| Objective With an overall incidence of 3 0 %,postoperative nausea and vomiting(PONV)is one of the most common postoperative problem in patients and can lead to serious negative impacts including aspiration pneumonia,dehydration,and wound dehiscence.The use of multimodal pharmacological prophylactic regimes has decreased PONV in general but it still occurs in over 6 0 % of female patients with bariatric surgery.This study aimed to evaluate the efficacy of ST3 6 acupoint injection with anisodamine in prevention of PONV among female patients after bariatric surgery.Methods Ninety patients undergoing laparoscopic sleeve gastrectomy at our hospital from February 2 0 2 2 to July 2 0 2 2 were randomly allocated to anisodamine(n = 6 0)or control group(n = 30)at the ratio of 2:1.Anisodamine or normal saline was injected into Zusanli(ST3 6)bilaterally after induction of general anesthesia.Age,height,weight,body mass index(BMI),history of hypertension,history of hyperlipidemia,history of diabetes,history of smoking and alcohol consumption,history of PONV and motion sickness,surgery history,ASA grade,length of anesthesia and surgery,intraoperative drug use,the time to the first rescue antiemetic,the incidence and severity of PONV at the 2nd,6 th,48 th and 72 nd postoperative hours,early recovery outcome indicators(time to first drink,time to get out of bed and time to exhaustion),postoperative complications,and so on were extracted.The gastrointestinal function,sleep-related quality of life,anxiety and depression status were also evaluated from baseline to postoperative 3 months.Results1.A total of 9 0 patients who met the inclusion criteria were recruited into the trial,preoperative basic data of patients in the two groups: overall baseline of patients were similar between the two groups,there was no statistically significant difference in age,height,weight,BMI,ASA grade,gastrointestinal function,sleep quality,anxiety,depression level,and the proportion of hypertension,hyperlipidemia,diabetes,family history of obesity,history of smoking and alcohol consumption,history of PONV and motion sickness,and history of surgery between the two groups.2.Intraoperative conditions of the two groups: there were no statistically significant difference in the intraoperative narcotic drugs consumption,the time of anesthesia and operation between the two groups.3.A total of 8 8 patients entered to the follow-up process and 7 patients were lost at postoperative 3 months.Postoperative conditions of the two groups: in the anisodamine group,2 5 patients(4 2.4 %)experienced vomiting within postoperative 2 4 h compared with 21(72.4%)in the control group(relative risk,0.59;95% confidence interval,0.40 to0.8 5).Time to first rescue antiemetic was 6.5 h in anisodamine group,and 1.7 h in the control group(P< 0.0 5).Less rescue antiemetic was required during the first 2 4 h in the anisodamine group(P< 0.0 5).There were no differences in either postoperative nausea or other recovery characteristics.Conclusion The addition of ST3 6 acupoint injection with anisodamine significantly reduced postoperative vomiting without affecting nausea in female patients with obesity undergoing laparoscopic sleeve gastrectomy. |
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