie","suffix":""},{"id":348775411,"identity":"65bb2cb1-e422-4c27-87f8-0ae35a395c7b","order_by":4,"name":"Molla Amsalu","email":"","orcid":"","institution":"Debre Berhan University","correspondingAuthor":false,"prefix":"","firstName":"Molla","middleName":"","lastName":"Amsalu","suffix":""}],"badges":[],"createdAt":"2024-07-28 22:23:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4818176/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4818176/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":64004198,"identity":"c47b50ca-cd5c-4722-8e89-2b472ae28d27","added_by":"auto","created_at":"2024-09-04 21:19:08","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":9264,"visible":true,"origin":"","legend":"\u003cp\u003eMagnitude of Pediatrics PONV in PACU and WARD of Addis Ababa Public Hospitals from Decemeber1, 2021 to May 30, 2022\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4818176/v1/914fa9b7871dc32bb471aba5.png"},{"id":64004199,"identity":"44165020-e8e0-4ded-af81-986e14472146","added_by":"auto","created_at":"2024-09-04 21:19:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":11690,"visible":true,"origin":"","legend":"\u003cp\u003eOverall Magnitude of Pediatrics at Addis Ababa Public Hospitals from Decemeber1, 2021 to May 30, 2022\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4818176/v1/da23af39cfd3ea1be4905db5.png"},{"id":64004645,"identity":"02912fb3-88ff-4227-9ffb-d1b515ff820a","added_by":"auto","created_at":"2024-09-04 21:27:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":820621,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4818176/v1/037d2cfc-4bcb-4647-9031-94b26423dfe8.pdf"}],"financialInterests":"Competing interest reported. we prefer Bmc","formattedTitle":"\u003cp\u003ePrevalence and Associated Factors of Postoperative Nausea and Vomiting Among Pediatric Patients Undergoing Elective Surgery Under General Anesthesia at Addis Ababa Public Hospital in 2021/22: a Multi-center Cross-sectional Study\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003ePostoperative nausea and vomiting (PONV) is not a recent problem; in the early 1990s, it was seen as a minor one, but it has recently grown to be a serious issue(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). PONV, which can persist for up to 24 hours following surgery, is a condition that causes nausea, vomiting, or retching in the post-anesthesia care unit (PACU) (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). The terrible feeling of nausea that comes along with the consciousness of wanting to vomit is called nausea. Vomiting is the violent, involuntary evacuation of stomach contents through the mouth (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). This study focused on postoperative vomiting (PONV) in children between the ages of 4 and 17 because it is difficult to report nausea in young children (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe vomiting area, situated in the dorsal part of the lateral reticular formation, is where vomiting occurs. Acetylcholine (ACh) and histamine (H1) receptors are the most prevalent in the vomiting center (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The nucleus tractussolitarius (NTS), the chemoreceptor trigger zone (CTZ), and the cerebral cortex (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) all provide information. The cerebral cortex receives afferent CNS input from circuits that mediate pain, smell, sight, emotion (fear/anxiety), and biological abnormalities. Children are affected by PONV twice as frequently as adults, and it can result in complications such extended PACU stays, aspiration, wound bleeding, and unanticipated readmissions, all of which place a significant financial burden on the patients(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Children are twice as prone as adults to outsource PONV (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePONV is a frighteningly common complication among children, with estimates ranging from 33.2 percent to 82 percent depending on the patient's risk factors (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). PONV is a dangerous complication that has been linked to an increased mortality risk in both adults and children. PONV's negative effects range from patient distress to surgical morbidity (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). While it is difficult to eliminate PONV in many cases completely, the risk can be reduced by using multimodal nonopioid analgesic regimens, whole intravenous medicines rather than volatile anesthetics, and a proper prophylactic medication regimen (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Identifying the prevalence and prevention of pediatric postoperative nausea and vomiting (PONV) is thought to improve patient satisfaction and provide cost-effective care while caring for patients (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMany studies indicate that the higher prevalence of pediatric postoperative nausea and vomiting is due to associated patient factors, anesthesia factors, and surgical factors (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). PONV has detrimental effects on the patient, surgical recovery, the healthcare professional, and the institution (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Children should be stratified to receive appropriate management of risk factors and antiemetic therapy (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).Wherever possible, strategies to decrease exposure to emetogenic substances should be used. By decreasing baseline risk factors and correctly treating those at risk, we can provide better perioperative care to children (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study aimed to know the magnitude and associated factors of PONV among pediatrics. We also compared the magnitude in OR, PACU, and Ward. We hypothesized that postoperative pain management in pediatrics with opioids is not a major concern like other factors.