ObjectiveTo compare the postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG) and single-anastomosis sleeve ileal bypass (SASI), and to explore the risk factors for PONV. MethodA total of 220 patients at the Affiliated Hospital of Xuzhou Medical University from June 2022 to December 2022 were prospectively collected, and were randomly divided into the LSG group and the SASI group; the general condition of the patients was recorded. PONV was assessed on the POD0, POD1, POD2, POD30, POD60, POD90, using the Rhodes index score.ResultsThe total Rhodes index score in the LSG group was higher than that in the SASI group [(25.56±13.54) vs. (16.06±11.28), P＜0.05]. The results of multiple linear regression analysis showed that female (P=0.014), LSG (P＜0.001), young age (P=0.050), and low BMI (P=0.019) were risk factors for PONV. ConclusionsCompared with LSG, the Rhodes index score after SASI is low. For young women with low BMI, special attention should be paid to the prevention and treatment of PONV after LSG.
Objective To explore the nursing effect of using Neiguan acupoint massage combined with chewing gum in patients undergoing day-case laparoscopic cholecystectomy. Methods A prospective study was conducted on patients who underwent day-case laparoscopic cholecystectomy in West China Hospital of Sichuan University between March 2023 and March 2024. The patients were randomly divided into the control group and the intervention group according to a random number table. The control group received routine care, while the intervention group received chewing gum and Neiguan acupoint massage intervention at the P6 acupoint in addition to routine care. The incidence of postoperative nausea and vomiting (PONV), pain scores, gastrointestinal function recovery time, medication use, and hospitalization related indicators were compared between the two groups of patients after surgery. Results A total of 298 patients were included. Among them, there were 163 cases in the control group and 135 cases in the intervention group. The incidence of PONV at 0.5 and 2 hours after surgery and the pain scores at 6, 12, and 24 hours after surgery in the intervention group were lower than those in the control group (P<0.05). The first bowel sounds recovery time, anal exhaust time, and eating time in the intervention group were shorter than those in the control group (P<0.05). Twenty-four hours after surgery, the usage rate of analgesic drugs (6.67% vs. 14.11%) and the usage rate of rescue antiemetic drugs (2.96% vs. 8.59%) in the intervention group were lower than those in the control group (P<0.05). There was no statistically significant difference in the delayed discharge rate or total cost between the two groups (P>0.05). The nursing satisfaction of the intervention group was higher than that of the control group (99.26% vs. 93.25%, P<0.05). Conclusions After the combination of Neiguan acupoint massage and chewing gum intervention in patients undergoingin day-case laparoscopic cholecystectomy, the PONV incidence and pain are significantly reduced, gastrointestinal functions recover faster, drug use rate is low, patient nursing satisfaction is high. This method can be promoted and applied.
Enhanced recovery after surgery (ERAS) is a protocol designed to improve perioperative outcomes by multidisciplinary team with evidence-based interventions. The implementation of ERAS concept has been proved to reduce postoperative complications and hospital stay. The anesthesia management under the concept of ERAS is the basis of safe and smooth ambulatory surgical protocol. This article summarizes the latest clinical evidence at home and abroad, and reviews the preoperative optimization, anesthesia mode selection, ventilation strategies, fluid management, temperature support, pain management, postoperative nausea and vomiting prevention, postoperative nutritional support, and postoperative sleep improvement in the management of anesthesia under ERAS concept, in order to provide a reference for anesthesia management in ambulatory surgery.
Objective To explore the latent classes of developmental trajectories and influencing factors of postoperative nausea and vomiting in patients undergoing open posterior spinal surgery. Methods Patients who underwent open posterior spinal surgery at Peking Union Medical College Hospital between November 2024 and October 2025 were enrolled. Demographic data and clinical data, as well as data on nausea, vomiting, and psychological status from postoperative day 1 to 3, were collected. Latent growth mixture model was used to identify developmental trajectories of PONV. Univariate analysis and binary logistic regression were performed to analyze the influencing factors of the latent postoperative nausea and vomiting classes. Results A total of 201 patients were included. Among them, there were 62 males and 139 females. Two distinct developmental trajectories of postoperative nausea and vomiting were identified by latent growth mixture model: the high risk postoperative nausea and vomiting class (84 patients, 41.8%) and the low risk postoperative nausea and vomiting class (117 patients, 58.2%). Logistic regression showed that a history of abdominal surgery, duration of peak pain on postoperative day 1, a history of previous postoperative nausea and vomiting or motion sickness, time from surgery completion to first oral intake, age and hemoglobin concentration on postoperative day 2 were associated with high risk of postoperative nausea and vomiting. Conclusions Two heterogeneous developmental trajectories of postoperative nausea and vomiting in patients undergoing open posterior spinal surgery were identified using latent growth mixture model, and the independent influencing factors were clarified. Medical staff can formulate targeted prevention and control measures based on the influencing factors of the latent classes, optimize management strategies for postoperative nausea and vomiting in spinal surgery patients, and provide a basis for precise clinical prevention and control of postoperative nausea and vomiting.