Postoperative management
Pain, Postoperative nausea and vomiting, pain, PONV, NRS
In the surgical ward, all participants were managed according to a standardized protocol by independent gynecologists. All patients were encouraged to begin ambulation and chew gum freely after they completely recovered from anesthesia. Diet was resumed in the following order depending on what the patient could tolerate: sips of water, a soft diet, and then a normal diet. Pain severity was measured using a numeric rating scale (NRS; 0 = no pain, 10 = worst imaginable pain). IV PCA was continued until NRS ≤ 3. Despite IV PCA administration, if patients reported breakthrough pain (NRS > 5), 30 mg ketorolac or 1 g acetaminophen was administered in sequence. If this proved ineffective, 50mg of meperidine was administered intravenously. Postoperative nausea and vomiting (PONV) was treated with 10 mg metoclopramide and 0.3 mg ramosetron. Discharge criteria included oral intake of solid food and adequate pain control without the need for IV analgesics.