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Design\u003c/h2\u003e\n \u003cp\u003eA multicentre cross-sectional study of 186 patients was examined for PONV at three selected Addis Ababa Public Hospitals, Black Lion Specialized Hospital, Paulus Specialized Hospital and Menilik II Specialized Hospital\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eSample size determination\u003c/h2\u003e\n \u003cp\u003eThe sample size is calculated by using single population proportion formula. Previously, the prevalence of pediatric PONV for pediatrics age of 6\u0026ndash;11 in Baghdad is 30%(\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e). using a single population proportion formula with 95% confidence interval or 5% level of significance and 5% margin of error, the sample size calculated as follow as:\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003eN= \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{{(\\text{Z}\\:{\\alpha\\:}/2)\\:\\:}^{2}\\:\\text{P}(1-\\text{p})\\:}{{d}^{2}}\\)\u003c/span\u003e\u003c/span\u003e\u003c/h2\u003e\n \u003cp\u003eWhere;\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003en is minimum sample size required⎫\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eZ 1- \u0026alpha;/2 is the standard normal variable at (1-\u0026alpha;) % confidence level and \u0026alpha; (level of⎫ significance), Usually 95% confidence level is used\u0026thinsp;=\u0026thinsp;1.96;\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eP is taken to be 0.3⎫\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eq\u0026thinsp;=\u0026thinsp;1-p\u0026thinsp;=\u0026thinsp;0.7⎫\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003ed\u0026thinsp;=\u0026thinsp;is the margin of sampling error tolerated, assumed to be 0.05.⎫\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n \u003cp\u003en = (〖1.962 \u0026times;0.3\u0026times;0.7)/〖0.05〗2\u0026thinsp;\u0026asymp;\u0026thinsp;323\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;(\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e) By using correction formula for finite population since source population is below 10,000, nf\u0026thinsp;=\u0026thinsp;n/(1\u0026thinsp;+\u0026thinsp;n/N),where is n is the minimum sample size and N is the total number of pediatric patients operated per three month at three hospitals is 450 from situational analysis, and using adjusted sample size formula for small population, 323/(1+(323/450))\u0026thinsp;\u0026asymp;\u0026thinsp;188.Therefore, the estimate sample size of the study will be 188. By taking 10% non-response rate the total sample will be \u0026asymp;\u0026thinsp;207.From the three hospitals of 450 total number of patient per three month ,TASH,NTASH\u0026thinsp;=\u0026thinsp;220,MIIRH,NMIIRH\u0026thinsp;=\u0026thinsp;80 and SPMHC,NSPMHC\u0026thinsp;=\u0026thinsp;150,the Total N\u0026thinsp;=\u0026thinsp;450,so sample size for each hospital will calculated as follow using this formula:\u003c/p\u003e\n \u003cp\u003enj\u0026thinsp;=\u0026thinsp;n/N *NJ\u003c/p\u003e\n \u003cp\u003enTASH\u0026thinsp;=\u0026thinsp;92,nMIIRH\u0026thinsp;=\u0026thinsp;33,nSPMHC\u0026thinsp;=\u0026thinsp;63,where\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003ej\u0026thinsp;=\u0026thinsp;1, 2, 3\u0026hellip;\u0026hellip;k\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;total sample size for the three hospitals\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003ek is the number of strata\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003en j\u0026thinsp;=\u0026thinsp;is the sample size of each hospital allocation\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003enj\u0026thinsp;=\u0026thinsp;is the source population size of each hospital.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003enTASH,is sample size for Tikur Anbesa Specialized Hospital\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003enMIIRH,is sample size for Menilik II Referral Hospital\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003enSPMHC,is sample size for St.paulos hospital medical college\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003eSampling technique\u003c/h2\u003e\n \u003cp\u003eSimple random sampling technique was used after labelling the record chart during the study period.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003eData Type and Method of Data Collection\u003c/h2\u003e\n \u003cp\u003ePrimary as well as secondary data information was used to conduct this study. The primary data included respondent\u0026rsquo;s socio economic, demographic, intra as well as immediate post-operative conditions. For collection of primary data, a paediatric parents/guards were interviewed. For the purpose of quality primary data collection, appropriate orientation and pre-test was given for data collectors (three graduate Degree anaesthesiology professionals). In addition, timely supervision was conducted by the principal investigator.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eInclusion Criteria\u003c/h2\u003e\n \u003cp\u003eAll pediatric patients of 4\u0026ndash;17 years old enrolled to undergo elective surgery under GA with Endotracheal Intubation and have consent from their family/guardian to participate in the study were included.