Poster Presentation: Postoperative Nausea and Vomiting Following Gender-Affirming Surgery: A Case Matched Controlled Study-Postoperative Nausea and Vomiting Following Gender-Affirming Surgery: A Case Matched Controlled Study

Postoperative Nausea and Vomiting Following Gender-Affirming Surgery: A Case Matched Controlled Study

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The Mayo Foundation for Medical Education and Research conducted a retrospective chart review investigating postoperative nausea and vomiting (PONV) in transgender and gender diverse (TGD) patients undergoing gender-affirming surgery compared to cisgender patients. The study included TGD patients from 2018 to 2023 who underwent facial feminization, genitourinary, or chest procedures, and matched them with cisgender controls. PONV was identified by the use of rescue antiemetics in the post-anesthesia care unit (PACU).<br /><br />The study aimed to determine if the incidence and risk factors for PONV in TGD patients would differ from those in cisgender patients. PONV was assessed using generalized estimating equations to summarize the risk among different groups. Both univariable and multivariable analyses were conducted, but due to a small number of events, an adjusted analysis wasn't performed for all comparisons, especially between TGD-AFAB (assigned female at birth) and cis-male patients.<br /><br />Key findings included:<br />- Female sex and age are known factors affecting the risk of PONV, likely due to the influence of sex hormones.<br />- Gender-affirming hormone therapy (GAHT) did not appear to alter the risk of PONV in TGD patients compared to their cisgender counterparts. <br />- There were no significant differences in PONV risk between TGD-AMAB (assigned male at birth) and TGD-AFAB patients compared to matched cisgender controls.<br />- The study encountered limitations such as the indirect measurement of PONV, incomplete surgical matching, and variability in whether GAHT was paused before surgery.<br /><br />Ultimately, the study concludes that the risk for PONV does not significantly differ between TGD patients and cisgender patients undergoing comparable surgical procedures. The findings suggest that anesthesia providers should consider the sex assigned at birth when evaluating PONV risk factors. Further research with prospective randomized control studies is recommended to provide more conclusive evidence.

Keywords

PONV

transgender

gender diverse

gender-affirming surgery

cisgender

postoperative nausea

Mayo Foundation

hormone therapy

risk factors

anesthesia