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- Title
Association between preoperative lumbar skeletal muscle index and postoperative nausea and vomiting in patients undergoing pyloruspreserving pancreatoduodenectomy: a retrospective study.
- Authors
Hyun Il Kim; Ki Jun Kim; Sangil Kim; Hae Dong Kim; Seung Hyun Kim
- Abstract
Background: Sarcopenia is associated with postoperative complications; however, its impact on the quality of postoperative recovery, such as postoperative nausea and vomiting (PONV) and pain, remains unclear. We investigated the association of preoperative lumbar skeletal muscle mass index (LSMI) with PONV, postoperative pain, and complications. Methods: Medical records of 756 patients who underwent pylorus-preserving pancreatoduodenectomy (PPPD) were retrospectively reviewed. The skeletal muscle areas were measured on abdominal computed tomography (CT) images. LSMI was calculated by dividing the skeletal muscle area by the square of the patient’s height. We analyzed the correlations between preoperative LSMI calibrated with confounding variables and PONV scores, PONV occurrence, pain scores, rescue analgesic administration, postoperative complications, and length of hospital stay. Results: The median (1Q, 3Q) LSMI was 47.72 (40.74, 53.41) cm² /m² . The incidence rates of PONV according to time period were as follows: post-anesthesia care unit, 42/756 (5.6%); 0–6 h, 54/756 (7.1%); 6–24 h, 120/756 (15.9%); 24–48 h, 46/756 (6.1%); and overall, 234/756 (31.0%). The incidence of PONV was inversely correlated with LSMI 24–48 h post-surgery and overall. LSMI and PONV scores were negatively associated 6–24 h and 24–48 h post-surgery. There was no association between LSMI and postoperative pain scores, rescue analgesic administration, complications, or length of hospital stay. Conclusions: Preoperative LSMI was associated with PONV in patients undergoing PPPD. Therefore, LSMI measured on preoperative abdominal CT can be a predictive indicator of PONV. Appropriate PONV prophylaxis is necessary in patients with low LSMI before PPPD.
- Subjects
PANCREATICODUODENECTOMY; SKELETAL muscle; POSTOPERATIVE nausea &; vomiting; COMPUTED tomography; POSTOPERATIVE pain
- Publication
Anesthesia & Pain Medicine, 2024, Vol 19, Issue 2, p161
- ISSN
1975-5171
- Publication type
Article
- DOI
10.17085/apm.23142