Exploring correlation between preoperative gut microbiota and PONV using 16S absolute quantitative sequencing: a prospective observational study

Abstract

Background: Postoperative nausea and vomiting (PONV) is a common complication following surgery. Despite various preventive measures, satisfactory outcomes have not been achieved. This study explores the potential of gut microbiota interactions with the host in understanding and preventing PONV, using 16S absolute quantitative sequencing technology to uncover new insights. Methods: Patients who experienced nausea and vomiting within 24 h after surgery were divided into a PONV group (n = 22) and a non-PONV group (n = 22). Microbial communities linked to PONV were assessed through bioinformatics analysis. Fecal samples from both groups were transplanted into rats, which were then anesthetized with isoflurane for 100 min. Pica behavior was monitored over the next 24 h to assess nausea and vomiting in the rats. Results: Significant differences in α- and β-diversity were observed between the PONV and non-PONV groups. Six key microorganisms were identified, with Bifidobacterium, Bilophila, and Oscillibacter showing a negative correlation with PONV severity. Receiver operating characteristic (ROC) analysis demonstrated that Bifidobacterium could reliably predict PONV. Rats receiving feces from the PONV group exhibited significantly higher kaolin consumption within 24 h post-anesthesia compared to those receiving feces from the non-PONV group. Conclusion: These results suggest a potential new mechanism for PONV involving gut microbiota, offering a theoretical basis for preoperative prediction of PONV based on gut microbial composition.