Objective To investigate the effect of penehyclidine hydrochloride on postoperative nausea and vomiting (PONV) in patients undergoing ambulatory laparoscopic cholecystectomy. Methods The medical records of patients who underwent laparoscopic cholecystectomy in ambulatory surgery mode at General Hospital of Northern Theater Command between October 2024 and October 2025 were retrospectively collected. According to whether penehyclidine hydrochloride was used during operation, the patients were divided into a study group (penehyclidine hydrochloride used during operation) and a control group (penehyclidine hydrochloride not used during operation). The general information, perioperative period indicators, the overall incidence of PONV within 48 hours after surgery, the severity and incidence of PONV at different postoperative periods, the incidence of adverse reactions and patient satisfaction of the two groups of patients were compared. Results A total of 110 patients were included, among whom 55 were in the study group and 55 were in the control group. Compared with the control group, the overall incidence of PONV within 48 hours after surgery in the study group decreased (34.5% vs. 56.4%; χ2=5.280, P=0.022), the severity and incidence of PONV at each time period from 0 to 6 hours, 6 to 12 hours, and 12 to 24 hours decreased (P<0.05), and the usage rate of rescue antiemetic drugs decreased (10.9% vs. 29.1%; χ2=5.682, P=0.017). The incidence of dry mouth (30.9% vs. 10.9%; χ2=6.652, P=0.010) and patient satisfaction [85 (75, 85) vs. 75 (70, 75); Z=5.531, P<0.001] in the study group were higher than those in the control group. There was no statistically significant difference in the general data of the patients, perioperative indicators except rescue antiemetic drugs, the severity and incidence of PONV from 24 to 48 hours after surgery, or dizziness, drowsiness, blurred vision, urinary retention, skin itching or other adverse reactions between the two groups (P>0.05). Conclusions The intraoperative use of penehyclidine hydrochloride in patients undergoing laparoscopic cholecystectomy in ambulatory mode can effectively reduce the incidence and severity of postoperative PONV. The overall safety is good and the patient satisfaction is high. It can be promoted and applied in the clinical anesthesia of ambulatory surgery.
