Effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trial
Abstract Background Postoperative nausea and vomiting (PONV) have always been a concern of clinicians and may increase medical costs for patients. Consensus guidelines recommend using multiple antiemetics with different mechanisms as prophylaxis in patients at high risk of PONV. Individualized risk...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-08-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-022-01809-z |
| _version_ | 1811340209155997696 |
|---|---|
| author | Wenjing Ma Yupeng Qi Can Liu Mingfang Wang Yun Zhang Weidong Yao |
| author_facet | Wenjing Ma Yupeng Qi Can Liu Mingfang Wang Yun Zhang Weidong Yao |
| author_sort | Wenjing Ma |
| collection | DOAJ |
| description | Abstract Background Postoperative nausea and vomiting (PONV) have always been a concern of clinicians and may increase medical costs for patients. Consensus guidelines recommend using multiple antiemetics with different mechanisms as prophylaxis in patients at high risk of PONV. Individualized risk scores for nausea and vomiting and individualized treatment strategies are feasible. This study evaluated the effect of individualized treatment strategies on postoperative nausea and vomiting after laparoscopic gynaecological operations. Methods This was a double-blind, randomized, controlled trial. A total of 119 adult patients who underwent gynaecological laparoscopic surgery under general anaesthesia were randomly divided into an individualized treatment group or a control group, with the individualized treatment group receiving individualized prevention according to a preoperative risk score of nausea and vomiting and the control group receiving no individualized prevention. Vomiting, retching, nausea, and use of rescue medication were all recorded for 24 h after the operation. The primary outcome variable was complete response, defined as no emesis or the use of rescue medication 24 h postoperatively. Results The complete response rate was higher in the individualized treatment group (56.7%) than in the control group (23.7%) (95% CI, 0.01–0.27; P < 0.001). The incidences of emesis (18.3% vs. 44.1%, P = 0.002) were significantly lower in the individualized treatment group than in the control group. There were no differences in any nausea (26.7% vs. 33.9%, P = 0.391) or rescue medication use (6.7% vs. 8.5%, P = 0.743). Adverse events and laboratory and electrocardiogram abnormalities occurred no more frequently in the individualized treatment group than in the control group. Conclusion In conclusion, this single-centre, double-blind, randomized study suggests that an individualized PONV prophylactic treatment strategy based on the number of PONV risk factors could be a safe and effective regimen to reduce the incidence of PONV in adult patients undergoing laparoscopic gynaecological surgery. |
| first_indexed | 2024-04-13T18:37:39Z |
| format | Article |
| id | doaj.art-097ad79e26424d5684166f12d3c6a76d |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-13T18:37:39Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-097ad79e26424d5684166f12d3c6a76d2022-12-22T02:34:49ZengBMCBMC Anesthesiology1471-22532022-08-012211610.1186/s12871-022-01809-zEffect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trialWenjing Ma0Yupeng Qi1Can Liu2Mingfang Wang3Yun Zhang4Weidong Yao5Department of Anesthesiology, First Affiliated Hospital of Wannan Medical CollegeDepartment of Critical Care Medicine, First Affiliated Hospital of Wannan Medical CollegeDepartment of Anesthesiology, First Affiliated Hospital of Wannan Medical CollegeDepartment of Anesthesiology, First Affiliated Hospital of Wannan Medical CollegeDepartment of Anesthesiology, First Affiliated Hospital of Wannan Medical CollegeDepartment of Anesthesiology, First Affiliated Hospital of Wannan Medical CollegeAbstract Background Postoperative nausea and vomiting (PONV) have always been a concern of clinicians and may increase medical costs for patients. Consensus guidelines recommend using multiple antiemetics with different mechanisms as prophylaxis in patients at high risk of PONV. Individualized risk scores for nausea and vomiting and individualized treatment strategies are feasible. This study evaluated the effect of individualized treatment strategies on postoperative nausea and vomiting after laparoscopic gynaecological operations. Methods This was a double-blind, randomized, controlled trial. A total of 119 adult patients who underwent gynaecological laparoscopic surgery under general anaesthesia were randomly divided into an individualized treatment group or a control group, with the individualized treatment group receiving individualized prevention according to a preoperative risk score of nausea and vomiting and the control group receiving no individualized prevention. Vomiting, retching, nausea, and use of rescue medication were all recorded for 24 h after the operation. The primary outcome variable was complete response, defined as no emesis or the use of rescue medication 24 h postoperatively. Results The complete response rate was higher in the individualized treatment group (56.7%) than in the control group (23.7%) (95% CI, 0.01–0.27; P < 0.001). The incidences of emesis (18.3% vs. 44.1%, P = 0.002) were significantly lower in the individualized treatment group than in the control group. There were no differences in any nausea (26.7% vs. 33.9%, P = 0.391) or rescue medication use (6.7% vs. 8.5%, P = 0.743). Adverse events and laboratory and electrocardiogram abnormalities occurred no more frequently in the individualized treatment group than in the control group. Conclusion In conclusion, this single-centre, double-blind, randomized study suggests that an individualized PONV prophylactic treatment strategy based on the number of PONV risk factors could be a safe and effective regimen to reduce the incidence of PONV in adult patients undergoing laparoscopic gynaecological surgery.https://doi.org/10.1186/s12871-022-01809-zPostoperative nausea and vomitingGynaecological laparoscopic surgeryIndividualized treatment strategy |
| spellingShingle | Wenjing Ma Yupeng Qi Can Liu Mingfang Wang Yun Zhang Weidong Yao Effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trial BMC Anesthesiology Postoperative nausea and vomiting Gynaecological laparoscopic surgery Individualized treatment strategy |
| title | Effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trial |
| title_full | Effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trial |
| title_fullStr | Effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trial |
| title_full_unstemmed | Effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trial |
| title_short | Effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery: a double-blind, randomized, controlled trial |
| title_sort | effect of individualized treatment strategy on postoperative nausea and vomiting in gynaecological laparoscopic surgery a double blind randomized controlled trial |
| topic | Postoperative nausea and vomiting Gynaecological laparoscopic surgery Individualized treatment strategy |
| url | https://doi.org/10.1186/s12871-022-01809-z |
| work_keys_str_mv | AT wenjingma effectofindividualizedtreatmentstrategyonpostoperativenauseaandvomitingingynaecologicallaparoscopicsurgeryadoubleblindrandomizedcontrolledtrial AT yupengqi effectofindividualizedtreatmentstrategyonpostoperativenauseaandvomitingingynaecologicallaparoscopicsurgeryadoubleblindrandomizedcontrolledtrial AT canliu effectofindividualizedtreatmentstrategyonpostoperativenauseaandvomitingingynaecologicallaparoscopicsurgeryadoubleblindrandomizedcontrolledtrial AT mingfangwang effectofindividualizedtreatmentstrategyonpostoperativenauseaandvomitingingynaecologicallaparoscopicsurgeryadoubleblindrandomizedcontrolledtrial AT yunzhang effectofindividualizedtreatmentstrategyonpostoperativenauseaandvomitingingynaecologicallaparoscopicsurgeryadoubleblindrandomizedcontrolledtrial AT weidongyao effectofindividualizedtreatmentstrategyonpostoperativenauseaandvomitingingynaecologicallaparoscopicsurgeryadoubleblindrandomizedcontrolledtrial |