Background

Doxylamine-pyridoxine is effective in reducing nausea and vomiting in pregnant females. However, its use in other patient populations has not been studied and there are no current recommendations for non-pregnant females receiving doxylamine-pyridoxine post-bariatric surgery during admission.Objective: To evaluate the effectiveness of doxylamine-pyridoxine in resolving postoperative nausea and vomiting (PONV) in non-pregnant females post-bariatric surgery.Setting: Large community hospital

Methods

We identified female patients who underwent bariatric surgery between November 2021 and November 2022 (n=222). Patient characteristics, procedure type, antiemetics used, readmission rates, number of calls or messages after hours and antiemetic refills were analyzed to evaluate for the evidence of PONV.

Results

The prevalence of PONV in the control group was 60/111 (54.1%) compared to 40/111 (36%) in patients who did receive doxylamine-pyridoxine (p<.001). Readmissions for nausea and vomiting within 30 days postoperatively occurred in 8/111 (7.2%) vs 2/111 (1.8%) (OR 0.24, 95% CI 0.05-1.14, p=.07) in the control group vs treatment group respectively. There was also a significant reduction in the mean number of calls or messages after hours in the control group compared to those in the treatment group (β=-1.30, 95% CI -1.73-0.42), p<.001). Required antiemetic refills within 30 days postoperatively occurred in 28/111 (25.2%) vs 18/111 (16.2%) (OR 0.57, 95% CI 0.30-1.11, p=.1) in the control group vs treatment group respectively.

Conclusions

Doxylamine-pyridoxine reduced PONV during admission for non-pregnant females post-bariatric surgery, shown by a significant reduction in the number of calls or MyChart messages for nausea/vomiting after hours.