妇科腔镜手术后恶心呕吐危险因素分析

目的:评估引起妇科腔镜手术术后恶心、呕吐(PONV)的潜在危险因素。方法:随机纳入需要全身麻醉的妇科腔镜手术患者167例,记录术后2h及24h的恶心程度视觉模拟评分(NVAS),对与恶心、呕吐相关的因素行统计学评价。检测因素包括:年龄、体重指数、麻醉方法(静脉全麻或静、吸复合全麻)、阿片类药物剂量、麻醉持续时间。结果:共有130(77.84%)例患者发生了一次或者多次PONV事件,使用吸入麻醉剂和麻醉时间延长均会显著地影响患者术后24h的NVAS评分(P<0.05),体重指数、年龄和阿片类药物剂量对NVAS评分无显著影响。结论:使用吸入麻醉剂(OR=3.10)和麻醉时间延长(OR=1.20)是影响妇科腔镜术后恶心呕吐发生率的危险因素,而体重指数、年龄与阿片类药物剂量在本研究中对NVAS评分无显著影响。

Risk factors for nausea and vomiting following gynecological laparoscopic surgery in adults

Objective:To evaluated the potential risk factors for post-operative nausea and vomiting(PONV)after gynecological laparoscopic surgery in adult patients.Methods:Univariare and multivariate analyses of clinical factors associated with PONV were undertaken in a retrospectiive case-control series of 167 adult patients undergoing gynecological laparoscopic surgery under general anaesthesia.We examined PONV for the first 2h and 24h.Factors examined were age,body mass index(BMI),type of general anaesthesia(intravenous anaesthesia or inhalation anesthesia),duration of surgery,and intraoperarive fentanyl dose.Result:One hundred and thirty patients(77.84%)reported one or more episodes of PONV during the study period.Duration of surgery and general anaesthesia with inhalational anaesthetics were significantly related to nausea and vomiting during 24 h postoperatively(P<0.05).Other factors,including BMI,age and intraoperarive fentanyl dose did not alter the risk for nausea and vomiting.Conclusion:We conclude that general anaesthesia with inhalational anaesthetics(OR=3.10)and duration of surgery(OR=1.20)are the main risk factors for PONV after gynecological laparoscopic surgery in adults.BMI,age and intraoperarive fentanyl dose did not alter the incidence of PONV in our patients.