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Effects of high intraoperative inspired oxygen on postoperative nausea and vomiting in gynecologic laparoscopic surgery

机译:高术中吸氧对妇科腹腔镜手术术后恶心呕吐的影响

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摘要

Study objective: To assess the efficacy of intraoperative different inspired oxygen fractions (FIO2) of 0.8 and 0.5 when compared with standard FIO2 0.3 in prevention of postoperative nausea and vomiting (PONV).Design: A prospective, controlled, randomized, double-blind study.Setting: General hospital, postanesthesia care unit (PACU) and gynecologic floor room. Patients: 120 ASA physical status I and II women, aged 21 to 76 y, undergoing elective gynecologic laparoscopic surgery.Interventions: Patients were randomized to receive gas mixture of 30% oxygen in air (FI O2=0.3, group G30), 50% oxygen in air (FIO2=0.5, group G50) or 80% oxygen in air (FIO2=0.8, group G80), n=36 in each group. A standardized sevoflurane general anesthesia, postoperative pain management and antiemetic regimen were used.Measurements: The incidence of nausea, vomiting or both was assessed for early (0-2h) and late PONV (2-24h) along with the use of rescue antiemetic, degree of nausea and severity of pain.Main results: There was no overall difference in the incidence of PONV at early and late assessment periods among the three groups. Patients in G80 had significantly less vomiting than G30 at 2 hours, 3% (1/36) vs. 22% (8/36), respectively, P=0.028. Nausea scores, rescue antiemetic use, pain scores and opioid consumption were not different among the groups.Conclusion: High intraoperative FIO2 of 0.8 and FIO2 of 0.5 does not prevent PONV in patients without antiemetic prophylaxis. Intraoperative FIO2 of 0.8 has beneficial effect on early vomiting only.
机译:研究目的:评估术中与标准FIO2 0.3相比术中不同的吸入氧气分数(FIO2)为0.8和0.5的预防术后恶心和呕吐(PONV)的效果设计:前瞻性,对照,随机,双盲研究地点:综合医院,麻醉后监护病房(PACU)和妇科病房。患者:120名年龄在21至76岁的ASA身体状况I和II型女性,接受选择性妇科腹腔镜手术。干预措施:患者随机接受空气中30%氧气的混合气体(FI O2 = 0.3,G30组),50%空气中的氧气(FIO2 = 0.5,G50组)或空气中80%的氧气(FIO2 = 0.8,G80组),每组n = 36。使用标准的七氟醚全身麻醉,术后疼痛处理和止吐方案。测量:评估PONV早期(0-2h)和晚期PONV(2-24h)的恶心,呕吐或两者的发生率,并使用抢救性止吐剂,主要结果:三组之间在评估的早期和晚期,PONV的发生率没有总体差异。 G80组患者在2小时时呕吐明显少于G30组,分别为3%(1/36)和22%(8/36),P = 0.028。两组之间的恶心评分,抢救止吐药的使用,疼痛评分和阿片类药物的消耗无差异。结论:术中FIO2较高(0.8)和FIO2(0.5)在未进行止吐预防的患者中不能预防PONV。术中FIO2为0.8仅对早期呕吐具有有益作用。

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