Postoperative nausea and vomiting in bariatric surgery: a position statement endorsed by the ASMBS and the ISPCOP

Schumann, Roman; Ziemann-Gimmel, Patrick; Sultana, Adrian; Eldawlatly, Abdelazeem; Kothari, Shanu N.; Shah, Sajani; Wadhwa, Anupama

doi:10.1016/j.soard.2021.08.005

Cited by 18 publications

(6 citation statements)

References 33 publications

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“…To manage PONV, we used a combination of antiemetics for prophylaxis and rescue. As indicative of the high rate of PONV in bariatric surgery, the proportion of vomiting within postoperative 24 h in the control group was 72.4%, which is similar to the rates reported in the previous study [ 19 ]. Compared with female patients undergoing laparoscopic gynecological surgeries, female patients who underwent LSG had a significantly higher occurrence of PONV (23.0% vs. 66.2%) [ 20 ].…”

Section: Discussionsupporting

confidence: 86%

ST36 acupoint injection with anisodamine for postoperative nausea and vomiting in female patients after bariatric surgery: a prospective, randomized controlled trial

et al. 2023

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Background The use of multimodal pharmacological prophylactic regimes has decreased postoperative nausea and vomiting (PONV) in general but it still occurs in over 60% of female patients after bariatric surgery. This study aimed to evaluate the efficacy of ST36 acupoint injection with anisodamine in prevention of PONV among female patients after bariatric surgery. Methods Ninety patients undergoing laparoscopic sleeve gastrectomy were randomly allocated to anisodamine or control group at the ratio of 2:1. Anisodamine or normal saline was injected into Zusanli (ST36) bilaterally after induction of general anesthesia. The incidence and severity of PONV were assessed during the first 3 postoperative days and at 3 months. The quality of early recovery of anesthesia, gastrointestinal function, sleep quality, anxiety, depression, and complications were also evaluated. Results Baseline and perioperative characteristics were comparable between two groups. In the anisodamine group, 25 patients (42.4%) experienced vomiting within postoperative 24 h compared with 21 (72.4%) in the control group (relative risk 0.59; 95% confidence interval 0.40–0.85). Time to first rescue antiemetic was 6.5 h in anisodamine group, and 1.7 h in the control group (P = 0.011). Less rescue antiemetic was required during the first 24 h in the anisodamine group (P = 0.024). There were no differences in either postoperative nausea or other recovery characteristics. Conclusions The addition of ST36 acupoint injection with anisodamine significantly reduced postoperative vomiting without affecting nausea in female patients with obesity undergoing laparoscopic sleeve gastrectomy.

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Section: Discussionsupporting

confidence: 86%

ST36 acupoint injection with anisodamine for postoperative nausea and vomiting in female patients after bariatric surgery: a prospective, randomized controlled trial

et al. 2023

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“…Nausea and vomiting are reported to be associated with a significant decrease in postoperative quality of life [ 17 ] and are among the most common causes of unplanned readmission in patients undergoing bariatric surgery [ 18 ]. Although there are studies reporting the estimated incidence of postoperative nausea and vomiting up to 80% after bariatric surgery [ 19 ], it is also reported that especially high-risk patients demonstrate high satisfaction with postoperative nausea and vomiting prophylaxis [ 20 ]. Therefore, the relatively low incidence of nausea and vomiting in the current study may be related to the multimodal approach with antiemetic prophylaxis using a combination of dexamethasone and ondansetron in both groups.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided External Oblique Intercostal Plane Block for Postoperative Analgesia in Laparoscopic Sleeve Gastrectomy: A Prospective, Randomized, Controlled, Patient and Observer-Blinded Study

Kavakli,

Sahin,

Koc

et al. 2024

OBES SURG

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Purpose The external oblique intercostal plane (EOI) block is a novel block technique for anterolateral upper abdominal wall analgesia. The superficial nature of the external oblique intercostal plane allows it to be easily identified even in patients with obesity. The aim of this study was to test the hypothesis that EOI block would reduce IV morphine consumption within 24 h after laparoscopic sleeve gastrectomy. Materials and Methods Patients were randomly assigned to one of two groups: EOI block group and control group. The patients in the EOI block group received ultrasound-guided bilateral EOI block with a total of 40 ml 0.25% bupivacaine after anesthesia induction. The patients in the control group received no intervention. Postoperatively, all the patients were connected to an intravenous patient controlled analgesia (PCA) device containing morphine. The primary outcome of the study was IV morphine consumption in the first postoperative 24 h. Results The median [interquartile range] morphine consumption at 24 h postoperatively was significantly lower in the EOI block group than in the control group (7.5 [3.5 to 8.5] mg vs 14 [12 to 20] mg, p = 0.0001, respectively). Numerical rating scale (NRS) scores at rest and during movement were lower in the EOI block group than in the control group at 2, 6, and 12 h but were similar at 24 h. No block-related complications were observed in any patients. Conclusion The results of the current study demonstrated that bilateral EOI block reduced postoperative opioid consumption and postoperative pain in patients with obesity undergoing laparoscopic sleeve gastrectomy. Trial Registration Clinicaltrials.gov identifier: NCT05663658. Graphical Abstract

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“…[ 9 10 ] Recently together with members of ISPCOP we have published a position statement on prophylaxis of postoperative nausea and vomiting (PONV) in bariatric surgery. [ 11 ] We believe more research is waiting for our fellows to launch. There are many areas of research interests in the perioperative care of obese patients undergoing WLS.…”

Section: Roadmap Phases To Establish the Baf Programmentioning

confidence: 99%

Launching a new fellowship

Eldawlatly

2022

Saudi Journal of Anaesthesia

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The dream is now real! We had started thinking of establishing “Bariatric Anesthesia Fellowship” (BAF) program in our setting since 2012. The reason was the increasing number of bariatric surgical cases for weight loss under general anesthesia (GA). The journey till establishing the BAF program consisted of two phases. Phase I started in 2012 to establish clinical practice guidelines (CPG) in “Anesthesia for Patients with Morbid Obesity undergoing weight loss surgery”. Phase II started in 2015 to establish BAF program. In 2021 the first draft of BAF program was submitted to the medical education for approval. In March 2022, we got the interim approval of the program. Though the journey took sometime but ultimately it ended with success and achieving the dream. In this review, we are going to discuss a roadmap consisted of two phases in an attempt to reach our goal of establishing the BAF program.

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Postoperative nausea and vomiting in bariatric surgery: a position statement endorsed by the ASMBS and the ISPCOP

Cited by 18 publications

References 33 publications

ST36 acupoint injection with anisodamine for postoperative nausea and vomiting in female patients after bariatric surgery: a prospective, randomized controlled trial

ST36 acupoint injection with anisodamine for postoperative nausea and vomiting in female patients after bariatric surgery: a prospective, randomized controlled trial

Ultrasound-Guided External Oblique Intercostal Plane Block for Postoperative Analgesia in Laparoscopic Sleeve Gastrectomy: A Prospective, Randomized, Controlled, Patient and Observer-Blinded Study

Launching a new fellowship

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