Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.
Sci Rep. 2024 Jun 16;14(1):13873. doi: 10.1038/s41598-024-64686-1.
This study aimed to quantify the association between body mass index (BMI) and postoperative nausea and vomiting (PONV) within the initial 48 h following thoracic surgery for lung cancer. We then explored whether changes in serum inflammatory factor concentrations were related to BMI during the early postoperative period. We conducted a propensity score-matched (PSM), retrospective cohort study at a specialized tertiary medical center. A total of 194 patients aged 18-80 years who underwent thoracic surgery for lung cancer at Shanghai Pulmonary Hospital between January and June 2021 were enrolled. The primary outcome was the incidence of PONV during the first 48 h after surgery. Nausea, vomiting or retching at different time periods, severe pain, and concentrations of perioperative serum inflammatory factors including CRP, IL-6, IL-12, and IFN-γ were also assessed. Patients in the high BMI group (BMI ≥ 25 kg/m) had a lower incidence of PONV than those in the normal BMI group (18.5-25 kg/m) within the first 48 h after surgery (22 vs. 50%, p = 0.004). The incidence of nausea was lower at 0-12 h (14.5 vs. 37.1%, p = 0.004) and 12-24 h (8.1 vs. 22.6%, p = 0.025) in the high BMI group after surgery, and the incidence of vomiting was lower at 0-12 h (12.9 vs. 30.6%, p = 0.017) in higher BMI after surgery. We found no significant difference in the incidence of severe pain [severe static pain (p = 0.697) and severe dynamic pain (p = 0.158)]. Moreover, higher concentrations of IL-12 (2.24 ± 2.67 pg/ml vs. 1.48 ± 1.14 pg/ml, p = 0.048) and IFN-γ [1.55 (1.00) pg/ml vs. 1.30 (0.89) pg/ml, p = 0.041] were observed in patients with normal BMI on the first day after surgery. Given this finding, patients with a normal BMI should receive more attention for the prevention of PONV than those with a high BMI following thoracic surgery for lung cancer.Trial registration: http://www.chictr.org.cn and ChiCTR2100052380 (24/10/2021).
这项研究旨在量化肺癌患者接受胸部手术后前 48 小时内体重指数（BMI）与术后恶心呕吐（PONV）之间的关联。然后，我们探讨了术后早期血清炎症因子浓度的变化是否与 BMI 有关。我们在一家专门的三级医学中心进行了一项倾向评分匹配（PSM）回顾性队列研究。共纳入 2021 年 1 月至 6 月期间在上海肺科医院接受肺癌胸部手术的 194 名年龄在 18-80 岁的患者。主要结局是术后前 48 小时内 PONV 的发生率。还评估了不同时间段的恶心、呕吐或干呕、剧烈疼痛以及围手术期血清炎症因子的浓度，包括 CRP、IL-6、IL-12 和 IFN-γ。术后前 48 小时内，高 BMI 组（BMI≥25kg/m）PONV 的发生率低于正常 BMI 组（18.5-25kg/m）（22%比 50%，p=0.004）。术后 0-12 小时（14.5%比 37.1%，p=0.004）和 12-24 小时（8.1%比 22.6%，p=0.025）恶心的发生率较低，术后 0-12 小时（12.9%比 30.6%，p=0.017）呕吐的发生率较低。我们发现严重疼痛的发生率无显著差异[严重静息痛（p=0.697）和严重动力痛（p=0.158）]。此外，术后第 1 天，正常 BMI 患者的 IL-12 浓度较高[2.24±2.67 pg/ml 比 1.48±1.14 pg/ml，p=0.048]和 IFN-γ[1.55（1.00）pg/ml 比 1.30（0.89）pg/ml，p=0.041]。因此，与高 BMI 患者相比，肺癌患者接受胸部手术后，正常 BMI 患者更应注意预防 PONV。试验注册：http://www.chictr.org.cn 和 ChiCTR2100052380（2021 年 10 月 24 日）。
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