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Abstract：
Purpose Postoperative nausea and vomiting (PONV) is a major problem after surgery. This study aimed to demonstrate the incidence of PONV and the potential associated factors in female patients undergoing laparoscopic gastrointestinal surgery against the background of double prophylactic therapy. Methods Our retrospective study recruited 109 female patients undergoing laparoscopic gastrointestinal surgery with double prophylactic therapy, combining palonosetron with dexamethasone, from October 2020 to March 2021, at the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Patient characteristics and perioperative management factors were included in univariate and multivariate analyses to identify factors influencing PONV. Results Four patients lacked complete records, and of the 105 patients included in the final analysis, 53 (50.5%) patients developed PONV. Two influencing factors for PONV were identified: a history of chemotherapy (odds ratio [OR] 0.325, 95% confidence interval [CI] 0.123-0.856; p = 0.023) and dosage of hydromorphone ≥ 0.02 mg/kg (OR 2.857, 95% CI 1.247-6.550; p = 0.013). The performance of the multivariate logistic regression was evaluated by analyzing receiver operating characteristic curves, resulting in an area under the curve value of 0.673. Conclusion The incidence of PONV remains high in female patients undergoing laparoscopic gastrointestinal surgery, even with double prophylactic therapy. A dosage of hydromorphone ≥ 0.02 mg/kg may increase risk of PONV, whereas a history of chemotherapy might be a protective factor.
摘要：
目的术后恶心和呕吐（PONV）是手术后的主要问题。这项研究旨在证明在双重预防性治疗背景下，接受腹腔镜胃肠手术的女性患者PONV的发生率和潜在的相关因素。方法我们的回顾性研究招募了109例接受双重预防性腹腔镜胃肠手术的女性患者，帕洛诺司琼与地塞米松合用，2020年10月至2021年3月，在中山大学附属第六医院，广州,中国。单因素和多因素分析包括患者特征和围手术期管理因素，以确定影响PONV的因素。结果4例患者无完整记录,在最终分析的105名患者中，53例（50.5%）患者发生PONV。确定了PONV的两个影响因素：化疗史（比值比[OR]0.325，95％置信区间[CI]0.123-0.856；p=0.023）和氢吗啡酮的剂量≥0.02mg/kg（OR2.857，95％CI1.247-6.550；p=0.013）。通过分析受试者工作特征曲线来评估多变量逻辑回归的性能，导致曲线下面积值为0.673。结论女性腹腔镜胃肠手术患者PONV的发生率较高。即使是双重预防性治疗。氢吗啡酮的剂量≥0.02mg/kg可能会增加PONV的风险，而化疗史可能是一个保护因素。
