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.
World J Surg. 2020 Dec;44(12):4070-4076. doi: 10.1007/s00268-020-05744-3. Epub 2020 Aug 18.
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).
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.
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.
Early postoperative pain, nausea and vomiting after LC were more common in women, who more frequently required analgesic and antiemetic rescue medication.
尽管有报道称女性术后疼痛和恶心呕吐（PONV）更为常见，但证据并不一致。本研究旨在探讨女性在接受腹腔镜胆囊切除术（LC）后是否对疼痛和 PONV 更为敏感。
对 370 名女性和 275 名男性进行回顾性队列研究。所有患者均在标准化全身麻醉下接受 LC。分析的变量包括临床和人体测量参数。终点为恶心、呕吐、疼痛的发生率，以及控制这些症状所需的额外止痛药和止吐药的使用。
女性比男性更年轻，体重也更轻（p<0.001）。女性 50%和男性 30%的 BMI 处于正常范围内（p<0.001）。术后 1、6、12 和 24 小时，女性疼痛更为常见（p<0.02）。与减轻疼痛强度的剂量相比，60 名女性和 19 名男性需要额外使用麻醉性镇痛药（p=0.01）。术后 1 和 6 小时，女性 PONV 更为常见（p<0.01）。35 名女性和 11 名男性需要使用止吐急救药物（p=0.008）。男性的住院时间更短（p<0.001）。每组各有 4 名患者发生术后并发症（p=0.14）。无死亡病例。
LC 术后早期疼痛、恶心和呕吐在女性中更为常见，她们更频繁地需要使用镇痛药和止吐药进行急救治疗。
