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Association between preoperative lumbar skeletal muscle index and postoperative nausea and vomiting in patients undergoing pylorus-preserving pancreatoduodenectomy: a retrospective study

Authors
 Hyun Il Kim  ;  Ki Jun Kim  ;  Sangil Kim  ;  Hae Dong Kim  ;  Seung Hyun Kim 
Citation
 Anesthesia and Pain Medicine, Vol.19(2) : 161-168, 2024-04 
Journal Title
Anesthesia and Pain Medicine
ISSN
 1975-5171 
Issue Date
2024-04
Keywords
Anesthesia recovery period ; General anesthesia ; Lumbar skeletal muscle index ; Postoperative complications ; Postoperative nausea and vomiting ; Retrospective studies ; Sarcopenia
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 pancreatodu-odenectomy (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.
Files in This Item:
T202406649.pdf Download
DOI
10.17085/apm.23142
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Jun(김기준) ORCID logo https://orcid.org/0000-0003-1950-7998
Kim, Sangil(김상일)
Kim, Seung Hyun(김승현) ORCID logo https://orcid.org/0000-0003-2127-6324
Kim, Hyun IL(김현일) ORCID logo https://orcid.org/0000-0003-2665-8620
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201145
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