{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:14:04Z","timestamp":1788444844656,"version":"build-2803163510"},"reference-count":25,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,20]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine whether the use of a venous access-site closure device is associated with the occurrence of postoperative nausea and vomiting (PONV) after atrial fibrillation (AF) ablation under propofol sedation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A single-centre retrospective observational study in Okayama, Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We retrospectively analysed consecutive patients who underwent AF ablation under deep propofol sedation with adaptive servo-ventilation. A total of 686 patients were included. Patients were managed using a standardised sedation protocol with or without low-dose pentazocine. Patients treated with conventional manual compression for haemostasis (n=383) were compared with those treated using a venous access-site closure device (n=303).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Postprocedural bed rest duration and the incidence and timing of PONV were compared between groups. Associations between closure device use and PONV were evaluated using logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>The primary outcome was the occurrence of PONV following AF ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All procedures were completed under propofol sedation without conversion to general anaesthesia. The duration of postprocedural bed rest was shorter in the device group than in the conventional-compression group (mean difference \u221214.7 hours, 95% CI \u221215.2 to \u221214.0).<\/jats:p>\n                    <jats:p>PONV occurred in 6\/303 patients (2.0%) in the device group and 20\/383 patients (5.2%) in the conventional-compression group, corresponding to a relative risk of 0.38 (95% CI 0.15 to 0.93), an OR 0.25 (95% CI 0.10 to 0.62) and a risk difference of \u22123.2% (95% CI \u22126.0% to \u22120.5%).<\/jats:p>\n                    <jats:p>In multivariable analysis, use of a venous closure device was associated with a lower likelihood of PONV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this single-centre observational study, use of a venous access-site closure device was associated with a lower occurrence of PONV after AF ablation under propofol sedation. These findings suggest that postprocedural management strategies enabling earlier mobilisation may be associated with improved patient comfort; however, causal inference is limited by the observational design.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117719","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:05:35Z","timestamp":1780502735000},"page":"e117719","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association between venous access-site closure device use and postoperative nausea and vomiting after atrial fibrillation ablation under propofol sedation: a single-centre retrospective observational study in Okayama, Japan"],"prefix":"10.1136","volume":"16","author":[{"given":"Haruna","family":"Sakanoue","sequence":"first","affiliation":[{"name":"Department of Nursing, Okayama Heart Clinic, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7758-154X","authenticated-orcid":false,"given":"Hirosuke","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Heart Rhythm Centre, Okayama Heart Clinic, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayaka","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Nursing, Okayama Heart Clinic, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumi","family":"Okano","sequence":"additional","affiliation":[{"name":"Department of Nursing, Okayama Heart Clinic, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Nursing, Okayama Heart Clinic, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunichi","family":"Higashiya","sequence":"additional","affiliation":[{"name":"Heart Rhythm Centre, Okayama Heart Clinic, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashia","family":"Murakami","sequence":"additional","affiliation":[{"name":"Heart Rhythm Centre, Okayama Heart Clinic, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Hirohata","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences, Department of Medical Technology, Okayama University, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9531-076X","authenticated-orcid":false,"given":"Shozo","family":"Kusachi","sequence":"additional","affiliation":[{"name":"Heart Rhythm Centre, Okayama Heart Clinic, Okayama, Japan"},{"name":"Graduate School of Health Sciences, Department of Medical 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