\u003c/p\u003e\n \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e\n \u003ch2\u003eExclusion criteria\u003c/h2\u003e\n \u003cp\u003ePediatric Patients Admitted to ICU\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003eData processing and analysis\u003c/h2\u003e\n \u003cp\u003eFor generation of valuable result from this study, descriptive statistics as well as econometric model was applied. Data was checked manually for completeness and clarity. After this, it was coded, entered, cleaned and analyzed using SPSS version 24 software program. Descriptive statistics was used to explore the socio-demographic characteristics of patients, and the results were summarized as frequencies and percentage. Bivariate and multivariate analysis was used to see the effect of independent variable on outcome variable. Variables, which were significant on bivariate analysis is at p-value less than or equals to 0.25was taken to multivariate analysis. The strength of association was measured by 95% confidence interval and P-value of 0.05 was used as statistically significant in all cases.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe magnitude of PONV among pediatrics population was 12% (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e), while the associated factors are anxiety,duration (Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eSociodemeographic Characteristics of Addis Ababa Public Hospital pediatric patientsTable 1\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocio-demographic characteristics of Pediatrics PONV at Addis Ababa Public Hospitals from December 1, 2021 to May 30, 2022 (n\u0026thinsp;=\u0026thinsp;186)\u003c/strong\u003e Intraoperative characteristics of Paediatrics PONV at Addis Ababa Public Hospitals Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eResponses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency (n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u0026ndash;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u0026ndash;17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eBMI (kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u0026ndash;25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePreoperative Anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eASA Physical Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIV and Above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eComorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo Comorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHas comorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eType Of Comorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon-Critical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCritical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHistory of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHistory of PONV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHistory motion sickness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e85.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eFamily history of smoking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eIntraoperative Pediatrics PONV characteristics at Addis Ababa Public Hospitals from December 1, 2021 to May 30, 2022 (n\u0026thinsp;=\u0026thinsp;186)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eResponses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency (n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eInduction used\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIV induction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIH induction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMaintenance used\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIV induction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIH induction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eTypes of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOphthalmic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon ophthalmic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eTotal Blood Loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBelow allowable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbove allowable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eTotal Fluid Given\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBelow allowable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbove allowable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eIntra-operative analgesic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOpoid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon-opoid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eDuration of Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;35 minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;35 minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eDuration of Anesthesia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;45 minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;45 minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"char\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003ePostoperative Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eResponses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency (n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePON in PACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePOV in PACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePONV IN PACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePON in PACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePOV in PACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePONV in PACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003ePostoperative Pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSevere\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAnalgesia given in PACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOpoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon opoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAnalgesia given in WARD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOpoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon opoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eTime ponv occurs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u0026ndash;6 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u0026ndash;12 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e \u003cstrong\u003ePostoperative Pediatrics PONV characteristics at different setting of PACU and ward at Addis Ababa Public Hospitals from December 1, 2021 to May 30, 2022 (n\u0026thinsp;=\u0026thinsp;186)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBar graph shows summary of a higher incidence of postoperative nausea in the PACU setting, but a lower incidence of both nausea and vomiting in the WARD of Addis Ababa Public Hospitals setting for paediatric patientsFigure 1\u003c/p\u003e\n\u003cp\u003eThe pie chart shows that in the overall summary, the majority (88%) of pediatric patients in Addis Ababa public hospitals do not experience postoperative nausea and vomiting, while a smaller percentage (12%) do experience PONVFigure 2\u003c/p\u003e\n\u003cp\u003eBinary Logistic Regression showing the significance of associated factors with a significance value of \u0026lt;\u0026thinsp;0.02 Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eTable 4 Binary Logistic Regression of Pediatrics PONV at Addis Ababa Public Hospitals from Decemeber1, 2021 to May 30, 2022(n=186)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eExp(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.69387755102041%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e95% C.I for EXP(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eUpper\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.637\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e2.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.777\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.755\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.880\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.963\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.552\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e3.223\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eASAClass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.457\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.374\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.595\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e3.174\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003ePreoperative Fasting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.540\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.646\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e3.671\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eComorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.512\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.380\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eHistory of Surgry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.608\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e4.206\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eHistory of PONV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e2.205\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eMotion Sickness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e4.507\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eOpoid Premedication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e3.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e13.831\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003ePremedication Used\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.391\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e2.210\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eSmoking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.701\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003ePremedication Used\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.821\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e2.470\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eTypes of Induction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e2.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.504\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e13.476\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eIV Used\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.847\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.646\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.702\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eIH maintanance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.910\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eCaudal Anesthesia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.170\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.338\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eTypes of Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.0125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.574\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.086\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eTotal Blood Loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.416\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.407\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.618\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e3.202\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eFluid Given\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e1.089\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eIntraoperative Analgesia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.683\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.601\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e4.712\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eDuration of Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eDuration of Anesthesia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e15.