Prevalence, Risk Factors, and Management of Postoperative Nausea and Vomiting After Laparoscopic Sleeve Gastrectomy (a Retrospective Multicentric Study).

Autor: Rashad AE; Gastroenterology Surgical Center, Mansoura University, Mansoura, 35516, Egypt.; Wadi Aldawaser Armed Forces Hospital, Wadi Aldawaser, Kingdom of Saudi Arabia, 18511., El Hefnawy E; Gastroenterology Surgical Center, Mansoura University, Mansoura, 35516, Egypt., Elmorshedi M; Gastroenterology Surgical Center, Mansoura University, Mansoura, 35516, Egypt., Abuyousif YA; Wadi Aldawaser Armed Forces Hospital, Wadi Aldawaser, Kingdom of Saudi Arabia, 18511., Salem A; Gastroenterology Surgical Center, Mansoura University, Mansoura, 35516, Egypt., Attia M; Gastroenterology Surgical Center, Mansoura University, Mansoura, 35516, Egypt., El Nakeeb A; Gastroenterology Surgical Center, Mansoura University, Mansoura, 35516, Egypt. elnakeebayman@yahoo.com.; Wadi Aldawaser Armed Forces Hospital, Wadi Aldawaser, Kingdom of Saudi Arabia, 18511. elnakeebayman@yahoo.com., Zaid A; Wadi Aldawaser Armed Forces Hospital, Wadi Aldawaser, Kingdom of Saudi Arabia, 18511., Aldossary HM; Wadi Aldawaser Armed Forces Hospital, Wadi Aldawaser, Kingdom of Saudi Arabia, 18511., Mohammed MN; Gastroenterology Surgical Center, Mansoura University, Mansoura, 35516, Egypt.; Mansoura University Hospital, Mansoura University, Mansoura, 35516, Egypt.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2023 Oct; Vol. 33 (10), pp. 3237-3245. Date of Electronic Publication: 2023 Aug 25.
DOI: 10.1007/s11695-023-06803-z
Abstrakt: Purpose: Postoperative nausea and vomiting (PONV) is a frequent unappealing laparoscopic sleeve gastrectomy (LSG) sequel. The study's purpose was to determine the prevalence, risk factors of PONV, and management of PONV after LSG.
Patients and Methods: This multicenter retrospective study included patients with morbid obesity who had LSG between January 2022 and April 2023. The age range for LSG was 16 to 65 years, and the eligibility requirements included morbid obesity according to international guidelines.
Results: PONV was experienced by 74.6% of patients who underwent LSG at 6 h postoperative. Multivariate analysis revealed that female gender, smokers, preoperative GERD, gastropexy, and severity of pain were found to be independent risk variables of the development of PONV, while antral preservation, opioid-free analgesia, and intraoperative combined analgesia were found to be independent protective variables against the development of PONV. Combined intravenous ondansetron and metoclopramide improved 92.6% of patients who developed PONV. Dexamethasone and antihistamines drugs are given for 42 cases with persistent PONV after using intravenous ondansetron and metoclopramide. Pain management postoperatively by opioid-free analgesia managed PONV. Helicobacter pylori status has no role in the development of PONV after LSG.
Conclusion: Female gender, smoking, presence of preoperative GERD, gastropexy, and severity of pain were found to be independent risk variables of the development of PONV, while antral preservation, opioid-free analgesia, and intraoperative combined analgesia were observed to be independent protective factors against the occurrence of PONV. Combined intravenous ondansetron and metoclopramide improved PONV. Dexamethasone and antihistamines drugs are given for persistent PONV.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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