Department of Anaesthesia, The Rotunda Hospital Dublin, Parnell Square, Dublin 1, Ireland.
BMC Anesthesiol. 2012 Jul 31;12:15. doi: 10.1186/1471-2253-12-15.
Intravenous fluid is recommended in international guidelines to improve patient post-operative symptoms, particularly nausea and vomiting. The optimum fluid regimen has not been established. This prospective, randomized, blinded study was designed to determine if administration of equivolumes of a colloid (hydroxyethyl starch 130/0.4) reduced post operative nausea and vomiting in healthy volunteers undergoing ambulatory gynecologic laparoscopy surgery compared to a crystalloid solution (Hartmann's Solution).
120 patients were randomized to receive intravenous colloid (N = 60) or crystalloid (N = 60) intra-operatively. The volume of fluid administered was calculated at 1.5 ml.kg-1 per hour of fasting. Patients were interviewed to assess nausea, vomiting, anti-emetic use, dizziness, sore throat, headache and subjective general well being at 30 minutes and 2, 24 and 48 hours post operatively. Pulmonary function testing was performed on a subgroup.
At 2 hours the proportion of patients experiencing nausea (38.2 % vs 17.9%, P = 0.03) and the mean nausea score were increased in the colloid compared to crystalloid group respectively (1.49 ± 0.3 vs 0.68 ± 0.2, P = 0.028). The incidence of vomiting and anti-emetic usage was low and did not differ between the groups. Sore throat, dizziness, headache and general well being were not different between the groups. A comparable reduction on post-operative FVC and FEV-1 and PEFR was observed in both groups.
Intra-operative administration of colloid increased the incidence of early postoperative nausea and has no advantage over crystalloid for symptom control after gynaecological laparoscopic surgery.
国际指南建议静脉补液以改善患者术后症状，尤其是恶心和呕吐。但尚未确定最佳补液方案。本前瞻性、随机、盲法研究旨在确定与晶体液（哈特曼氏液）相比，在接受日间妇科腹腔镜手术的健康志愿者中输注等容量胶体（羟乙基淀粉 130/0.4）是否会减少术后恶心和呕吐。
120 例患者随机分为静脉输注胶体（N=60）或晶体液（N=60）。术中计算每小时禁食 1.5ml/kg 的液体量。术后 30 分钟和 2、24 和 48 小时对患者进行访谈，以评估恶心、呕吐、止吐药使用、头晕、咽痛、头痛和主观整体舒适度。对亚组进行肺功能检查。
术后 2 小时，与晶体液组相比，胶体组发生恶心的患者比例（38.2%比 17.9%，P=0.03）和平均恶心评分（1.49±0.3 比 0.68±0.2，P=0.028）均增加。呕吐和使用止吐药的发生率较低，两组之间无差异。咽痛、头晕、头痛和整体舒适度在两组之间无差异。两组术后 FVC、FEV-1 和 PEFR 均有类似程度的降低。
术中输注胶体增加了术后早期恶心的发生率，在妇科腹腔镜手术后控制症状方面没有优于晶体液。
