Incidence and risk factors of postoperative nausea and vomiting in lung cancer patients following lobectomy and application of analgesic pumps

Abstract

Objective To investigate the occurrence rate and risk factors of postoperative nausea and vomiting (PONV) in lung cancer patients following lobectomy and application of analgesic pumps. Methods This retrospective study reviewed clinical data from patients that had undergone lobectomy for lung cancer under general anaesthesia. The risk factors of PONV were analysed using binary logistic regression models. Results A total of 203 patients (97 females) were enrolled. The rate of PONV was 29.6% (60 of 203 patients) for all patients, 42.3% (41 of 97 patients) for female patients and 17.9% (19 of 106 patients) for male patients. Female patients undergoing thoracotomy (odds ratio [OR] 7.770, 95% confidence interval [CI] 1.747, 34.568) or having surgery durations ≥120 min (OR 4.493, 95% CI 1.502, 12.851) were significantly more susceptible to PONV. The risk of PONV in female patients that received postoperative dolasetron (100 mg, once a day) was significantly lower (OR 0.075, 95% CI 0.007, 0.834). For male patients, the risk of PONV was significantly lower in those with a body mass index ≥24 kg/m2 (OR 0.166; 95% CI 0.035, 0.782). Conclusion Female and male patients have different risk factors for PONV following lobectomy for lung cancer and application of analgesic pumps.

Comparative efficacy of prophylactic protocols in reducing perioperative nausea and vomiting during video-assisted thoracoscopic radical resection of lung cancer

“…For instance, even with routine antiemetic prophylaxis, up to 30% of patients may experience PONV after breast cancer surgery 27 . Similarly, in patients undergoing general anesthesia for lobectomy in lung cancer, the incidence of PONV is reported to be 29.6% 7 . In the case of laparoscopic bariatric surgery, the prevalence of PONV ranges from 44 to 90% 28 .…”

“…PONV is a frequently encountered complication following anesthesia and surgery, with an incidence ranging from 20 to 30% 6 . In patients undergoing lobectomy for lung cancer under general anesthesia, the incidence of PONV was reported to be 29.6% 7 . PONV can give rise to various adverse events, such as aspiration, wound dehiscence, bleeding, dehydration, electrolyte imbalance, and the inability to initiate oral medication 8 , 9 .…”

“…These include being female, younger age, undergoing high-risk surgery, exposure to volatile anesthetics, a history of PONV or motion sickness, non-smoking status, administration of post-operative opioids, and prolonged anesthesia duration 14 . Studies have indicated that female patients and non-smokers undergoing lobectomy are more likely to experience a higher incidence of PONV 7 . Furthermore, increased doses of fentanyl per kilogram per hour have been identified as an independent risk factor for PONV during thoracoscopic lung wedge resection 15 .…”

Early Ambulation Following Lung Resection Surgery: Impact on Short-term Outcomes in Patients with Lung Cancer

“…Pain had no effect on early ambulation during pulmonary rehabilitation; this was due to opioid use for pain control, which affected the incidence of PONV. Female sex, history of motion sickness or PONV, nonsmoking, and the use of postoperative opioids were reported as risk factors for PONV 28) , and the incidence of PONV was significantly higher with lobectomy than that with VATS 29) . Accurate identification of these risk factors may facilitate the promotion of postoperative ambulation on the following day, potentially enhancing the outcomes gleaned from this study.…”

Effect of ondansetron compared to lidocaine and placebo for reducing propofol injection pain: A systematic review and meta-analysis of randomized controlled trials

“…Prolonged vomiting can also cause fluid depletion and dehydration, as well as an increase in post-operative morbidity. [11,12] PONV avoidance and post-operative pain reduction are both patient concerns. [13] Ondansetron is a 5-hydroxytryptamine 3 antagonist that acts as an anti-emetic and antinauseant by blocking serotonin-induced depolarization of vagal afferent neurons.…”