Magner J J, McCaul C, Carton E, Gardiner J, Buggy D
Department of Anaesthesia, Rotunda Hospital, Parnell Square, Dublin 1, Ireland.
Br J Anaesth. 2004 Sep;93(3):381-5. doi: 10.1093/bja/aeh219. Epub 2004 Jun 25.
I.V. fluid administration has been shown to reduce postoperative nausea and vomiting (PONV). The optimum dose is unknown. We tested the hypothesis that administration of i.v. crystalloid of 30 ml kg(-1) would reduce the incidence of PONV compared with 10 ml kg(-1) of the same fluid.
A total of 141 ASA I female patients undergoing elective gynaecological laparoscopy were randomized, in double-blind fashion, to receive either 10 ml kg(-1) (n=71; CSL-10 group) or 30 ml kg(-1) (n=70; CSL-30 group) of i.v. compound sodium lactate (CSL).
In the first 48 h after anaesthesia, the incidence of vomiting was lower in the CSL-30 group than in the CSL-10 group (8.6% vs 25.7%, P=0.01). Anti-emetic use was less in the CSL-30 group at 0.5 h (2.9% vs 14.3%, P=0.04). The incidence of severe nausea was significantly reduced in the treatment group at awakening (2.9% vs 15.7%, P=0.02), 2 h (0.0% vs 8.6%, P=0.04) and cumulatively (5.7% vs 27.1%, P=0.001). The numbers needed to treat to prevent vomiting, severe nausea and antiemetic use in the first 48 h were 6, 5 and 6, respectively.
I.V. administration of CSL 30 ml kg(-1) to healthy women undergoing day-case gynaecological laparoscopy reduced the incidence of vomiting, nausea and anti-emetic use when compared with CSL 10 ml kg(-1).
静脉输液已被证明可减少术后恶心和呕吐（PONV）。最佳剂量尚不清楚。我们检验了这样一个假设，即与给予10 ml/kg的相同晶体液相比，给予30 ml/kg的静脉晶体液会降低PONV的发生率。
总共141例接受择期妇科腹腔镜检查的ASA I级女性患者，采用双盲方式随机分组，分别接受10 ml/kg（n = 71；CSL-10组）或30 ml/kg（n = 70；CSL-30组）的静脉复方乳酸钠（CSL）。
麻醉后的前48小时内，CSL-30组的呕吐发生率低于CSL-10组（8.6% 对25.7%，P = 0.01）。CSL-30组在0.5小时时使用止吐药的情况较少（2.9% 对14.3%，P = 0.04）。治疗组在苏醒时（2.9% 对15.7%，P = 0.02）、2小时时（0.0% 对8.6%，P = 0.04）以及累计发生率（5.7% 对27.1%，P = 0.001）方面，严重恶心的发生率均显著降低。在最初48小时内预防呕吐、严重恶心和止吐药使用所需的治疗人数分别为6、5和6。
对于接受日间妇科腹腔镜检查的健康女性，静脉给予30 ml/kg的CSL与给予10 ml/kg的CSL相比，可降低呕吐、恶心的发生率以及止吐药的使用。
