Gender Differences in Postoperative Pain, Nausea and Vomiting After Elective Laparoscopic Cholecystectomy
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ORIGINAL SCIENTIFIC REPORT
Gender Differences in Postoperative Pain, Nausea and Vomiting After Elective Laparoscopic Cholecystectomy Marcela Salazar-Parra1,2 • Bertha Georgina Guzman-Ramirez2 • Kevin Josue Pintor-Belmontes2 • Francisco Jose´ Barbosa-Camacho2 • Aldo Bernal-Herna´ndez2 • Roberto Ulises Cruz-Neri1,2 • Clotilde Fuentes-Orozco2 • Laura Lizeth Reyes Aguirre2 • Dinorah Rodrı´guez-Navarro2 • Irma Valeria Brancaccio-Pe´rez2 • Isaac Esparza-Estrada2 • Enrique Cervantes-Pe´rez3 • Gabino Cervantes-Guevara4 • Guillermo Alonso Cervantes-Cardona5 • Alejandro Gonza´lez-Ojeda2
Accepted: 9 August 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Although reports suggest that pain and postoperative nausea and vomiting (PONV) may be more frequent in women, the evidence is inconsistent. The objective of this study was to investigate whether women are more sensitive to pain and PONV after laparoscopic cholecystectomy (LC). Methods A total of 370 women and 275 men were included in a retrospective cohort study. All underwent LC under standardized general anesthesia. The variables analyzed included clinical and anthropometric parameters. End points were the incidence of nausea, vomiting, pain, and the requirement for additional pain relievers and antiemetics to control these. Results The women were younger and had lower body weight than the men (p \ 0.001). Body mass index was within the normal range for 50% of women and 30% of men (p \ 0.001). Pain was more common in women at 1, 6, 12 and 24 h after surgery (p \ 0.02). Narcotics in addition to the doses used to lessen pain intensity (p = 0.01) were required in 60 women and 19 men (p \ 0.001). PONV was more frequent in women at 1 and 6 h after surgery (p \ 0.01). Rescue antiemetics were required in 35 women and 11 men (p = 0.008). Hospital stay was shorter for men (p \ 0.001). Four patients in each group developed postoperative complications (p = 0.14). There was no mortality. Conclusions Early postoperative pain, nausea and vomiting after LC were more common in women, who more frequently required analgesic and antiemetic rescue medication.
4
Department of Welfare and Sustainable Development, University Center of the North, University of Guadalajara, 46200 Colotlan, Jalisco, Mexico
5
Department of Philosophical, Methodological and Instrumental Disciplines, Health Sciences University Center, University of Guadalajara, 44340 Guadalajara, Jalisco, Mexico
& Alejandro Gonza´lez-Ojeda [email protected] 1
Postgraduate Research Division, Faculty of Medicine, University of Colima, Avenida Universidad 333, Las Vı´boras, 28040 Colima, Col., Mexico
2
02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domı´nguez 1000, 44430 Guadalajara, Jalisco, Mexico
3
Department of Clinical Nutrition, National Institute of Medical Sciences and Nutrition Salvador Zubira´n, University of Mexico, Mexico City, Mexico
123
World J Surg
Introduction Laparoscopic cholecystectomy (LC) is one
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