Nurse-led non-pharmacological interventions for prevention and management of postoperative nausea and vomiting in adults undergoing laparoscopic surgery: an evidence summary.

BACKGROUND

Postoperative nausea and vomiting (PONV), as a common complication in laparoscopic surgery, significantly delays patients' recovery and increases the incidence of unplanned readmission. Although drug prevention is widely used, nurse-led non-pharmacological interventions can provide safe and effective collaborative management. However, the current evidence is fragmented and there is a lack of guidelines specific to laparoscopic surgery, resulting in significant differences in clinical practice. This study aimed to integrate the best evidence and establish standardized non-pharmacological nursing strategies for the prevention and treatment of PONV in adults undergoing laparoscopic surgery.

METHODS

Following the standard methodology of the Fudan University Center for Evidence-based Nursing (registration number: ES20257623) and guided by the "5S" evidence pyramid model, we systematically searched multiple databases and guideline repositories from inception to December 4, 2025. We included evidence summary, clinical decision, guidelines, expert consensus statements, systematic reviews and meta-analyses. Literature screening, quality appraisal, and evidence extraction were performed independently by two reviewers. Methodological quality was assessed using validated screening tools. A summary of findings table was constructed to present the synthesized evidence.

RESULTS

From 1,564 initial records, 39 publications were included: 5 evidence summaries, 1 clinical decision, 8 guidelines, 4 expert consensuses and 21 systematic reviews. We synthesized 28 best practice recommendations across five key domains: pre-operative risk assessment (identification of risk factors, risk quantification tools, stratified PONV prophylaxis), intraoperative preventive interventions (fluid management, acupoint stimulation, high-concentration oxygen), post-operative symptom management (symptom assessment tool, non-pharmacological management), follow-up care (health education, prevention and control of PDNV), system support (organizational management).

CONCLUSION

This evidence summary provided a comprehensive, clinically actionable framework for nurses to lead proactive, evidence-based PONV care for laparoscopic surgery patients. Effective nursing interventions directly reduced PONV incidence, decreased antiemetic requirements, and improved patient comfort and satisfaction. In addition, nursing practice can shift from reactive management to proactive prevention, thereby delivering patient-centered benefits. The findings should be adapted to local contexts to develop standardized nursing procedures, thereby translating evidence into clinical practice.

CLINICAL TRIAL NUMBER: Not applicable.