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003ePostOperative Fluid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.921\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.486\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e755945.452\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003ePain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e7.681\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003ePACU analgesia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.886\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e1.295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e44.315\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.551020408163264%\" valign=\"top\"\u003e\n \u003cp\u003eWard Analgesia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\" valign=\"top\"\u003e\n \u003cp\u003e313.446\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\" valign=\"top\"\u003e\n \u003cp\u003e3.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\n \u003cdiv align=\"char\" class=\"colspec\"\u003eA significance value of \u0026lt;0.02 from Binary Logistic Regression re-entered to Multiple logistic regression and re analysed as below, then a significant value of \u0026lt; 0.05 from\u0026nbsp;multiple logistic regression\u0026nbsp;are assumed to be associated risk factors of PONVTable 5\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/div\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5 Multiple Logistic Regression of Pediatrics PONV at Addis Ababa Public Hospitals from Decemeber1, 2021 to May 30, 2022 (n=186)\u003c/strong\u003e\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eExp(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.42424242424242%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e95% C.I for EXP(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eLower \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Upper\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnxiety\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.771\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.551\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.232323232323232%\" valign=\"top\"\u003e\n \u003cp\u003e1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevious Motion Sickness\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" valign=\"top\"\u003e\n \u003cp\u003e.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.232323232323232%\" valign=\"top\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of PONV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" valign=\"top\"\u003e\n \u003cp\u003e.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.232323232323232%\" valign=\"top\"\u003e\n \u003cp\u003e21.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInhalational anesthesia\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" valign=\"top\"\u003e\n \u003cp\u003e.910\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.232323232323232%\" valign=\"top\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery Duration\u0026gt;30min\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" valign=\"top\"\u003e\n \u003cp\u003e.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.601\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.232323232323232%\" valign=\"top\"\u003e\n \u003cp\u003e1.302\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e[Anesthesia Duration\u0026gt;45min\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" valign=\"top\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.232323232323232%\" valign=\"top\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpoid Analgesia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.070707070707071%\" valign=\"top\"\u003e\n \u003cp\u003e.223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.446\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.232323232323232%\" valign=\"top\"\u003e\n \u003cp\u003e32.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe main results of the present study were as follows: (i) the overall paediatrics PONV level did not differ from the existing data except the case of using opioid for pain management in our case; (ii) there was a significance in anxiety in paediatrics in to resulting PONV; (iii) there was a PONV from Previous Motion Sickness; (iv) there was PONV if there is previous history of PONV; (v) Increment of duration of surgery and anaesthesia both results in PONV.\u003c/p\u003e \u003cp\u003eIn contrast to study done in different areas of the world ,our research states opioid postoperative analgesia do not result in PONV providing (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) the odds ratio for opioid analgesia is 0.446, indicating that the use of opioid analgesia is associated with 55.4% lower odds of the outcome, compared to not using opioid analgesia, holding all other variables constant. However, the confidence interval is extremely wide, ranging from 0.030 to over 3\u0026nbsp;million, suggesting that the estimate is highly imprecise and the effect is not statistically significant. Maintaining a vigilant approach to identifying and addressing PONV risk factors can ensure that the majority of paediatric patients continue to have a smooth and comfortable recovery (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSex