Khan Shariq A, Lim Hsiang, Harikrishnan Shivani, Kothandan Harikrishnan
Anaesthesia, Sengkang General Hospital, Singapore, SGP.
Biostatistics, Singapore General Hospital, Singapore, SGP.
Cureus. 2024 Oct 30;16(10):e72737. doi: 10.7759/cureus.72737. eCollection 2024 Oct.
Background The probability of postoperative nausea and vomiting (PONV) may be influenced by the time of day. Since there has been no recent study published exploring this association, we conducted a study to determine the effect of surgical time of day on PONV. Methods With ethics approval, data of all patients undergoing elective non-cardiac non-neurosurgery, with a high risk of PONV, and which had a 24-hour assessment of PONV between October 2017 and December 2020 were extracted. Surgical sessions were classified as either morning surgery (defined as start-time and end-time before noon) or afternoon surgery (defined as surgery start-time at or after 12 noon). Those patients who had surgical sessions extending from morning sessions to afternoon sessions were excluded. A propensity-score-matching (PSM) based on 1:1 matching was performed to potential biases. For the entire study population before matching, we used Pearson's chi-square test or Fisher's exact test for categorical variables, and Student's t-test or Mann-Whitney U-test for normally or non-normally distributed continuous variables, respectively. For the matched study population, we used conditional logistic regression to test for differences. A p-value of <0.05 was considered statistically significant. Results Of the 3808 surgical sessions, 1439 surgical sessions were excluded from the analysis because they extended between morning and afternoon surgery. After 1:1 PSM, 1043 matched pairs were obtained. The incidence of PONV, prior to matching, remained statistically insignificant even after PSM. Conclusion We found that the time of surgery (morning or afternoon) did not affect both the overall incidence and severity of PONV. The association between PONV and time of day remained statistically insignificant prior to and after propensity matching for a number of covariates.
术后恶心呕吐（PONV）的发生率可能受一天中不同时间的影响。由于近期没有关于探索这种关联的研究发表，我们开展了一项研究以确定手术时间对PONV的影响。方法：在获得伦理批准后，提取了2017年10月至2020年12月期间所有接受择期非心脏非神经外科手术、有PONV高风险且对PONV进行了24小时评估的患者数据。手术时段分为上午手术（定义为开始时间和结束时间均在中午之前）或下午手术（定义为手术开始时间在中午12点及以后）。排除那些手术时段从上午持续到下午的患者。基于1:1匹配进行倾向得分匹配（PSM）以减少潜在偏倚。对于匹配前的整个研究人群，我们分别对分类变量使用Pearson卡方检验或Fisher精确检验，对正态或非正态分布的连续变量使用Student t检验或Mann-Whitney U检验。对于匹配后的研究人群，我们使用条件逻辑回归来检验差异。p值<0.05被认为具有统计学意义。结果：在3808个手术时段中，1439个手术时段因跨越上午和下午手术而被排除在分析之外。经过1:1 PSM后，获得了1043对匹配数据。即使在PSM后，匹配前PONV的发生率在统计学上仍无显著差异。结论：我们发现手术时间（上午或下午）对PONV的总体发生率和严重程度均无影响。在对多个协变量进行倾向得分匹配前后，PONV与一天中时间的关联在统计学上均无显著差异。
