Shan Xiaodong, Wang Yongjin, Xiao Xiaoao, Gao Yuanqing, Sun Xitai
Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China; Key Laboratory of Cardiovascular and Cerebrovascular Medicine, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China.
Key Laboratory of Cardiovascular and Cerebrovascular Medicine, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China.
Surg Obes Relat Dis. 2025 Mar;21(3):247-255. doi: 10.1016/j.soard.2024.09.013. Epub 2024 Oct 12.
Whether preoperative exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG) remains unclear.
To investigate the association between preoperative GLP-1RAs exposure and PONV after LSG.
University Hospital, China.
We reviewed a retrospective cohort of patients underwent LSG between January 1, 2017, and December 30, 2021 at Nanjing Drum Tower Hospital, dividing the patients into 2 groups on the basis of whether they were exposed to GLP-1RAs preoperatively. A 1:1 propensity score matching was performed to balance the characteristics between the groups. Associations between GLP-1RAs exposure and PONV were determined by logistic regressions.
A total of 564 eligible patients underwent LSG, 351 (62.2%, 95% CI 58.2-66.1) of whom had PONV. In total cohort, PONV occurred in 72(84.7%) patients exposed to GLP-1RAs preoperatively and 279 (58.2%) patients not exposed to GLP-1RAs (adjusted odds ratio 6.782, 95% confidence interval 3.307-13.907, P < .001). In the 158 matched patients, PONV occurred in 66 (83.5%) patients exposed to GLP-1RAs preoperatively and 48 (60.8%) matched patients not exposed to GLP-1RAs (adjusted odds ratio 3.830, 95% confidence interval 1.461-10.036, P = .006). Subgroup analysis by dosage forms and doses revealed a positive association between greater doses and an increased risk of PONV after LSG for both once-daily and once-weekly formulations.
Preoperative exposure to GLP-1RAs is associated with an increased risk of PONV in patients undergoing LSG, particularly at higher doses of exposure.
术前使用胰高血糖素样肽-1受体激动剂（GLP-1 RAs）是否与腹腔镜袖状胃切除术（LSG）术后恶心呕吐（PONV）相关尚不清楚。
探讨术前GLP-1 RAs暴露与LSG术后PONV之间的关联。
中国大学附属医院。
我们回顾了2017年1月1日至2021年12月30日在南京鼓楼医院接受LSG的患者的回顾性队列，根据患者术前是否使用GLP-1 RAs将其分为两组。进行1:1倾向评分匹配以平衡两组之间的特征。通过逻辑回归确定GLP-1 RAs暴露与PONV之间的关联。
共有564例符合条件的患者接受了LSG，其中351例（62.2%，95%CI 58.2-66.1）发生了PONV。在整个队列中，术前使用GLP-1 RAs的患者中有72例（84.7%）发生了PONV，未使用GLP-1 RAs的患者中有279例（58.2%）发生了PONV（调整后的优势比为6.782，95%置信区间为3.307-13.907，P <.001）。在158例匹配患者中，术前使用GLP-1 RAs的患者中有66例（83.5%）发生了PONV，未使用GLP-1 RAs的匹配患者中有48例（60.8%）发生了PONV（调整后的优势比为3.830，95%置信区间为1.461-10.036，P =.006）。按剂型和剂量进行的亚组分析显示，对于每日一次和每周一次的制剂，更高剂量与LSG术后PONV风险增加之间存在正相关。
术前使用GLP-1 RAs与接受LSG的患者PONV风险增加相关，尤其是在更高剂量暴露时。
