Study of penehyclidine for the prevention of postoperative nausea and vomiting following laparoscopic sleeve gastrectomy under general anesthesia: a randomized, prospective, double-blind trial.

Abstract

Purpose: To investigate the efficacy of penehyclidine (PHC) for preventing postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG) under general anesthesia.

Materials and methods: In this prospective study, 219 patients who were scheduled to undergo LSG were randomly assigned to three cohorts: the control cohort (received normal saline), the infusion cohort (administered 0.25 mg of PHC intravenously followed by an additional 0.25 mg through an intravenous analgesia pump for 48 h after LSG), and the bolus cohort (received a single intravenous dose of 0.5 mg of PHC). The study outcomes included the incidence of PONV within the first 48 h postoperatively, the severity and intensity of PONV, side effects and postoperative recovery outcomes. Univariate and multivariate logistic analyses were performed to identify independent risk factors associated with PONV.

Results: Compared with the control cohort, both the infusion and bolus cohorts presented considerably lower incidences of PONV (61.64% vs. 12.33% vs. 38.36%, P < 0.05), as well as significantly decreased PONV severities (P < 0.05) and intensities (P < 0.05). There were no significant differences in side effects and postoperative recovery outcomes among the three cohorts, with the exception of dry mouthand the administration of rescue antiemetic therapy (P < 0.05). Additionally, the Apfel risk score and PHC intervention were identified as independent risk factors associated with PONV incidence following LSG (P < 0.05).

Results: PHC effectively prevented PONV occurrence and reduced its severity in LSG patients without decreasing postoperative recovery outcomes, particularly in the infusion cohort.