Intraoperative Noise Isolation and Postoperative Nausea and Vomiting after Gynecological Laparoscopic Surgery: A Randomized Controlled Trial
Chong Fu, Xiaoxuan Hu, Duoduo Tao, Yaoyu Ying, Fan Xia, Di Jin, Juan Wang, Hong Liu, Lingzhong Meng, Fuhai Ji, Huayue LiuBackground:
Postoperative nausea and vomiting (PONV) remain common after gynecological laparoscopic surgery despite guideline-based prophylaxis. Auditory information is still processed during clinically adequate general anesthesia, and operating rooms are persistently noisy, but whether attenuating intraoperative sound exposure alters PONV is unknown.
Methods:
In this single-center, patient- and assessor-blinded randomized trial, women aged 18 to 65 yr undergoing elective gynecological laparoscopic surgery were randomized 1:1 to wear passive noise-attenuating earmuffs from induction until the end of surgery or to usual care. All patients received dexamethasone and palonosetron. The primary outcome was PONV incidence within 48 h, defined as any episode of nausea, retching, or vomiting, assessed across three prespecified windows (post-anesthesia care unit, to 24 h, and 24 to 48 h). Secondary outcomes included PONV severity, its components, rescue antiemetic use, pain, and quality of recovery.
Results:
Of 364 patients assessed, 192 were randomized. PONV within 48 h occurred in 34 of 96 patients (35.4%) with noise isolation and 50 of 96 (52.1%) with control (adjusted risk difference, −0.179 [95% CI, −0.318 to −0.040];
Conclusions:
Among women receiving dual antiemetic prophylaxis for gynecological laparoscopic surgery, intraoperative noise isolation was associated with a lower incidence and severity of PONV.