Prospective Assessment of Postoperative Nausea Early After Bariatric Surgery

The most common reason for readmission after bariatric surgery is postoperative nausea and vomiting (PONV). The aim of this study was to compare the incidence and severity of PONV between patients undergoing laparoscopic sleeve gastrectomy (SG) and gastric bypass (GB).

This was a prospective observational cohort study that evaluated all patients who underwent non-revisional isolated SG or GB at a tertiary care center. Patients were asked to grade their nausea on a 10-point Likert scale at 2 h postoperatively and the morning of each postoperative day (POD).

There were 65 patients that matched the inclusion criteria, of which 29 underwent SG and 36 underwent GB. There were no significant differences in age (p = 0.198), BMI (p = 0.294), American Society of Anesthesiology classification (p = 0.380), or male gender (p = 0.164) when comparing SG and GB patients. Perioperative PONV prophylaxis was similar. There were no differences in LOS (2.6 ± 1.3 vs 2.3 ± 0.5 days, p = 0.919) or readmission/visit to the emergency department due to PONV (10.3% vs 13.9%, p = 0.665) between the two groups. Prolonged LOS due to PONV occurred in 20.7% of SG patients and 19.4% of GB patients (p = 0.901).

The severity and incidence of PONV are similar following SG and GB. Importantly, there was no difference in hospital utilization due to PONV between SG and GB.