Postoperative nausea and vomiting in benign gynecological laparoscopic surgery when acetaminophen is combined with non-opioid analgesic management
Non-opioid analgesic management using intravenous acetaminophen has been reported to reduce pain and postoperative nausea and vomiting (PONV). This study aimed to assess the incidence rate and risk factors for PONV following benign gynecological laparoscopic surgery with non-opioid analgesic management, when using intravenous acetaminophen to achieve appropriate perioperative management. We conducted a retrospective observational study comprising 53 patients who underwent five types of laparoscopic surgical procedures for benign diseases. The patients were administered a single dose of intravenous acetaminophen at the conclusion of the operation, after which pain relief was induced with non-steroidal anti-inflammatory drugs and pentazocine. We analyzed patient characteristics, surgical outcomes, and numbers of analgesics and antiemetics administered postoperatively. Onset of PONV developed by postoperative day one. The incidence rate of PONV in patients who underwent surgery that included total hysterectomy was 94%, which was significantly higher than in those who underwent other procedures ( p = 0.020). From the perspective of PONV, current postoperative pain management for laparoscopic surgery, including total hysterectomy, needs to be modified.