Tympanomastoidectomy for chronic otitis media may be performed as an outpatient procedure. Postoperative nausea and vomiting can be predicted based on preoperative findings and is associated with an increase need for a 23-hour observation stay following the surgery.


One or both of the following was most predictive of post-operative nausea and vomiting requiring an observational stay (odds ratio 5.21):

(1) history of previous post-operative nausea and vomiting

(2) history of motion sickness


Other factors associated with post-operative nausea and vomiting in multivariate analysis:

(1) age > 50 years (odds ratio 1.56)

(2) induction agent (volatile agents vs thiopental; odds ratio 2.14)

(3) maintenance inhalational agent (desflurane vs isoflurane, odds ratio 2.31)


Other factors associated with a prolonged hospital stay:

(1) surgery in the afternoon


The severity of disease did not correlate with length of stay.


Any patient undergoing tympanomastoidectomy may require a 23 hour observation stay, but it is more likely if one or more risk factors (for PONV, late day surgery) is present.


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