Influencing factors and prevention of postoperative nausea and vomiting in patients undergoing daytime laparoscopic cholecystectomy

doi:10.3877/cma.j.issn.2095-3232.2025042

Abstract

Abstract:

Objective

To investigate the influencing factors， prevention and treatment of postoperative nausea and vomiting （PONV） in patients undergoing daytime laparoscopic cholecystectomy（LC）.

Methods

Clinical data of 495 patients with benign gallbladder diseases who received consecutive daytime LC in Beijing Chaoyang Hospital Affiliated to Capital Medical University from June 2019 to May 2021 were analyzed retrospectively.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them， 176 patients were male and 319 female， aged from 19 to 69 years， with a median age of 43 years.Multi-mode prevention of PONV was adopted after LC.Medical records including gender， age， abdominal surgery， hypertension， smoking and cardiovascular and cerebrovascular diseases were collected and analyzed.Preoperative laboratory examination and American Society of Anesthesiologists （ASA） classification， intraoperative pneumoperitoneal pressure， intraoperative blood loss and operation time were also obtained.Influencing factors of PONV were identified by Logistic regression analysis.

Results

All 495 patients successfully completed LC and were discharged on the day of operation.The incidence of PONV was 13.9%（69/495）， which was relieved after use of antiemetic drugs.Multivariate Logistic regression analysis showed that gender （OR=0.144， 95%CI： 0.063-0.330）， age（OR=0.956， 95%CI： 0.931-0.982）， operation time （OR=1.017， 95%CI： 1.493-2.876） and pneumoperitoneal pressure （OR=2.072， 95%CI： 0.645-1.173） were the independent influencing factors of PONV in patients undergoing daytime LC （all P＜0.05）.

Conclusions

Gender， age， operation time and pneumoperitoneal pressure are the independent influencing factors of PONV in patients undergoing daytime LC.For young female patients， precaution should be strengthened， the pneumoperitoneal pressure should be reduced as much as possible during operation and surgical process should be accelerated.

Key words: Cholecystectomy, laparoscopic, Postoperative nausea and vomiting, Influencing factors

Chunyi Liu, Qi Sun, Zhongwei Shi, Jing Huang. Influencing factors and prevention of postoperative nausea and vomiting in patients undergoing daytime laparoscopic cholecystectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(02): 245-249.

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Figures/Tables 2

指标	非PONV组	PONV组	统计值	P值
性别女（例）	257	62	χ ²=3.743	＜0.001
年龄（岁， $\overset{ˉ}{x}$ ±s）	45±12	41±8	t=3.566	＜0.001
WBC（×10⁹， $\overset{ˉ}{x}$ ±s）	6.5±1.7	6.2±1.6	t=1.451	0.150
中性粒细胞（%， $\overset{ˉ}{x}$ ±s）	59±9	58±9	t=0.426	0.671
AST［U/L，M（Q₁，Q₃）］	20（17，24）	20（17，24）	Z=0.086	0.931
ALT［U/L，M（Q₁，Q₃）］	20（15，28）	20（14，32）	Z=0.310	0.757
TB ［μmol/L，M（Q₁，Q₃）］	13.4（10.7，16.8）	11.8（9.5，15.2）	Z=2.831	0.006
DB ［μmol/L，M（Q₁，Q₃）］	3.9（3.0，5.1）	3.6（2.9，4.2）	Z=2.686	0.008
术中出血量［ml，M（Q₁，Q₃）］	10（5，10）	10（5，10）	Z=1.451	0.150
气腹压（mmHg， $\overset{ˉ}{x}$ ±s）	12.2±0.6	12.6±0.9	t=-3.776	＜0.001
手术时间（min， $\overset{ˉ}{x}$ ±s）	64±21	71±21	t=-2.396	0.019
ASA分级Ⅰ级（例）	372	57	χ ²=0.628	0.530
腹部手术史（例）	38	14	χ ²=1.516	0.130
有腹痛症状（例）	310	48	χ ²=0.427	0.669
吸烟史（例）	41	3	χ ²=0.703	0.482
高血压病史（例）	59	7	χ ²=0.494	0.622
心脑血管史（例）	1	0	χ ²=0.031	0.975
原发病（例）			χ ²=0.245	0.807
胆囊结石	337	53
胆囊息肉	75	15
胆囊肌腺症	14	1

指标	非PONV组	PONV组	统计值	P值
性别女（例）	257	62	χ ²=3.743	＜0.001
年龄（岁， $\overset{ˉ}{x}$ ±s）	45±12	41±8	t=3.566	＜0.001
WBC（×10⁹， $\overset{ˉ}{x}$ ±s）	6.5±1.7	6.2±1.6	t=1.451	0.150
中性粒细胞（%， $\overset{ˉ}{x}$ ±s）	59±9	58±9	t=0.426	0.671
AST［U/L，M（Q₁，Q₃）］	20（17，24）	20（17，24）	Z=0.086	0.931
ALT［U/L，M（Q₁，Q₃）］	20（15，28）	20（14，32）	Z=0.310	0.757
TB ［μmol/L，M（Q₁，Q₃）］	13.4（10.7，16.8）	11.8（9.5，15.2）	Z=2.831	0.006
DB ［μmol/L，M（Q₁，Q₃）］	3.9（3.0，5.1）	3.6（2.9，4.2）	Z=2.686	0.008
术中出血量［ml，M（Q₁，Q₃）］	10（5，10）	10（5，10）	Z=1.451	0.150
气腹压（mmHg， $\overset{ˉ}{x}$ ±s）	12.2±0.6	12.6±0.9	t=-3.776	＜0.001
手术时间（min， $\overset{ˉ}{x}$ ±s）	64±21	71±21	t=-2.396	0.019
ASA分级Ⅰ级（例）	372	57	χ ²=0.628	0.530
腹部手术史（例）	38	14	χ ²=1.516	0.130
有腹痛症状（例）	310	48	χ ²=0.427	0.669
吸烟史（例）	41	3	χ ²=0.703	0.482
高血压病史（例）	59	7	χ ²=0.494	0.622
心脑血管史（例）	1	0	χ ²=0.031	0.975
原发病（例）			χ ²=0.245	0.807
胆囊结石	337	53
胆囊息肉	75	15
胆囊肌腺症	14	1

影响因素	b	SE（b）	Waldχ²	OR	95%CI	P值
性别	-1.937	0.423	20.968	0.144	0.063～0.330	＜0.001
年龄	-0.045	0.014	10.623	0.956	0.931～0.982	0.001
手术时间	-0.016	0.006	6.929	1.017	1.493～2.876	0.008
TB	-0.018	0.054	0.110	1.018	1.004～1.029	0.741
DB	0.139	0.153	0.833	0.870	0.916～1.132	0.361
气腹压	-0.729	0.167	18.974	2.072	0.645～1.173	＜0.001

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