Effect of bundled care on postoperative nausea and vomiting in patients undergoing day laparoscopic cholecystectomy_West China Medical Journal

Authors：

LIU Yi ¹ , LUO Zhen ² , TANG Xuejiao ¹ ,  LIANG Peng ³

1. Department of Anesthesiology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Day Surgery Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIANG Peng, Email: liangpengwch@scu.edu.cn

Keywords：

Postoperative nausea and vomiting; day laparoscopic cholecystectomy; bundled care; day surgery

DOI：

10.7507/1002-0179.202311240

Video：

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Objective To explore whether bundled care for anesthesia management can reduce the risk of postoperative nausea and vomiting (PONV). Methods The data of laparoscopic cholecystectomy patients admitted to the Day Surgery Center of West China Hospital, Sichuan University between July and November 2021 were retrospectively collected. Patients were divided into a bundled care group and a control group based on whether anesthesia management was implemented according to the bundled care. The demographic characteristics, intraoperative anesthesia management methods, postoperative conditions, and incidence of PONV between the two groups of patients were analyzed and compared. Results A total of 314 patients were included. Among them, there were 124 cases in the bundled care group and 190 cases in the control group; PONV occurred in 52 cases, the incidence of PONV was 16.6% (52/314). Except for surgical time and postoperative incision infiltration (P>0.05), there were statistically significant differences in age, gender, body mass index, anesthesia time, airway establishment, and postoperative analgesic use between the two groups of patients (P<0.05). There was no statistically significant difference in the occurrence of PONV between the bundled care group and the control group (17 vs. 35 cases; χ²=1.205, P>0.05). The results of logistic regression analysis showed that PONV was correlated with gender [odds ratio=0.107, 95% confidence interval (0.030, 0.375), P<0.001], and using bundled care [odds ratio=0.388, 95% confidence interval (0.169, 0.894), P=0.026]. Conclusions Women are at high risk of PONV among patients undergoing day laparoscopic cholecystectomy. The risk of PONV is lower when using bundled care.

Citation： LIU Yi, LUO Zhen, TANG Xuejiao, LIANG Peng. Effect of bundled care on postoperative nausea and vomiting in patients undergoing day laparoscopic cholecystectomy. West China Medical Journal, 2024, 39(2): 195-199. doi: 10.7507/1002-0179.202311240 Copy

1.	贺广宝, 高红梅, 鲍杨, 等. 腹腔镜胆囊切除术术后恶心呕吐的危险因素分析. 临床和实验医学杂志, 2020, 19(1): 105-108.
2.	Fujii Y. The utility of antiemetics in the prevention and treatment of postoperative nausea and vomiting in patients scheduled for laparoscopic cholecystectomy. Curr Pharm Des, 2005, 11(24): 3173-3183.
3.	Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg, 2006, 102(6): 1884-1898.
4.	Wang LJ, Cang J, Xue ZG. Cost-effectiveness comparison between 6 interventions for the prevention of postoperative nausea and vomiting (PONV) on low-risk patients. Fudan Univ J Med Sci, 2014, 41(1): 74-80.
5.	Apfel CC, Philip BK, Cakmakkaya OS, et al. Who is at risk for postdischarge nausea and vomiting after ambulatory surgery?. Anesthesiology, 2012, 117(3): 475-486.
6.	Gan TJ, Meyer TA, Apfel CC, et al. Society for ambulatory anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2007, 105(6): 1615-1628.
7.	Lee C, Chung JY, Lee M. Sex-related differences in the efficacy of dexamethasone pretreatment for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: a randomized controlled study. Turkish J Med Sci, 2017, 47(4): 1282-1286.
8.	Gan TJ, Belani KG, Bergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2020, 131(2): 411-448.
9.	Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg, 2014, 12(12): 1500-1524.
10.	Mayo I, Lizarondo L, Stokan M. Experiences of adult patients in discharge and recovery from day surgery: a qualitative systematic review protocol. JBI Database System Rev Implement Rep, 2019, 17(2): 164-169.
11.	马洪升, 程南生, 朱涛. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
12.	Choi SU. Is postoperative nausea and vomiting still the big “little” problem?. Korean J Anesthesiol, 2016, 69(1): 1-2.
13.	Sridharan K, Sivaramakrishnan G. Drugs for preventing post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: network meta-analysis of randomized clinical trials and trial sequential analysis. Int J Surg, 2019, 69: 1-12.
14.	Chandrakantan A, Glass PS. Multimodal therapies for postoperative nausea and vomiting, and pain. Br J Anaesth, 2011, 107(Suppl 1): i27-i40.
15.	Elvir-Lazo OL, White PF, Yumul R, et al. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Res, 2022: F1000 Faculty Rev-983.
16.	Hussain AM, Khan FA, Ahmed A, et al. Effect of gender on pain perception and analgesic consumption in laparoscopic cholecystectomy: an observational study. J Anaesthesiol Clin Pharmacol, 2013, 29(3): 337-341.
17.	Johansson E, Hultin M, Myrberg T, et al. Early post-operative nausea and vomiting: a retrospective observational study of 2030 patients. Acta Anaesthesiol Scand, 2021, 65(9): 1229-1239.
18.	Ismail EA, Bakri MH, Abd-Elshafy SK, et al. Dexamethasone alone versus in combination with intra-operative super-hydration for postoperative nausea and vomiting prophylaxis in female patients undergoing laparoscopic cholecystectomy: a randomized clinical trial. Korean J Anesthesiol, 2017, 70(5): 535-541.
19.	Wheeler M, Oderda GM, Ashburn MA, et al. Adverse events associated with postoperative opioid analgesia: a systematic review. J Pain, 2002, 3(3): 159-180.

