Impact of prophylactic 5-hydroxytryptamine-3 receptor antagonist on postoperative nausea and vomiting in patients undergoing laparoscopic or robotic colorectal cancer surgery: a propensity score-matched analysis.

PURPOSE: Postoperative nausea and vomiting (PONV) is a common complication of surgery. This study evaluated the efficacy of prophylactic 5-hydroxytryptamine-3 receptor antagonist (5HT3RA) in preventing PONV in patients undergoing laparoscopic or robotic colorectal cancer (CRC) surgery.

METHODS

Between April and June, 2022, 100 consecutive patients received 5HT3RA prophylaxis before anesthesia induction. We compared these patients retrospectively with 368 patients who underwent similar procedures without 5HT3RA in 2021. Propensity score matching (PSM) was applied to reduce bias, resulting in two matched groups (n = 100 in each group).

RESULTS

The incidences of PONV, nausea, and vomiting in the entire cohort were 26.7%, 25.2%, and 10.4%, respectively. After PSM, no significant differences were found between the groups in clinical characteristics, anesthesia time, operative time, blood loss, time to first flatus, or length of postoperative hospital stay. Moreover, no significant differences were found in the incidences of PONV, nausea, or vomiting. Multivariate analyses identified female sex as an independent risk factor for PONV (P = 0.02 before PSM; P < 0.01 after PSM).

CONCLUSIONS

The findings of the present study using PSM analysis suggest that the prophylactic administration of 5HT3RA did not reduce the incidence of PONV in patients undergoing laparoscopic or robotic CRC surgery.