| Summary: | Postoperative nausea and vomiting (PONV) are common complications after anesthesia, but no study has considered the effects of a proton pump inhibitor (PPI) and gastroesophageal reflux disease (GERD) on PONV at the same time. Thus, we investigated the effects of a PPI and GERD on PONV. Patients aged ≥18 years who underwent general anesthesia between 2010 and 2019 were enrolled. In total, 202,439 patients were included and 21,361 In a multivariate analysis, the OR for PONV was higher in subjects with GERD (OR, 1.157; 95% CI, 1.032−1.298; <i>p</i> = 0.012). The OR was lower for subjects with taking a PPI (OR, 0.890; 95% CI, 0.832−0.953; <i>p</i> < 0.0001). In patients without GERD, the incidence of PONV was lower when lansoprazole (OR, 0.801; 95% CI, 0.718−0.894; <i>p</i> < 0.0001), pantoprazole (OR, 0.856; 95% CI, 0.748−0.980; <i>p</i> = 0.025) and ilaprazole (OR, 0.391; 95% CI, 0.158−0.966; <i>p</i> = 0.042) were taken. However, in GERD patients, all PPIs did not show reducing the incidence of PONV. Taken together, the results show that a lansoprazole, pantoprazole, and ilaprazole reduced PONV in patients without GERD, and PPI could not reduce PONV in patients with GERD.
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