Turkistani Ahmed, Abdullah Khalid, Manaa Essam, Delvi Bilal, Khairy Gamal, Abdulghani Badiah, Khalil Nancy, Damas Fatma, El-Dawlatly Abdelazeem
Department of Anesthesia, College of Medicine, King Saud University, Kingdom of Saudi Arabia.
Saudi J Anaesth. 2009 Jul;3(2):48-52. doi: 10.4103/1658-354X.57872.
Postoperative nausea and vomiting (PONV) is a common complication following general anesthesia. Different regimens have been described for the treatment of PONV with few that mention the prevention of it. Therefore, we conducted this study to compare the effect of preloading with either crystalloids or colloids on the incidence of PONV following laparoscopic cholecystectomy (LC), under general anesthesia.
This study was carried out on 80 patients who underwent LC. The patients were divided into four groups (each 20 patients), to receive preloading of intravenous fluid, as follows: Group 1 received, 10 ml/kg of low-MW tetrastarch in saline (Voluven), group 2 received, 10 ml/kg medium-MW pentastarch in saline (Pentaspan), group 3, received 10 ml/kg of high-MW heta-starch in saline (Hespan), and group 4, received 10 ml/kg Lactated Ringer's, and this was considered as the control group. All patients received the standard anesthetic technique. The incidence of PONV was recorded, two and 24 hours following surgery. The need for antiemetics and/or analgesics was recorded postoperatively.
The highest incidence of PONV was in group 3 (75% of the patients) compared to the other three groups. Also the same trend was found with regard to the number of patients who needed antiemetic therapy. It was the highest incidence in group 3 (70%), followed by group 2 (60%), and then group 1(35%), and the least one was in the control group (25%).
Intravascular volume deficits may be a factor in PONV and preloading with crystalloids showed a lower incidence of PONV.
术后恶心呕吐（PONV）是全身麻醉后常见的并发症。已有多种治疗PONV的方案，但很少提及预防措施。因此，我们开展本研究，比较在全身麻醉下，晶体液或胶体液预负荷对腹腔镜胆囊切除术（LC）后PONV发生率的影响。
本研究纳入80例行LC的患者。患者被分为四组（每组20例），接受静脉输液预负荷，具体如下：第1组接受10 ml/kg的低分子羟乙基淀粉氯化钠注射液（万汶），第2组接受10 ml/kg的中分子羟乙基淀粉200/0.5氯化钠注射液（聚明胶肽），第3组接受10 ml/kg的高分子羟乙基淀粉氯化钠注射液（贺斯），第4组接受10 ml/kg的乳酸林格氏液，该组作为对照组。所有患者均采用标准麻醉技术。记录术后2小时和24小时PONV的发生率。术后记录使用止吐药和/或镇痛药的情况。
与其他三组相比，第3组PONV发生率最高（75%的患者）。在需要止吐治疗的患者数量方面也发现了相同的趋势。第3组发生率最高（70%），其次是第（60%），然后是第1组（35%），最低的是对照组（25%）。
血管内容量不足可能是PONV的一个因素，晶体液预负荷显示PONV发生率较低。
