Postoperative vomiting/nausea in Chinese patients undergoing bariatric surgery

Abstract

Purpose: To assess the incidence of post-operative vomiting/nausea (PVN), as well as usage and effectiveness of PVN prophylaxis in Chinese patients receiving bariatric surgery. Methods: This prospective observational study included 82 patients subjected to bariatric surgery using total intravenous (IV) anesthesia. Patients were given PVN prophylactic treatment as per the local practice depending on Apfel et al criterion for simplified risk score useful for PVN prediction. Postsurgery, the patients were evaluated at 2, 4, 6, 24, 48 and 72 h using a questionnaire. Univariate analysis of risk factors associated with PVN was carried conducted with Pearson's Chi-squared test for category variables and Mann-Whitney-Wilcoxon test for a continuous variable. Results: About 69 % of the patients developed PVN within 24 h post-surgery, and the risk increased with increase in the number of PVN risk factors. Significant contrasts were seen with respect to PVN, with higher occurrence in females (81.36 %), when compared to males (39.13 %) within the first 24 h (p < 0.05). Two patients got sub-optimum PVN prophylactic therapy as per guidelines, 19 patients had optimum therapy, while 61 patients had supra-optimum therapy. Moreover, 63.94 % of patients who obtained supra-optimum PVN prophylactic therapy experienced PVN within 24 h post-surgery, while 84.21 % of patients with optimum PVN prophylactic therapy experienced PVN within the same period (p < 0.05). Overall, 35.37 % of patients experienced serious nausea 24 h post-surgery. Conclusion: PVN incidence is high, notwithstanding the fact that almost all the patients received optimum or supra-optimum prophylactic therapy. These findings raise dubiety regarding the viability and significance of using risk-based PVN prophylactic therapy in patients under bariatric surgery. Thus, further research is needed in this regard.