| OBJECTIVE:The aim of this study was to compare the prevalence of postoperative nausea and vomiting(PONV)in matched patients undergoing laparoscopic sleeve gastrectomy(LSG)and laparoscopic gynecological surgeries(LGS)and investigate the main cause of the high occurrence of PONV in bariatric surgeries.METHODS:Medical records of female patients with a body mass index(BMI)greater than 30 kg/m~2undergoing LSG or LGS from January1,2016 to September 1,2020 were reviewed for PONV episodes in the first postoperative 48 hours.A 1:1 propensity score matching(PSM)method was performed between cases subject to the two types of surgery,and PONV rates were compared.RESULTS:A total of 278 patients met the inclusion criteria(LSG=101,LGS=177),and 74 matched subjects were selected from each group after PSM.An increased occurrence of PONV was noted in female patients with LSG compared with those undergoing LGS(66.2%vs.23.0%;p<0.001).PONV severity was significantly worse in the LSG(p<0.001),and more frequent use of rescue antiemetics was detected in the LSG group compared with the LGS group(51.4%vs.17.6%;p<0.001).The time of first use of rescue drugs was much earlier in the LGS group(p=0.034).CONCLUSIONS:Female patients undergoing LSG are at increased risk of PONV compared with those with LGS,indicating a critical role of procedure-related alterations of gastric physiology in the high occurrence of PONV after bariatric surgery.Purpose: The aim of this study was to evaluate the effectiveness and safety of acupuncture therapy(AT)on postoperative nausea and vomiting(PONV)after gynaecologic surgery(GS).Methods: A comprehensive literature search of all published randomized controlled trials(RCTs)or prospective cohort studies assessing the effectiveness of AT on PONV in patients undergoing GS was conducted in three databases: Pub Med,EMBASE and Cochrane Library.The incidence of PONV,the use of rescue antiemetics,and side effects of AT were analysed using Review Manager 5.3 software.Findings: Nine RCTs and one prospective cohort study identified in the literature search from database inception(1966)to December 31,2019,including 1075 participants were included in the present study.AT significantly reduced the risk of developing postoperative nausea(PON)and postoperative vomiting(POV)by 48%(relative risk [RR] = 0.52;95%confidence interval [CI],0.44–0.61;P < 0.00001)and 42%(RR = 0.58;95% CI,0.49–0.68;P < 0.00001),respectively.No significant differences in the incidence of side effects such as bleeding and needle pain were observed between groups(P = 0.54).AT was also associated with a lower rate of rescue antiemetic usage(P < 0.00001)and a higher degree of satisfaction with postoperative recovery(P < 0.0001).Moreover,the optimal therapeutic effect of AT on preventing PONV was achieved when the treatment time was controlled within 30 minutes and transcutaneous acupoint electrical stimulation(TAES)was applied.Conclusion: AT is an effective and safe physical therapy for the prophylaxis of PONV in patients undergoing GS. |
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