Joris J L, Poth N J, Djamadar A M, Sessler D I, Hamoir E E, Defêchereux T R, Meurisse M R, Lamy M L
Department of Anaesthesia and Intensive Care Medicine, CHU de Liège, Belgium.
Br J Anaesth. 2003 Dec;91(6):857-61. doi: 10.1093/bja/aeg267.
Supplemental intra-operative oxygen 80% halves the incidence of nausea and vomiting after open and laparoscopic abdominal surgery, perhaps by ameliorating intestinal ischaemia associated with abdominal surgery. It is unlikely that thyroid surgery compromises intestinal perfusion. We therefore tested the hypothesis that supplemental perioperative oxygen does not reduce the risk of postoperative nausea and vomiting (PONV) after thyroidectomy.
One hundred and fifty patients undergoing thyroidectomy were given sevoflurane anaesthesia. After induction, patients were randomly assigned to the following treatments: (i). 30% oxygen, (ii). 80% oxygen, or (iii). 30% oxygen with droperidol 0.625 mg.
The overall incidence of nausea during the first 24 h after surgery was 48% in the patients given oxygen 30%, 46% in those given oxygen 80%, and 22% in those given droperidol (P=0.004). There were no significant differences between the oxygen 30% and 80% groups in incidence or severity of PONV, the need for rescue antiemetics, or patient satisfaction. Droperidol significantly shortened the time to first meal.
Supplemental oxygen was ineffective in preventing nausea and vomiting after thyroidectomy, but droperidol reduced the incidence.
术中补充80%的氧气可使开腹和腹腔镜腹部手术后恶心呕吐的发生率减半，这可能是通过改善与腹部手术相关的肠道缺血来实现的。甲状腺手术不太可能影响肠道灌注。因此，我们检验了围手术期补充氧气不能降低甲状腺切除术后恶心呕吐（PONV）风险的假设。
150例行甲状腺切除术的患者接受七氟醚麻醉。诱导后，患者被随机分配至以下治疗组：（i）. 30%氧气；（ii）. 80%氧气；或（iii）. 30%氧气加0.625 mg氟哌利多。
术后24小时内，接受30%氧气治疗的患者恶心的总体发生率为48%，接受80%氧气治疗的患者为46%，接受氟哌利多治疗的患者为22%（P = 0.004）。在PONV的发生率或严重程度、使用抢救性止吐药的需求或患者满意度方面，30%氧气组和80%氧气组之间无显著差异。氟哌利多显著缩短了首次进食的时间。
补充氧气对预防甲状腺切除术后恶心呕吐无效，但氟哌利多可降低其发生率。
