Effects Of Preoperative Motion Sickness Susceptibility On The Incidence Of Postoperative Nausea And Vomiting Following Gynecological Laparoscopic Surgery

Objective This study was designed to investigate the influencing factors of postoperative nausea and vomiting(PONV)after gynecological laparoscopic surgery,also to study the correlation between preoperative motion sickness sensitivity(MSS)and PONV in gynecological laparoscopic surgery.With a view to better reduce and prevent the incidence of PONV following gynecological laparoscopic surgery.Methods 80 participants selected from Fujian Provincial Hospital Jinshan Branch were scheduled for elective laparoscopic salpingectomy,benign ovary tumor resection and benign uterine tumor resection from September 2017 to January 2018,expected to stay in hospital for more than 3 days,with ASA I-II,BMI 18.5-27.9 kg/m~2(excl:application of hormone,antihistamines,anti-emetics,sedative and antidepressants within 48 h preoperative,gastrointestinal disorders,alcoholism,allergies,pregnancy or lactation,cannot cooperate for any reason,such as language comprehension deficits,mental illness,etc,and refused to participate in this study).Using motion sickness susceptibility questionnaire–Long(MSSQ-Long)to calculated motion sickness susceptibility index(MSSI),MSSI-A(childhood motion sickness susceptibility index)and MSSI-B(adult motion sickness susceptibility index)with all participants before surgery.All the patients received unified method of anesthesia and postoperative analgesia.Age,BMI,ASA classification,smoking history,motion sickness(MS)history or history of PONV,premenstrual syndrome(PMS),types of surgery,pneumoperitoneum time,dosage of intraoperative sufentanil and postoperative complications were recorded.World Health Organization(WHO)nausea and vomiting rating was used to record the nausea and vomiting 48 hours postoperative.All enrolled patients were divided into PONV group and Non-PONV group according to the incidence of PONV.Using SPSS 22.0 to comparative analysis the correlation and the possible action mechanism between age,BMI,PMS,smoking history,MS/history of PONV,operation type,pneumoperitoneum time,anesthetic(intraoperative dosage sufentanil),preoperative MSS and PONV of these two groups patients.Results 80 patients were initially enrolled in this study,5 of them refused to participate in the study,2 of them transferred to open operation,other patients had a smooth operation.73 patients were enrolled finally.In these 73 cases,42 patients had PONV within 48 hours after surgery,while 31patients had no PONV,the total incidence of PONV was 57.53%.1.There were no statistically significant difference in the age,BMI,PMS,smoking history,type of operation,intraoperative sufentanil,pneumoperitoneum time and total operation time between PONV group and Non-PONV group s(P>0.05).No correlation was found between those factors above and the occurrence of PONV.2.There were no statistically significant difference in MSSI、MSSI-A、MSSI-B between two groups(P<0.05).MSSI、MSSI-A、MSSI-B(76.65±12.47、37.78±8.12、38.87±6.83)of PONV group were higher than Non-PONV group(31.79±9.34、15.60±5.60、16.19±5.17).Correlation analysis suggests the occurrence of PONV were positively correlated with MSSI,MSSI-A,MSSI-B(r=0.348,P=0.003;r=0.291,P=0.013;r=0.285,P=0.015).3.73 patients’severity of PONV were as following:level 0 had 31 cases(42.47%),level 2 had 6 cases(8.22%),level 3 had 15 cases(20.55%);level 4 had14 cases(19.18%);level 5 had 7 cases(9.59%).There was no statistically significant difference between MSSI,MSSI-A and MSSI-B in patients with different rating of nausea and vomiting(P>0.05).4.Binary classification logistic regression analysis showed MSSI was the possible risk factors for PONV(P<0.05),while age,BMI,PMS,smoking history,type of operation,amount of intraoperative sufentanil,pneumoperitoneum time,operation time had no significant effect on PONV(P>0.05).Conclusion 1.Higher preoperative MSS may increcse the risk of PONV following gynecological laparoscopic surgery.The MSSI of childhood and adult were positively correlated with the risk of PONV.2.MSSI may be a significant risk factor for the occurrence of PONV in female patients with gynecological laparoscopic surgery,suggesting that it may be one of the predictors of PONV in these patients.3.No correlation was found between the severity of PONV and preoperative MSSI in patients with gynecological laparoscopic surgery.4.There was no significant correlation between the occurence of PONV and the age,BMI,PMS,smoking history,type of surgery,time of operation,duration of pneumoperitoneum,the total amount of sufentanil in the operation.