Abstract
Postoperative nausea and vomiting (PONV) are common complications after anesthesia, but no study has considered the effects of a proton pump inhibitor (PPI) and gastroesophageal reflux disease (GERD) on PONV at the same time. Thus, we investigated the effects of a PPI and GERD on PONV. Patients aged ≥18 years who underwent general anesthesia between 2010 and 2019 were enrolled. In total, 202,439 patients were included and 21,361 In a multivariate analysis, the OR for PONV was higher in subjects with GERD (OR, 1.157; 95% CI, 1.032–1.298; p = 0.012). The OR was lower for subjects with taking a PPI (OR, 0.890; 95% CI, 0.832–0.953; p < 0.0001). In patients without GERD, the incidence of PONV was lower when lansoprazole (OR, 0.801; 95% CI, 0.718–0.894; p < 0.0001), pantoprazole (OR, 0.856; 95% CI, 0.748–0.980; p = 0.025) and ilaprazole (OR, 0.391; 95% CI, 0.158–0.966; p = 0.042) were taken. However, in GERD patients, all PPIs did not show reducing the incidence of PONV. Taken together, the results show that a lansoprazole, pantoprazole, and ilaprazole reduced PONV in patients without GERD, and PPI could not reduce PONV in patients with GERD.
Highlights
Postoperative nausea and vomiting (PONV) is defined as nausea or vomiting that occurs within the first 24–48 h after surgery [1]
The results show that a lansoprazole, pantoprazole, and ilaprazole reduced PONV in patients without Gastroesophageal reflux disease (GERD), and pump inhibitors (PPIs) could not reduce PONV in patients with GERD
Evidence from randomized trials demonstrated that while taking a PPI preoperatively is not associated with the occurrence of PONV [12,13], GERD is a predictor of PONV [14]
Summary
Postoperative nausea and vomiting (PONV) is defined as nausea or vomiting that occurs within the first 24–48 h after surgery [1]. Proton pump inhibitors (PPIs) are occasionally used to reduce pH and the amount of gastric acid before general anesthesia, but they may have an anti-nausea effect [6]. Gastroesophageal reflux disease (GERD), known as acid reflux, is a disease in which the stomach contents rise into the esophagus and cause symptoms or complications. GERD can lead to abnormal reflux of gastric contents into the esophagus due to failure of the anti-backflow function of the lower esophageal sphincter (LES) [7]. Few studies have investigated the effects of a PPI and GERD on PONV, and none has considered their effects on PONV at the same time. We investigated the effects of a PPI and GERD on PONV in a large retrospective study
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