Medina-Diaz-Cortés Guillermo, Brancaccio-Pérez Irma Valeria, Esparza-Estrada Isaac, Barbosa-Camacho Francisco José, Fuentes-Orozco Clotilde, González-Hernández Paola Guadalupe, Chejfec-Ciociano Jonathan Matías, Ramírez-Sánchez Marco Vinicio, Sánchez-López Veronica Alexandra, Cortés-Flores Ana Olivia, Álvarez-Villaseñor Andrea Socorro, Chávez-Tostado Mariana, Cervantes-Pérez Enrique, Cervantes-Guevara Gabino, Cervantes-Cardona Guillermo Alonso, González-Ojeda Alejandro
Biomedical Research Unit 02. Specialties Hospital, Western Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez 1000, 44430, Guadalajara, Jalisco, Mexico.
Medical Auxiliary Coordination of Health Research, Mexican Institute of Social Security, Calle Francisco I. Madero 315, 23020, La Paz, Baja California Sur, Mexico.
World J Surg. 2022 Feb;46(2):356-361. doi: 10.1007/s00268-021-06367-y. Epub 2021 Nov 3.
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.
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.
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.
Early PONV and pain after LC were more frequent in premenopausal women, who also required more rescue analgesic and antiemetic medication.
腹腔镜胆囊切除术（LC）后出现的术后症状和疼痛在女性中很常见。然而，尚无证据表明不同年龄组在发病率和严重程度上存在差异。我们评估了LC术后不良症状在年轻女性中是否比老年女性更常见。
本回顾性队列研究纳入了150名绝经前女性（平均年龄37.6±3.6岁）和145名绝经后女性（59±5.2岁）。分析了临床和人体测量参数。研究终点为术后恶心呕吐（PONV）和疼痛的发生率，以及术后所需的额外镇痛药和止吐药。
年轻组42.7%的患者体重指数正常，老年组为64.8%（P<0.001）。在整个研究期间，年轻组报告的疼痛更频繁、更剧烈（P<0.01）。18%的绝经前女性需要额外使用麻醉药，而绝经后女性为7.6%（P=0.001），绝经前女性用于减轻疼痛的剂量更高（P=0.02）。术后1小时和6小时，年轻组PONV更频繁（P<0.005）。29名绝经前女性和13名绝经后女性需要使用抢救性止吐药（P=0.01）。老年患者住院时间较短（P=0.01）。两组均观察到轻微并发症（0.7%和2.1%）。无死亡病例。
绝经前女性LC术后早期PONV和疼痛更频繁，她们也需要更多的抢救性镇痛和止吐药物。
