Perioperative Antiemetic Therapy for Fast-Track Laparoscopic Bariatric Surgery

  • Olumuyiwa A. Bamgbade
  • Oluwafemi Oluwole
  • Rong R. Khaw
Original Contributions

Abstract

Background

Postoperative nausea and vomiting (PONV) is problematic in bariatric surgery patients and has negative impacts on perioperative outcome. Antiemetic prophylaxis may reduce PONV. Perioperative antiemetic prophylaxis or therapy is crucial and may enhance fast-track bariatric surgery. This study examined the impact of intraoperative multimodal antiemetic prophylaxis on fast-track bariatric surgery.

Methods

This prospective observational clinical study explored the perioperative data of 400 consecutive laparoscopic bariatric surgery patients, over a 6-year period. Perioperative outcomes and variables were analyzed and compared between different intraoperative antiemetic modes.

Results

The mean BMI was 49, mean age was 42, and male:female ratio was 1:4. About 70% of patients received intraoperative multimodal antiemetic, comprising combinations of prochlorperazine, dexamethasone, ondansetron, or cyclizine. PONV occurred in 19.5% of patients. Intraoperative multimodal antiemetic was associated with significantly less PONV, shorter post-anesthesia care unit duration, earlier postoperative drinking, and shorter hospital stay (p = 0.001). Compared to other multimodal antiemetic modes, dexamethasone + cyclizine + prochlorperazine provided the best prophylaxis and outcome: p = 0.002.

Conclusion

PONV is a common and peculiar problem in bariatric surgery patients. However, intraoperative multimodal antiemetic prophylaxis effectively minimizes PONV. Intraoperative multimodal antiemetic enhances fast-track bariatric surgical care, patient satisfaction, and perioperative outcomes.

Keywords

Postoperative vomiting Multimodal antiemetic Laparoscopic bariatric surgery Fast track Enhanced recovery Dexamethasone Cyclizine Prochlorperazine 

Notes

Acknowledgements

This study was approved and registered by the research department of Central Manchester University Hospital, Manchester, England. Institutional support is acknowledged, but there was no conflict of interest or financial involvement regarding any of the authors.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants in the study.

Statement of Human Rights

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Olumuyiwa A. Bamgbade
    • 1
  • Oluwafemi Oluwole
    • 2
  • Rong R. Khaw
    • 3
  1. 1.Department of AnaesthesiaUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Community Health and EpidemiologyUniversity of SaskatchewanSaskatoonCanada
  3. 3.Department of SurgeryUniversity of ManchesterManchesterUK

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