1. 贺广宝, 高红梅, 鲍杨, 等. 腹腔镜胆囊切除术术后恶心呕吐的危险因素分析. 临床和实验医学杂志, 2020, 19(1): 105-108.
2. Fujii Y. The utility of antiemetics in the prevention and treatment of postoperative nausea and vomiting in patients scheduled for laparoscopic cholecystectomy. Curr Pharm Des, 2005, 11(24): 3173-3183.
3. Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg, 2006, 102(6): 1884-1898.
4. Wang LJ, Cang J, Xue ZG. Cost-effectiveness comparison between 6 interventions for the prevention of postoperative nausea and vomiting (PONV) on low-risk patients. Fudan Univ J Med Sci, 2014, 41(1): 74-80.
5. Apfel CC, Philip BK, Cakmakkaya OS, et al. Who is at risk for postdischarge nausea and vomiting after ambulatory surgery?. Anesthesiology, 2012, 117(3): 475-486.
6. Gan TJ, Meyer TA, Apfel CC, et al. Society for ambulatory anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2007, 105(6): 1615-1628.
7. Lee C, Chung JY, Lee M. Sex-related differences in the efficacy of dexamethasone pretreatment for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: a randomized controlled study. Turkish J Med Sci, 2017, 47(4): 1282-1286.
8. Gan TJ, Belani KG, Bergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2020, 131(2): 411-448.
9. Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg, 2014, 12(12): 1500-1524.
10. Mayo I, Lizarondo L, Stokan M. Experiences of adult patients in discharge and recovery from day surgery: a qualitative systematic review protocol. JBI Database System Rev Implement Rep, 2019, 17(2): 164-169.
11. 马洪升, 程南生, 朱涛. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
12. Choi SU. Is postoperative nausea and vomiting still the big “little” problem?. Korean J Anesthesiol, 2016, 69(1): 1-2.
13. Sridharan K, Sivaramakrishnan G. Drugs for preventing post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: network meta-analysis of randomized clinical trials and trial sequential analysis. Int J Surg, 2019, 69: 1-12.
14. Chandrakantan A, Glass PS. Multimodal therapies for postoperative nausea and vomiting, and pain. Br J Anaesth, 2011, 107(Suppl 1): i27-i40.
15. Elvir-Lazo OL, White PF, Yumul R, et al. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Res, 2022: F1000 Faculty Rev-983.
16. Hussain AM, Khan FA, Ahmed A, et al. Effect of gender on pain perception and analgesic consumption in laparoscopic cholecystectomy: an observational study. J Anaesthesiol Clin Pharmacol, 2013, 29(3): 337-341.
17. Johansson E, Hultin M, Myrberg T, et al. Early post-operative nausea and vomiting: a retrospective observational study of 2030 patients. Acta Anaesthesiol Scand, 2021, 65(9): 1229-1239.
18. Ismail EA, Bakri MH, Abd-Elshafy SK, et al. Dexamethasone alone versus in combination with intra-operative super-hydration for postoperative nausea and vomiting prophylaxis in female patients undergoing laparoscopic cholecystectomy: a randomized clinical trial. Korean J Anesthesiol, 2017, 70(5): 535-541.
19. Wheeler M, Oderda GM, Ashburn MA, et al. Adverse events associated with postoperative opioid analgesia: a systematic review. J Pain, 2002, 3(3): 159-180.

West China Medical Journal

Effect of bundled care on postoperative nausea and vomiting in patients undergoing day laparoscopic cholecystectomy

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