PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING IN PATIENTS WITH MORBID OBESITY UNDERGOING LAPAROSCOPIC BARIATRIC SURGERY
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Keywords: Postoperative nausea and vomiting (PONV), Morbid obesity, Laparoscopic bariatric surgery, Anti-emetic medications##article.abstract##
Obesity is a chronic disease of the 21st century and an epidemic spreading worldwide [1]. According to statistics, 1.4 billion adults around the world suffer from overweight [1,2]. Of these, 900 million women and over 500 million men suffer from obesity. Postoperative nausea and vomiting (PONV) are common and distressing complications following bariatric surgery, particularly in patients with morbid obesity. [3,4]. These complications can significantly impact patient recovery and satisfaction. This article explores the prevention strategies for PONV in patients undergoing laparoscopic bariatric surgery [5,6]. Key factors contributing to PONV include the use of anesthetics, pain management, hormonal changes, and gastrointestinal disruptions post-surgery. The article reviews preoperative, anesthetic, pharmacological, and postoperative approaches to minimize the risk of PONV[7,8]. Effective preoperative assessment, careful selection of anesthetics, the use of antiemetic medications, and appropriate pain management are essential for improving postoperative outcomes [9]. Additionally, gradual reintroduction of food and fluids, along with dietary and lifestyle adjustments, play a crucial role in reducing PONV [10]. The goal of this review is to provide a comprehensive overview of effective prevention strategies that can enhance recovery and improve patient comfort after laparoscopic bariatric surgery.
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1.Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, Riley LM, Ezzati M (2011) National, regional and global trends in body-mass index since 1980: systemic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 377:557–567
2.Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. Obes. Res. 2018;6 Suppl 2:51S-209S
3.Apfel CC, Heidrich FM, Jukar-Rao S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth. 2012;109:742–53. doi: 10.1093/bja/aes276. [DOI] [PubMed] [Google Scholar]
4.Apfel CC, Laara E, Koivuranta M, et al. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91:693–700. doi: 10.1097/00000542-199909000-00022. [DOI] [PubMed] [Google Scholar]
5. Glass PSA, White PF: Practice guidelines for the management of postoperative nausea and vomiting: Past, present, and future. Anesth Analg. 2007;105(6):1528–9. 10.1213/01.ane.0000295854.53423.8A [DOI] [PubMed] [Google Scholar]
6. Fero KE, Jalota L, Hornuss C: Pharmacologic management of postoperative nausea and vomiting. Expert Opin Pharmacother. 2011;12(15):2283–96. 10.1517/14656566.2011.598856 [DOI] [PubMed] [Google Scholar]
7. Apipan B, Rummasak D, Wongsirichat N: Postoperative nausea and vomiting after general anesthesia for oral and maxillofacial surgery. J Dent Anesth Pain Med. 2016;16(4):273–281. 10.17245/jdapm.2016.16.4.273 [DOI] [PMC free article] [PubMed] [Google Scholar]
8. Dzwonczyk R, Weaver TE, Puente EG, et al. : Postoperative nausea and vomiting prophylaxis from an economic point of view. Am J Ther. 2012;19(1):11–5. 10.1097/MJT.0b013e3181e7a512 [DOI] [PubMed] [Google Scholar]
9.Kocián P, Pazdírek F, Přikryl P, Vymazal T, Hoch J, Whitley A. Should minimally invasive approaches in rectal surgery be regarded as a key element of modern enhanced recovery perioperative care? Acta Chir Belg. 2023 Apr;123(2):163-169. [PubMed] [Reference list]
10. Habib AS, Chen YT, Taguchi A, Hu XH, Gan TJ. Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis. Curr Med Res Opin. 2006 Jun;22(6):1093-9. doi: 10.1185/030079906X104830. PMID: 16846542.
