Treatment of nausea and vomiting after bariatric surgery.
Saleh Nader, Atrin |
Recenzentas / Reviewer | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Aim:
This study is aimed to perform a systematic review to identify methods of prevention and treatments of nausea and vomiting after bariatric surgery.
Objectives: • To describe recent methods of bariatric surgery. • To describe in short principles of enhanced recovery after bariatric surgery. • To identify problems of postoperative nausea and vomiting after bariatric surgery. • To describe the physiology and current recommendations of prevention of postoperative nausea and vomiting after surgery. • To describe current studies on postoperative nausea and vomiting after bariatric surgery, identifying available treatment options of postoperative nausea and vomiting.
Methods: This systematic review was initiated by online literature search, using key words ”nausea and vomiting after gastric surgery”, ” problems of recovery after gastric surgery” and ” recovery after gastric surgery” and ” Enhanced Recovery After Surgery”, which result in a wide range of articles. In order to narrow the research, the key word ”nausea and vomiting after bariatric surgery” was used. Only articles with full text, related to our main objectives were included in this systematic review. Articles containing only abstract and those articles that were duplicated and not related to this study were excluded.
Results: The online literature search resulted in finding of a total of 114 articles: n= 97 on PubMed, n=17 on JAMA network. In the following two screening processes 98 articles were excluded due to lack of, leaving 16 eligible articles that were used in this study. Among the eligible studies 6 of them [1] [2] [3] [4] [5] [7] addressed the effect of using a multiple prophylactic antiemetic drug regimen as treatment of PONV. There was a very small variation in the outcomes of the studies. All the studies supported that the use of multiple prophylactic antiemetic drug regimen in bariatric surgery is a very effective treatment of PONV. Two studies [7], [6] addressed the effect of the pharmacological substance, aprepitant (neurokinin-1 inhibitor) on PONV. These studies showed that aprepitant is associated with a lower incidence of PONV when used in addition to ondansetron [6], but when used in combination with triple antiemetic [7] (dexamethasone, droperidol, and ondansetron), it did not have a very significant effect. Another study showed that the use of [8] opioid-sparing analgesia (dexmedetomidine) is superior to the conventional analgesic regimens in lowering the incidence of postoperative nausea and vomiting. The type of anesthesia used during bariatric surgery was reported to have a significant influence on PONV, opioid-free anesthetics is associated with a lower incidence PONV in patients undergoing bariatric surgery, and should preferably be used in case of bariatric surgery [9]. One specific study was conducted on intraoperative pressure, in this study the influence IAP on PONV was tested, which showed that there is no correlation between the degree of pressure used during surgery and the possible PONV [10]. There were two studies on ERAS [11] [12], both studies reported ERAS to have a significant benefit on reducing the incidence of PONV. A very interesting study on Healing Touch [13] showed patients undergoing bariatric surgery can benefit from this techniq and it can be used as a complementory treatment of both postsurgical pain och PONV.
Conclusions: The most effective treatment of PONV is multiple prophylactic antiemetic regimens. Other methods such as Healing Touch can be used as a complementary method to decrease PONV further more.
Tikslas: Šio tyrimo tikslas buvo atlikti sisteminę apžvalgą, siekiant nustatyti pykinimo ir vėmimo profilaktikos ir gydymo metodus po bariatrinonių operacijų.
Metodas: Ši sisteminę apžvalga buvo pradėta internetinės literatūros paieška ,kurios rezultatas - 114 straipsnių: n = 97 PubMed, n = 17 JAMA tinkle. Iš šių straipsnių 29 tinkami straipsniai buvo įtraukti į šį tyrimą.
Rezultatai: Šis tyrimas parodė, kad efektyviausias pykinimo ir vėmimo po operacijų gydymas yra yra keleto antiemetinių veistų derivivous. Kiti metodai, tokie kaip Healing Touch, gali būti naudojami kaip papildomas metodas toliau mažinti pykinimo ir vėmimo po operacijų.