腹腔镜胆囊切除术CO2气腹压对病人术后恶心呕吐发生的影响

目的探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中二氧化碳(CO2)气腹压对病人术后恶心呕吐发生的影响。方法选择ASA均为Ⅰ级、年龄在20~50岁之间、行LC的育龄女性病人60例,术前均无其他并发疾病,随机分为A、B两组,每组30例。A组病人术中气腹压为12mmHg,B组病人术中气腹压为15mmHg。麻醉方法均采用快速全麻诱导,气管插管后行机械通气,以异丙酚、芬太尼和维库溴铵维持麻醉,记录气腹压力、气腹持续时间以及术后恶心呕吐发生情况。结果两组病人的年龄及气腹持续时间比较差异无显著性(P>0.05),A组病人术后恶心呕吐发生率明显低于B组病人(P<0.05)。结论在病人年龄和气腹持续时间一致的情况下,CO2气腹压的高低可能与术后恶心呕吐的发生率存在一定的相关性。

Occrrence of nausea and vomiting influenced by CO2 pneumoperitoneum pressure in laparoscopic cholecystectomy

Objective To evaluate the occurrence of nausea and vomiting postoperatively influenced by CO_2 pneumoperitoneum pressure in 1 aparoscopic cholecystectomy(LC).Methods 60 female cases with ASAⅠ、 aged20~50、gallstone alone were divided into A group and B group randomly,each group consisted of 30 cases.During operation,CO_2 pneumoperitoneum pressure was 12 mmHg and 15 mmHg in group A and group B respectively. All patients were carried out rapid induced general anaesthesia combined with mechanical breath by means of trachea intubation followed by maintainable anaesthesia.Every patient was required to record age, CO_2 pneumoperitoneum pressure during operation,continous time of pneumoperitoneum and occurrence of neasea and vomiting.Results There was not significant meaning between two groups in both age and continous time of pneumoperitoneum(P>0.05),but the occurrence rate of nausea and vomiting in group A was obvious lower than that in group B(P<0.05).Conclusion There was maybe correlation between the height of CO_2 pneumoperitoneum pressure and the occurreace rate of nausea and vomiting postoperatively under the conditions of matched age and the continous time of CO_2 pneumoperitoneum.