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A history of severe nausea and vomiting during pregnancy predicts a higher incidence of postoperative nausea and vomiting after breast cancer surgery without breast reconstruction

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Abstract

Background

Postoperative nausea and vomiting (PONV) occur in up to 30 percent of patients after breast cancer surgery despite routine administration of antiemetic prophylaxis. A history of nausea and vomiting during pregnancy (NVP) has been reported as a risk factor of intraoperative nausea and vomiting in caesarean delivery. Nevertheless, whether a history of severe nausea and vomiting during pregnancy (SNVP) is associated with a higher occurrence of PONV remains unclear.

Methods

In this study, 121 sequential female patients who were scheduled to undergo breast cancer surgery were assigned to study group (30 cases, with SNVP) or control group (91 cases, with mild NVP (MNVP)). The incidence of PONV and the need for rescue antiemetic were recorded in post-anesthesia care unit (PACU), at 6 h, 12 h, 24 h, and 36 h after operation. Moreover, postoperative pain, level of satisfaction, and the relationship of ER/PR status in breast cancer tissue with SNVP and PONV were also investigated.

Results

Data from 115 patients were analyzed. The incidence of PONV in the SNVP group was significantly higher than that in the MNVP group at 6 h (P < 0.005), 12 h (P < 0.05), and 24 h after the operation (P < 0.05). The incidence of PONV in the MNVP group was approximately 30% lower than in the SNVP group. Besides, more severe PONV, a larger number of demands for rescue antiemetic, fewer patient satisfaction scores, and more dizziness were observed in the SNVP group. Yet, no relationship was found between ER/PR status of breast cancer tissue and SNVP or PONV.

Conclusions

Compared to patients with MNVP, those with a history of SNVP experienced a higher incidence of PONV and severe PONV, presented with a larger number of requirements for postoperative antiemetic and a lower level of satisfaction.

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Availability of data and materials

All the data used and analyzed are available from corresponding authors upon the reasonable request.

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Acknowledgements

We thank our colleagues at the Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

Funding

This study was funded by Beijing Hope Marathon Special Fund of Chinese Cancer Foundation (LC2019B11), and Sanming Project of Medicine in Shenzhen, Cancer Pain Treatment and Perioperative Medical Team of Professor Li Sun in Cancer Hospital, Chinese Academy of Medical Sciences. The funders had no role in study design, data collection and analysis, preparation of the manuscript, or decision to publish.

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Author notes

  1. Baona Wang and Tao Yan contributed equally to this work.

Authors and Affiliations

  1. Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Baona Wang, Tao Yan, Guohua Zhang & Hui Zheng

  2. Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China

    Li Sun

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  1. Baona Wang
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  2. Tao Yan
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  3. Li Sun
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  4. Guohua Zhang
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  5. Hui Zheng
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Contributions

WBN contributed to study design, data collection and analysis, drafting of manuscript. ZGH and ZH contributed to study design, data collection and analysis, drafting of manuscript. YT contributed to the study design, data analysis and interpretation, and revised the manuscript. SL contributed to data analysis, and revised the manuscript. All authors have read and approved the final manuscript.

Corresponding authors

Correspondence to Guohua Zhang or Hui Zheng.

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All the authors declare that they have no conflict of interest.

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This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Wang, B., Yan, T., Sun, L. et al. A history of severe nausea and vomiting during pregnancy predicts a higher incidence of postoperative nausea and vomiting after breast cancer surgery without breast reconstruction. Breast Cancer 28, 506–512 (2021). https://doi.org/10.1007/s12282-020-01190-0

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  • DOI: https://doi.org/10.1007/s12282-020-01190-0

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