Intraoperative Respiratory and Hemodynamic Strategies for Reducing Nausea, Vomiting, and Pain after Surgery: Systematic Review and Meta-Analysis

A web-based dynamic predictive model for postoperative nausea and vomiting in patient receiving gynecological laparoscopic surgery

OBJECTIVE

The aim of this study was to develop a web-based dynamic prediction model for postoperative nausea and vomiting (PONV) in patients undergoing gynecologic laparoscopic surgery.

METHODS

The patients (N = 647) undergoing gynecologic laparoscopic surgery were included in this observational study. The candidate risk-factors related to PONV were included through literature search. Lasso regression was utilized to screen candidate risk-factors, and the variables with statistical significance were selected in multivariable logistic model building. The web-based dynamic Nomogram was used for model exhibition. Accuracy and validity of the experimental model (EM) were evaluated by generating receiver operating characteristic (ROC) curves and calibration curves. Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model. Decision curve analysis (DCA) was used to evaluate the clinical practicability of the risk prediction model.

RESULTS

Ultimately, a total of five predictors including patient-controlled analgesia (odds ratio [OR], 4.78; 95% confidence interval [CI], 1.98-12.44), motion sickness (OR, 4.80; 95% CI, 2.71-8.65), variation of blood pressure (OR, 4.30; 95% CI, 2.41-7.91), pregnancy vomiting history (OR, 2.21; 95% CI, 1.44-3.43), and pain response (OR, 1.64; 95% CI, 1.48-1.83) were selected in model building. Assessment of the model indicates the discriminating power of EM was adequate (ROC-areas under the curve, 93.0%; 95% CI, 90.7%-95.3%). EM showed better accuracy and goodness of fit based on the results of the calibration curve. The DCA curve of EM showed favorable clinical benefits.

CONCLUSIONS

This dynamic prediction model can determine the PONV risk in patients undergoing gynecologic laparoscopic surgery.

Research hotspots and trends in postlaparoscopic shoulder pain from 2003 to 2023: A bibliometric analysis

The incidence of postlaparoscopic shoulder pain has recently increased and has attracted increasing attention from clinical workers, but no study has performed bibliometric and visual analysis of the relevant literature. This study used bibliometric and visual analysis to conduct a comprehensive and systematic evaluation of postlaparoscopic shoulder pain to help researchers understand the latest global trends and hotspots and provide a reference for caregivers to carry out PLSP care interventions and research. Related studies on postlaparoscopic shoulder pain from 2003 to 2023 were retrieved from the Web of Science Core Collection. We analysed current research trends and hotspots in this field using VOSviewer and CiteSpace. A total of 2451 authors from 352 institutions in 50 countries published 464 studies related to postlaparoscopic shoulder pain. The United States was the country with the most publications and worked closely with other countries. Donmez Turgut was the researcher with the most published articles, while Bisgaard T had the most citations per article. The Journal of Surgical Endoscopy was cited most frequently, totalling 356 times. Through keyword significance analysis, we found that relieving postlaparoscopic shoulder pain in patients through integrated care interventions was an emerging research hotspot. This bibliometric and visual analysis provides a comprehensive review of studies related to postlaparoscopic shoulder pain. The current global research trend and hotspot is to alleviate postlaparoscopic shoulder pain through integrated care interventions, but the advantages of this approach are not outstanding. However, further research and global collaboration are still needed. Our findings can help researchers understand the current status of postlaparoscopic shoulder pain research and identify new directions for future research.

[Perioperative hyperoxia-More harmful than beneficial?]

BACKGROUND

The ideal perioperative oxygen concentration is controversial and study results are inconsistent.

OBJECTIVE

Current knowledge on the beneficial and adverse effects of perioperative hyperoxia.

MATERIAL AND METHODS

Narrative review RESULTS: Perioperative hyperoxia is unlikely to increase the incidence of atelectasis, pulmonary or cardiovascular complications or mortality. Few and small potential beneficial effects, such as reduction of surgical wound infections or postoperative nausea and vomiting have been demonstrated. According to the current state of evidence, it is recommended to avoid perioperative hyperoxia and to aim for normoxia instead.