Real-time Decision Support for Postoperative Nausea and Vomiting (PONV) Prophylaxis

Summary

The purpose of this study is to determine how automated recommendations are best presented to optimize the adherence to guidelines on prophylaxis for nausea and vomiting after surgery.

Conditions

• Postoperative Nausea and Vomiting

Interventions

PROCEDURE

Automated recommendation at the start of the case

The first notification is the main notification that informs the anesthesia providers at the start of anesthesia of the risk score for that individual patient and the recommended number of prophylactic interventions. The notification occurs within the anesthesia information management system (AIMS)

PROCEDURE

Automated notification at the start of surgery

The second notification within the AIMS will notify the anesthesia providers at the start of surgery when no prophylaxis has been given while three or more interventions were recommended.

PROCEDURE

Preoperative recommendations: by email

A recommendation on PONV prophylaxis to anesthesia providers through email at the Vanderbilt University Medical Center.

PROCEDURE

Automated notification at the end of surgery

A notification will remind anesthesia providers at the closing of surgery how many prophylactic interventions are required to adhere to the recommended number of interventions.

DEVICE

Anesthesia Information Management System (AIMS)

The anesthesia electronic record keeping system

DEVICE

Perioperative Data Warehouse (PDW)

The data warehouse that is used to gather perioperative data and create user reports. In this instance the PDW will be used to send the preoperative emails.

PROCEDURE

General anesthesia

Any anesthetic drugs that are used to induce general anesthesia above the level of sedation.

PROCEDURE

Elective surgery

Surgical procedures that are scheduled and not an emergency.

DRUG

Propofol

Anesthetic drug used to maintain general anesthesia

DRUG

Sevoflurane

Anesthetic drug used to maintain general anesthesia

DRUG

Isoflurane

Anesthetic drug used to maintain general anesthesia

DRUG

Desflurane

Anesthetic drug used to maintain general anesthesia

DRUG

Scopolamine

Prophylactic antiemetic

DRUG

Droperidol

Prophylactic antiemetic \& rescue antiemetic

DRUG

Haloperidol

Prophylactic antiemetic \& rescue antiemetic

DRUG

Dexamethasone

Prophylactic antiemetic \& rescue antiemetic

DRUG

Promethazine

Prophylactic antiemetic \& rescue antiemetic

DRUG

Meclizine

Prophylactic antiemetic \& rescue antiemetic

DRUG

Aprepitant

Prophylactic antiemetic \& rescue antiemetic

DRUG

Metoclopramide

Rescue antiemetic

DRUG

Fentanyl

Analgesic drug / Opioid

DRUG

Sufentanil

Analgesic drug / Opioid

DRUG

Alfentanil

Analgesic drug / Opioid

DRUG

Remifentanil

Analgesic drug / Opioid

DRUG

Morphine

Analgesic drug / Opioid

DRUG

Meperidine

Analgesic drug / Opioid

DRUG

Hydromorphone

Analgesic drug / Opioid

DRUG

Methadone

Analgesic drug / Opioid

DRUG

Oxycodone

Analgesic drug / Opioid

DRUG

Oxymorphone

Analgesic drug / Opioid

DRUG

Hydrocodone

Analgesic drug / Opioid

DRUG

Ketamine

Analgetic / Analgesic drug

DRUG

Ondansetron

Prophylactic antiemetic \& rescue antiemetic

DRUG

Granisetron

Prophylactic antiemetic \& rescue antiemetic

DRUG

Dolasetron mesylate

Prophylactic antiemetic \& rescue antiemetic

DRUG

Palonosetron

Prophylactic antiemetic \& rescue antiemetic

DRUG

Tropisetron

Prophylactic antiemetic \& rescue antiemetic

DRUG

Ramosetron

Prophylactic antiemetic \& rescue antiemetic

Sponsors & Collaborators

• Vanderbilt University

  lead OTHER

Principal Investigators

• Jonathan P Wanderer, MD, MPhil · Vanderbilt University Medical Center, Division of Anesthesiology

Study Design

Allocation

NA

Purpose

PREVENTION

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2016-07-31

Primary Completion

2017-11-02

Completion

2017-11-30

FDA Device

Yes

Countries

• United States

Study Locations