Postoperative Nausea and Vomiting with Application of Postoperative Continuous Positive Airway Pressure after Laparoscopic Gastric Bypass
Abstract
Background This study was performed to assess postoperative nausea and vomiting (PONV) with application of postoperative continuous positive airway pressure (CPAP) for patients undergoing Roux-en-Y gastric bypass (RYGB).Methods The anesthesia database was searched for patients who underwent RYGB for 5 years. Three hundred fifty-six patients met the inclusive criteria. Wilcoxon two-sample rank test, Fisher's exact test, and multivariate logistic regression were used to analyze the data and identify the potential factors. A p value less than 0.05 was considered significant.Results The overall incidence of the PONV (nausea or emesis or both) was 42%during the first 24 h postoperatively. Thirty-six percent and 35% in CPAP and no-CPAP groups respectively had reported nausea in postanesthesia care unit (PACU). There was no difference between groups (p > 0.05). There was a less frequent occurrence of emesis in both groups. The incidence of emesis in PACU was 19% in CPAP group and 17% in no-CPAP group (p > 0.05). No statistically significant differences of PONV in postoperative 24 h could be shown between the groups (p > 0.05). The postoperative hypertension occurred more often and intravenous antihypertensive medications were required more in no-CPAP patients (p = 0.013). More patients in no-CPAP group developed oxygenation disturbances (p = 0.012).The mean length of PACU stay was significantly longer in this group (p = 0.029). Reintubation and intensive care unit admission occurred more frequently in no-CPAP patients; however, the difference did not reach statistical significance.Conclusions There was no significantly increased risk of PONV with the use of postoperative CPAP. We recommend the routine use of postoperative CPAP for patients with obstructive sleep apnea undergoing RYGB to optimize their respiratory function.
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Meta-analysis of observational studies suggested a trend towards lower odds of reintubation with perioperative CPAP (OR 0.28, 95% CI 0.07 to 1.04).
“Meta-analysis of observational studies suggested higher odds of postoperative pneumonia (OR 0.24, 95% CI 0.07 to 0.82), a trend towards lower odds of reintubation (OR 0.28, 95% CI 0.07 to 1.04), and shorter hospital stay (WMD − 1.6 days, 95% CI − 1.83 to − 1.28) albeit relevant evidence was of low certainty due to imprecision and the observational study design (Supplementary Table S7) [51, 52, 60,”
Meta-analysis of observational studies suggested higher odds of postoperative pneumonia (OR 0.24, 95% CI 0.07 to 0.82) with perioperative CPAP.
“Meta-analysis of observational studies suggested higher odds of postoperative pneumonia (OR 0.24, 95% CI 0.07 to 0.82), a trend towards lower odds of reintubation (OR 0.28, 95% CI 0.07 to 1.04), and shorter hospital stay (WMD − 1.6 days, 95% CI − 1.83 to − 1.28) albeit relevant evidence was of low certainty due to imprecision and the observational study design (Supplementary Table S7) [51, 52, 60,”
Meta-analysis of observational studies suggested shorter hospital stay with perioperative CPAP (WMD −1.6 days, 95% CI −1.83 to −1.28).
“Meta-analysis of observational studies suggested higher odds of postoperative pneumonia (OR 0.24, 95% CI 0.07 to 0.82), a trend towards lower odds of reintubation (OR 0.28, 95% CI 0.07 to 1.04), and shorter hospital stay (WMD − 1.6 days, 95% CI − 1.83 to − 1.28) albeit relevant evidence was of low certainty due to imprecision and the observational study design (Supplementary Table S7) [51, 52, 60,”
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- Authors
- Meng, L.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Meng, Li
- Venue
- Obesity Surgery
- Published
- 2008-10-17
- Volume
- 20
- Issue
- 7
- Pages
- 876-880
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W1970642271
- Cited by
- 25
- References
- 21
- Citations by year
- 2024: 1 · 2023: 2 · 2022: 3 · 2020: 1 · 2019: 1 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- postoperative nausea and vomiting, continuous positive airway pressure
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Care, Postoperative Complications, Postoperative Period, Retrospective Studies, Gastric Bypass, Incidence, Sleep Apnea, Obstructive, Postoperative Nausea and Vomiting, Continuous Positive Airway Pressure, Young Adult
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