is not a significant predictor of the outcome, as the p-value of 0.510 is greater than 0.05 in our study. The odds ratio of 0.748 indicates that the odds of the outcome are 25.2% lower for males compared to females, but this effect is not statistically significant (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBMI is not a significant predictor of the outcome, as the p-value of 0.755 is greater than 0.05. The odds ratio of 0.880 suggests that for every one-unit increase in BMI, the odds of the outcome decrease by 12%, but this effect is not statistically significant (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThese researches suggest that the medical teams in Addis Ababa public hospitals are effective at managing postoperative vomiting, but may need to focus more on addressing nausea, particularly in the PACU setting (21). Investigating factors contributing to nausea, such as anaesthetic management, pain control, or patient-specific risk factors, could help inform targeted interventions to further improve PONV outcomes (22).\u003c/p\u003e \u003cp\u003eThe Presence of comorbidities is not a significant predictor of the outcome, as the p-value of 0.512 is greater than 0.05 (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).History of Motion sickness have been suggested to be associated with paediatrics PONV, as the p-value of 0.022 is less than 0.05. The odds ratio of 0.914 suggests that the odds of the outcome are 8.6% lower for individuals with a history of motion sickness, and this effect is statistically significant (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn recent public health research, the anxiety reduction method with family of children has been used as an important term separate from motion sickness (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Both have been considered independent risk factors for several risk factors, such as long duration of surgery and anaesthesia (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Finally, the use of inhalational induction do not associated with paediatrics PONV in our setting contradicting research done by Kenny GNC (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe limitations of this study were, we face financial problem since it is multicenter\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe overall prevalence of postoperative nausea and vomiting was 12% .It was moderate compared with most studies conducted in Africa and other parts of the world. History of motion sickness/PONV/anxiety and duration of surgery and anesthesia above 45/30 minute respectively were the major factors associated with postoperative nausea and vomiting /PONV/ in pediatrics. We recommend that since medicine is ever dynamic science further research is necessary on magnitude and associated factors of pediatrics postoperative nausea and vomiting.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, I would like to praise Lord for everything and then my deep gratitude and appreciation goes to my advisor Lidya Haddis for her continuous encouragement, suggestions and valuable advice to develop this thesis\u003c/p\u003e\n\u003cp\u003eSecondly. I would like to thanks Addis Ababa University for being sponsorship and approval of my research to conduct this study\u003c/p\u003e\n\u003cp\u003eThirdly I would like to thank Debre Berhan University for giving me chance to learn Master of Science in anesthesia.\u003c/p\u003e\n\u003cp\u003eFinally my special thanks go to the writer of the literatures I used for citations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdvisor: Lidya Haddis\u003c/p\u003e\n\u003cp\u003ePrincipal Invigilator: Desta Waktasu (MSc Student)\u003c/p\u003e\n\u003cp\u003eThe authors confirm contribution to the paper as follows:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudy conception and design: Desta Waktasu and Lidya Haddis\u003c/p\u003e\n\u003cp\u003eData collection: Desta Waktasu\u003c/p\u003e\n\u003cp\u003eAnalysis and interpretation of results: Desta Waktasu,Lidya Haddis,Emebat Seyoum and Mistre Nigussie\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Draft manuscript preparation: Desta Waktasu and Molla Amsalu\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors reviewed the results and approved the final version of the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement:\u0026nbsp;\u003c/strong\u003eAll experimental procedures were approved by the Human Research Ethics Committee of the AAU and conformed to the principles outlined in the Declaration of Helsinki (approval number approval number (Ames /17/2021/2022). This study was guided by ethical standards and national and international laws. All pediatrics Guards/family signed the consent form after receiving instructions regarding the possible risks and benefits and was granted privacy, confidentiality, and anonymity rights. The participant’s guards were free to stop participating any stage of the experiment without giving reasons for their decision.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement:\u0026nbsp;\u003c/strong\u003eInformed consent was obtained from all subjects involved in the study to publish this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e Data supporting the study results can be provided followed by request sent to the corresponding author’s e-mail\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e None.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKocaturk O, Keles S, Omurlu IK. Risk factors for postoperative nausea and vomiting in pediatric patients undergoing ambulatory dental treatment. Niger J Clin Pract. 