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Article

Postoperative Vomiting Following Laparoscopic Cholecystectomy Is Associated with Intraoperative Fluid Administration: A Retrospective Cohort Study

Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan
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Author to whom correspondence should be addressed.
These authors have contributed equally to this work.
Academic Editors: Domenica Matranga, Filippa Bono and Laura Maniscalco
Int. J. Environ. Res. Public Health 2021, 18(10), 5305; https://doi.org/10.3390/ijerph18105305
Received: 22 March 2021 / Revised: 9 May 2021 / Accepted: 12 May 2021 / Published: 17 May 2021
(This article belongs to the Special Issue Healthcare and Health: Measures and Evaluation)
Potential risk factors for postoperative vomiting (POV) are important for daily anesthesia practice. To identify the risk factors associated with POV we retrospectively reviewed 553 adult patients who underwent scheduled simple laparoscopic cholecystectomy under sevoflurane-based general anesthesia between January and December 2018. Patients who experienced POV were predominantly women, had lower body weight, and higher ASA (American Society of Anesthesiologists) physical status. The POV group showed female sex predominance, lower body weight, and higher ASA physical status, with a significant difference when compared with the non-POV group. In univariate analysis, female sex and Apfel scores of 2, 3, and 4 were associated with a higher POV incidence. Age > 70 years, higher body weight, and ASA physical status III were associated with a lower POV incidence. In multivariate logistic regression, sex, age, Apfel score, and intraoperative crystalloid infusion rate were POV predictive factors. Receiver operating characteristic analysis showed a negative association between the intraoperative crystalloid infusion rate and POV occurrence with an area under the curve of 0.73 (p = 0.001). The cutoff intraoperative crystalloid infusion rate was 2 mL/kg/h with 82% sensitivity and 49% specificity (≥2 mL/kg/h was associated with a lower POV incidence vs. <2 mL/kg/h (OR, 95% CI; 0.52 [0.33–0.83])). To decrease POV in these patients, identifying high-risk factors and an intraoperative crystalloid administration of ≥2 mL/kg/h should be considered in patients undergoing LC under sevoflurane-based general anesthesia. View Full-Text
Keywords: general anesthesia; laparoscopic cholecystectomy; nausea; sevoflurane; vomiting general anesthesia; laparoscopic cholecystectomy; nausea; sevoflurane; vomiting
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MDPI and ACS Style

Hsieh, C.-Y.; Poon, Y.-Y.; Ke, T.-Y.; Chiang, M.-H.; Li, Y.-Y.; Tsai, P.-N.; Wu, S.-C. Postoperative Vomiting Following Laparoscopic Cholecystectomy Is Associated with Intraoperative Fluid Administration: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 5305. https://doi.org/10.3390/ijerph18105305

AMA Style

Hsieh C-Y, Poon Y-Y, Ke T-Y, Chiang M-H, Li Y-Y, Tsai P-N, Wu S-C. Postoperative Vomiting Following Laparoscopic Cholecystectomy Is Associated with Intraoperative Fluid Administration: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(10):5305. https://doi.org/10.3390/ijerph18105305

Chicago/Turabian Style

Hsieh, Chia-Yu; Poon, Yan-Yuen; Ke, Ting-Yu; Chiang, Min-Hsien; Li, Yan-Yi; Tsai, Peng-Neng; Wu, Shao-Chun. 2021. "Postoperative Vomiting Following Laparoscopic Cholecystectomy Is Associated with Intraoperative Fluid Administration: A Retrospective Cohort Study" Int. J. Environ. Res. Public Health 18, no. 10: 5305. https://doi.org/10.3390/ijerph18105305

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