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Medina-Diaz-Cortés G, Brancaccio-Pérez IV, Esparza-Estrada I, Barbosa-Camacho FJ, Fuentes-Orozco C, González-Hernández PG, Chejfec-Ciociano JM, Ramírez-Sánchez MV, Sánchez-López VA, Cortés-Flores AO, Álvarez-Villaseñor AS, Chávez-Tostado M, Cervantes-Pérez E, Cervantes-Guevara G, Cervantes-Cardona GA, González-Ojeda A. Differences in Postoperative Pain, Nausea, and Vomiting After Elective Laparoscopic Cholecystectomy in Premenopausal and Postmenopausal Mexican Women. World J Surg 2021; 46:356-361. [PMID: 34731260 DOI: 10.1007/s00268-021-06367-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postoperative symptoms and pain after laparoscopic cholecystectomy (LC) are common in women. However, there is no evidence of differences in incidence and severity among different age groups. We evaluated whether adverse postoperative symptoms were more common in younger than in older women after LC. METHODS One hundred and fifty premenopausal (mean age 37.6 ± 3.6 y) and 145 postmenopausal women (59 ± 5.2 y) were included in this retrospective cohort study. Clinical and anthropometric parameters were analyzed. Study endpoints were the incidences of postoperative nausea and vomiting (PONV) and pain, and the additional analgesics and antiemetics needed after surgery. RESULTS Body mass index was normal in 42.7% of patients in the younger group and 64.8% in the older group (P < 0.001). Reported pain was more frequent and intense in the younger group throughout the study period (P < 0.01). Additional narcotics were required in 18% of premenopausal versus 7.6% of postmenopausal women (P = 0.001), and the doses used to reduce pain were higher for premenopausal women (P = 0.02). PONV was more frequent in the younger group at 1 and 6 h after surgery (P < 0.005). Rescue antiemetics were required in 29 premenopausal and 13 postmenopausal women (P = 0.01). Hospital stay was shorter for the older patients (P = 0.01). Minor morbidity was observed in both groups (0.7% and 2.1%). There was no mortality. CONCLUSIONS Early PONV and pain after LC were more frequent in premenopausal women, who also required more rescue analgesic and antiemetic medication.
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Affiliation(s)
- Guillermo Medina-Diaz-Cortés
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Irma Valeria Brancaccio-Pérez
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Isaac Esparza-Estrada
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Francisco José Barbosa-Camacho
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Paola Guadalupe González-Hernández
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Jonathan Matías Chejfec-Ciociano
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Marco Vinicio Ramírez-Sánchez
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Veronica Alexandra Sánchez-López
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Ana Olivia Cortés-Flores
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Andrea Socorro Álvarez-Villaseñor
- Medical Auxiliary Coordination of Health Research, Mexican Institute of Social Security, Calle Francisco I. Madero 315, 23020, La Paz, Baja California Sur, Mexico
| | - Mariana Chávez-Tostado
- Department of Human Reproduction, Health Sciences University Center, Universidad de Guadalajara, Calle Hospital 320, 44280, Guadalajara, Jalisco, Mexico
| | - Enrique Cervantes-Pérez
- Department of Internal Medicine, Hospital Civil de Guadalajara Fray Antonio Alcalde, Calle Hospital 278, 44280, Guadalajara, Jalisco, Mexico
| | - Gabino Cervantes-Guevara
- Department of Welfare and Sustainable Development, University Center of the North, University of Guadalajara, Carretera Federal 23, Km 191, 46200, Colotlán, Jalisco, Mexico
| | - Guillermo Alonso Cervantes-Cardona
- Department of Philosophical, Methodological and Instrumental Disciplines, Health Sciences University Center, University of Guadalajara, Sierra Mojada 950, 44340, Guadalajara, Jalisco, Mexico
| | - Alejandro González-Ojeda
- Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico.
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Salazar-Parra M, Guzman-Ramirez BG, Pintor-Belmontes KJ, Barbosa-Camacho FJ, Bernal-Hernández A, Cruz-Neri RU, Fuentes-Orozco C, Aguirre LLR, Rodríguez-Navarro D, Brancaccio-Pérez IV, Esparza-Estrada I, Cervantes-Pérez E, Cervantes-Guevara G, Cervantes-Cardona GA, González-Ojeda A. Gender Differences in Postoperative Pain, Nausea and Vomiting After Elective Laparoscopic Cholecystectomy. World J Surg 2020; 44:4070-4076. [PMID: 32812138 DOI: 10.1007/s00268-020-05744-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2020] [Indexed: 01/17/2023]
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.
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Affiliation(s)
- Marcela Salazar-Parra
- Postgraduate Research Division, Faculty of Medicine, University of Colima, Avenida Universidad 333, Las Víboras, 28040, Colima, Col., Mexico.,02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Bertha Georgina Guzman-Ramirez
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Kevin Josue Pintor-Belmontes
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Francisco José Barbosa-Camacho
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Aldo Bernal-Hernández
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Roberto Ulises Cruz-Neri
- Postgraduate Research Division, Faculty of Medicine, University of Colima, Avenida Universidad 333, Las Víboras, 28040, Colima, Col., Mexico.,02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Clotilde Fuentes-Orozco
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Laura Lizeth Reyes Aguirre
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Dinorah Rodríguez-Navarro
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Irma Valeria Brancaccio-Pérez
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Isaac Esparza-Estrada
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico
| | - Enrique Cervantes-Pérez
- Department of Clinical Nutrition, National Institute of Medical Sciences and Nutrition Salvador Zubirán, University of Mexico, Mexico City, Mexico
| | - Gabino Cervantes-Guevara
- Department of Welfare and Sustainable Development, University Center of the North, University of Guadalajara, 46200, Colotlan, Jalisco, Mexico
| | - Guillermo Alonso Cervantes-Cardona
- Department of Philosophical, Methodological and Instrumental Disciplines, Health Sciences University Center, University of Guadalajara, 44340, Guadalajara, Jalisco, Mexico
| | - Alejandro González-Ojeda
- 02-Biomedical Research Unit, Western Medical Center, Specialties Hospital, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico.
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