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Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy

BACKGROUND: The incidence of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic hysterectomy is very high compared with other surgeries, even when many prophylactic measures have been taken. However, the pathogenesis of PONV is multifactorial. Female sex, a history of motio...

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Autores principales: Qu, Meng-Di, Zhang, Meng-Yuan, Wang, Gong-Ming, Wang, Zhun, Wang, Xu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642561/
https://www.ncbi.nlm.nih.gov/pubmed/33195649
http://dx.doi.org/10.12998/wjcc.v8.i20.4816
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author Qu, Meng-Di
Zhang, Meng-Yuan
Wang, Gong-Ming
Wang, Zhun
Wang, Xu
author_facet Qu, Meng-Di
Zhang, Meng-Yuan
Wang, Gong-Ming
Wang, Zhun
Wang, Xu
author_sort Qu, Meng-Di
collection PubMed
description BACKGROUND: The incidence of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic hysterectomy is very high compared with other surgeries, even when many prophylactic measures have been taken. However, the pathogenesis of PONV is multifactorial. Female sex, a history of motion sickness or PONV, nonsmokers, and perioperative opioid use are the most closely related factors. Among the multiple risk factors, suboptimal gastrointestinal (GI) perfusion may be attributed to some cases of PONV, and increased systemic vascular resistance (SVR) may lead to GI ischemia. The hypothesis of this research was that SVR is related to PONV. AIM: To investigate the relationship between SVR and PONV in patients undergoing laparoscopic hysterectomy. METHODS: A total of 228 patients who underwent elective laparoscopic hysterectomy were included in this prospective observational study. SVR was monitored using a noninvasive hemodynamic monitoring system. Four indices of SVR, the baseline, mean, area under the curve (AUC), and weighted AUC, were used for analysis. The incidence and severity of nausea and vomiting were evaluated while patients were awake and throughout the intervals from 0 to 2 h, 2 to 6 h, and 6 to 24 h starting upon arrival at the post-anesthesia care unit. The associations between various SVR indices and PONV were investigated by logistic regression. P < 0.05 was considered statistically significant. RESULTS: The incidence of PONV in the study was 56.14% (128/228), and PONV tended to appear within 6 h after surgery. Five variables were significant in univariate analyses, however, only SVR mean [odds ratio (OR) = 1.015, 95%CI: 1.005-1.109, P = 0.047] and duration of surgery (OR = 1.316, 95%CI: 1.003-2.030, P = 0.012) were associated with PONV after logistic regression analysis. Furthermore, patients with high SVR mean were more likely to suffer from PONV after laparoscopic hysterectomy. On average, patients who developed PONV needed more time to tolerate diet and demonstrated poorer sleep quality on the first night after surgery. CONCLUSION: In this study, PONV was a common complication after laparoscopic hysterectomy. SVR was associated with PONV, and high SVR mean was associated with a significantly increased risk of PONV.
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spelling pubmed-76425612020-11-13 Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy Qu, Meng-Di Zhang, Meng-Yuan Wang, Gong-Ming Wang, Zhun Wang, Xu World J Clin Cases Observational Study BACKGROUND: The incidence of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic hysterectomy is very high compared with other surgeries, even when many prophylactic measures have been taken. However, the pathogenesis of PONV is multifactorial. Female sex, a history of motion sickness or PONV, nonsmokers, and perioperative opioid use are the most closely related factors. Among the multiple risk factors, suboptimal gastrointestinal (GI) perfusion may be attributed to some cases of PONV, and increased systemic vascular resistance (SVR) may lead to GI ischemia. The hypothesis of this research was that SVR is related to PONV. AIM: To investigate the relationship between SVR and PONV in patients undergoing laparoscopic hysterectomy. METHODS: A total of 228 patients who underwent elective laparoscopic hysterectomy were included in this prospective observational study. SVR was monitored using a noninvasive hemodynamic monitoring system. Four indices of SVR, the baseline, mean, area under the curve (AUC), and weighted AUC, were used for analysis. The incidence and severity of nausea and vomiting were evaluated while patients were awake and throughout the intervals from 0 to 2 h, 2 to 6 h, and 6 to 24 h starting upon arrival at the post-anesthesia care unit. The associations between various SVR indices and PONV were investigated by logistic regression. P < 0.05 was considered statistically significant. RESULTS: The incidence of PONV in the study was 56.14% (128/228), and PONV tended to appear within 6 h after surgery. Five variables were significant in univariate analyses, however, only SVR mean [odds ratio (OR) = 1.015, 95%CI: 1.005-1.109, P = 0.047] and duration of surgery (OR = 1.316, 95%CI: 1.003-2.030, P = 0.012) were associated with PONV after logistic regression analysis. Furthermore, patients with high SVR mean were more likely to suffer from PONV after laparoscopic hysterectomy. On average, patients who developed PONV needed more time to tolerate diet and demonstrated poorer sleep quality on the first night after surgery. CONCLUSION: In this study, PONV was a common complication after laparoscopic hysterectomy. SVR was associated with PONV, and high SVR mean was associated with a significantly increased risk of PONV. Baishideng Publishing Group Inc 2020-10-26 2020-10-26 /pmc/articles/PMC7642561/ /pubmed/33195649 http://dx.doi.org/10.12998/wjcc.v8.i20.4816 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Observational Study
Qu, Meng-Di
Zhang, Meng-Yuan
Wang, Gong-Ming
Wang, Zhun
Wang, Xu
Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy
title Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy
title_full Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy
title_fullStr Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy
title_full_unstemmed Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy
title_short Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy
title_sort intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642561/
https://www.ncbi.nlm.nih.gov/pubmed/33195649
http://dx.doi.org/10.12998/wjcc.v8.i20.4816
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