2018;21(5):597\u0026ndash;602. \u003c/li\u003e\n\u003cli\u003eHung L wei, Chou M yueh, Liang C kuang, Liu K. Journal of Clinical Gerontology \u0026amp; Geriatrics Being older as a risk factor for vomiting in those undergoing spinal anesthesia. 2012;3:68\u0026ndash;72. \u003c/li\u003e\n\u003cli\u003eMoon YE. Postoperative nausea and vomiting. 2014;67(3):164\u0026ndash;70. \u003c/li\u003e\n\u003cli\u003eMartin S, Baines D, Holtby H, Carr AS. The Association of Paediatric Anaesthetists of Great Britain \u0026amp; Ireland. Guidelines on the Prevention of Post-operative Vomiting in Children. 2016;(Spring):1\u0026ndash;36. \u003c/li\u003e\n\u003cli\u003ePierre S, Whelan R. Nausea and vomiting after surgery. Contin Educ Anaesthesia, Crit Care Pain. 2013;13(1):28\u0026ndash;32. \u003c/li\u003e\n\u003cli\u003eMcCracken G, Houston P, Lefebvre G. Guideline for the Management of Postoperative Nausea and Vomiting. J Obstet Gynaecol Canada [Internet]. 2008;30(7):600\u0026ndash;7. Available from: http://dx.doi.org/10.1016/S1701-2163(16)32895-X\u003c/li\u003e\n\u003cli\u003eUrits I, Orhurhu V, Jones MR, Adamian L, Borchart M, Galasso A, et al. Postoperative nausea and vomiting in paediatric anaesthesia. Turkish J Anaesthesiol Reanim. 2020;48(2):88\u0026ndash;95. \u003c/li\u003e\n\u003cli\u003eNurhussen A, Al\u0026rsquo;ferid F, Birhanu T. Prevalence and Associated Factors of Post-operative Nausea and Vomiting in Elective Surgical Patients Operated under Anesthesia at Tikur Anbesa Specialized Teaching Hospital. Anesthesiology. 2020;91(24):1693\u0026ndash;700. \u003c/li\u003e\n\u003cli\u003eRose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth. 1999;83(1):104\u0026ndash;17. \u003c/li\u003e\n\u003cli\u003eMorrison C, Wilmshurst S. Postoperative vomiting in children. BJA Educ [Internet]. 2019;19(10):329\u0026ndash;33. Available from: https://doi.org/10.1016/j.bjae.2019.05.006\u003c/li\u003e\n\u003cli\u003eGan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Vol. 131, Anesthesia and Analgesia. 2020. 411\u0026ndash;448 p. \u003c/li\u003e\n\u003cli\u003eGuidelines C, Panel A, Trust T, Trust T, Guideline C. No Title. 2022;1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eAli ZT. Study of the Postoperative Nausea and Vomiting Incidence for Pediatric Surgery in Baghdad Educational Hospital. 2018;(7). \u003c/li\u003e\n\u003cli\u003eKenny GNC. Risk factors for postoperative nausea and vomiting. 1994;49:6\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eMorrison C, Wilmshurst S. Postoperative vomiting in children. BJA Educ. 2019;19(10):329\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003eRussell AC. Development and Validation of a Nausea Severity Scale for Assessment of Nausea in Children with Abdominal Pain-Related Functional Gastrointestinal Disorders. \u003c/li\u003e\n\u003cli\u003eAli U, Tsang M, Igbeyi B, Balakrishnan S, Shackell K, Kotzer G, et al. RESEARCH REPORT A 4 year quality improvement initiative reducing post ‐ operative nausea and vomiting in children undergoing strabismus surgery at a quaternary paediatric hospital. 2019;(May):690\u0026ndash;7. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"prevalence, paediatrics, postoperative, nausea, vomiting","lastPublishedDoi":"10.21203/rs.3.rs-4818176/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4818176/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003eBackground: Postoperative nausea and vomiting (PONV) is a common and distressing complication following surgical procedures, affecting up to 70% of paediatric patients. PONV can lead to delayed recovery, increased hospital stay, and reduced patient satisfaction, posing a significant burden on healthcare systems. In the paediatric population, PONV is particularly concerning due to the potential risk of aspiration, dehydration, and electrolyte imbalances\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMethods: A multicentre cross-sectional study method was carried out, with study population of 186 surgical paediatrics patient populations from December 1, 2021 to May 30, 2022. The magnitude of Paediatrics population was evaluated according to specific criteria encompassing socio demographic and preoperative paediatrics characteristics, intraoperative, and postoperative characteristics of paediatrics PONV.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eResults: The magnitude of \u003c/em\u003epediatrics\u003cem\u003e PONV in PACU and Ward identified with their associated risk factors of perioperative anxiety, motion sickness and long duration of surgery and anaesthesia.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConclusion: The magnitude of paediatrics PONV at Addis Ababa Public Hospital is 12%.Using opioid for postoperative management is not related to paediatrics PONV in our study. Reduction strategy as well as prevention and treatment are vital for enhancing paediatrics patient safety and perioperative care quality.\u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"Prevalence and Associated Factors of Postoperative Nausea and Vomiting Among Pediatric Patients Undergoing Elective Surgery Under General Anesthesia at Addis Ababa Public Hospital in 2021/22: a Multi-center Cross-sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-04 21:19:03","doi":"10.21203/rs.3.rs-4818176/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c54465f5-a333-410c-98bc-815c3e404c05","owner":[],"postedDate":"September 4th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-09-04T21:19:03+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-04 21:19:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4818176","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4818176","identity":"rs-4818176","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}