McKeen Dolores M, Arellano Ramiro, O'Connell Colleen
Department of Women's & Obstetric Anesthesia, IWK Health Centre, Dalhousie University, 5850/5980 University Avenue, Halifax, NS B3K 6K8, Canada.
Can J Anaesth. 2009 Sep;56(9):651-7. doi: 10.1007/s12630-009-9136-4. Epub 2009 Jul 29.
Postoperative nausea and vomiting are among the most common and distressing side effects of general anesthesia. Supplemental intraoperative 80% oxygen reduces postoperative nausea and vomiting following open and laparoscopic abdominal surgery. However, this benefit has not been observed in other patient populations. We undertook this study to evaluate the effect of 80% supplemental intraoperative oxygen on the incidence of postoperative nausea and vomiting following ambulatory surgery for laparoscopic tubal ligation.
Following Research Ethics Board approval, 304 subjects were enrolled into one of two arms of a randomized prospective controlled study. The intervention group (n = 147) breathed 80% oxygen and the control group (n = 145) breathed routine 30% oxygen (balance medical air) while both groups were receiving a standardized general anesthetic. Nausea was assessed as: none, mild, moderate, or severe; vomiting was any emetic episode or retching. Any assessment either greater than none (nausea) or greater than zero (vomiting) was considered positive.
The incidence of postoperative nausea and vomiting up to 24 hr following surgery was 69% in the 80% oxygen intervention group and 65% in the 30% oxygen control group (P = 0.62). There were no differences in nausea alone, vomiting, or antiemetic use in the postoperative anesthetic care unit or at any time (pre- or post-discharge) up to 24 hr after surgery.
This trial of 304 women did not demonstrate that administering intraoperative supplemental 80% oxygen during ambulatory surgery for laparoscopic tubal ligation prevented postoperative nausea or vomiting during the initial postoperative 24 hr compared with women who received routine 30% oxygen.
术后恶心呕吐是全身麻醉最常见且令人困扰的副作用之一。术中补充80%的氧气可降低开腹和腹腔镜腹部手术后的术后恶心呕吐发生率。然而，在其他患者群体中尚未观察到这种益处。我们开展本研究以评估术中补充80%氧气对腹腔镜输卵管结扎门诊手术后恶心呕吐发生率的影响。
经研究伦理委员会批准，304名受试者被纳入一项随机前瞻性对照研究的两个组之一。干预组（n = 147）吸入80%的氧气，对照组（n = 145）吸入常规的30%氧气（其余为医用空气），两组均接受标准化全身麻醉。恶心程度分为：无、轻度、中度或重度；呕吐为任何呕吐发作或干呕。任何大于无（恶心）或大于零（呕吐）的评估都被视为阳性。
术后24小时内，80%氧气干预组的术后恶心呕吐发生率为69%，30%氧气对照组为65%（P = 0.62）。术后麻醉护理单元或术后24小时内（出院前或出院后）的任何时间，单纯恶心、呕吐或使用止吐药方面均无差异。
这项针对304名女性的试验表明，与接受常规30%氧气的女性相比，腹腔镜输卵管结扎门诊手术期间给予术中补充80%氧气并不能预防术后最初24小时内的恶心或呕吐。
