Department of Anesthesiology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan.
J Anesth. 2013 Feb;27(1):18-24. doi: 10.1007/s00540-012-1468-5. Epub 2012 Aug 28.
The first purpose of this study was to determine the incidence of postoperative nausea and/or vomiting (PONV) 0-48 h after anesthesia at a Japanese cancer center. The second purpose of this study was to collect information on PONV risk factors, independently, in the categories of patient-related, anesthesia-related, and surgery-related factors.
The frequency of nausea and vomiting was prospectively investigated from 0 to 48 h after anesthesia in 1645 patients (11-94 years of age) at a single medical institution. The occurrence of nausea and vomiting and the use of antiemetics were recorded up to 48 h after anesthesia. Patient-related, anesthesia-related, and surgery-related factors were also recorded and submitted to multiple logistic regression analysis to determine the relationship of these factors to nausea and vomiting.
The incidences of nausea and vomiting from 0 to 24 h after anesthesia were 40 and 22 %, respectively. The incidences 24-48 h after anesthesia were 10 and 3 %, respectively. Female sex, previous history of PONV, prolonged anesthesia, and remifentanil use during surgery were identified as risk factors for both nausea and vomiting. The use of a volatile anesthetic, use of fentanyl during surgery, postoperative use of opioids, nonsmoking status, and drinking alcohol on 4 or fewer days per week were identified as risk factors for nausea alone.
The incidence of and risk factors for PONV at a Japanese cancer center according to this study are comparable to those reported elsewhere.
本研究的首要目的是确定日本癌症中心麻醉后 0-48 小时内术后恶心和/或呕吐(PONV)的发生率。本研究的第二个目的是独立收集与患者相关、麻醉相关和手术相关因素相关的 PONV 风险因素的信息。
本研究在一家医疗机构中对 1645 名(11-94 岁)患者进行前瞻性调查,记录麻醉后 0 至 48 小时内的恶心和呕吐频率。记录麻醉后 48 小时内的恶心和呕吐发生情况以及止吐药的使用情况。还记录了患者相关、麻醉相关和手术相关因素,并提交给多因素逻辑回归分析,以确定这些因素与恶心和呕吐的关系。
麻醉后 0-24 小时恶心和呕吐的发生率分别为 40%和 22%。麻醉后 24-48 小时的发生率分别为 10%和 3%。女性、PONV 史、麻醉时间延长以及手术中使用瑞芬太尼被确定为恶心和呕吐的共同危险因素。使用挥发性麻醉剂、手术中使用芬太尼、术后使用阿片类药物、不吸烟和每周饮酒不超过 4 天被确定为仅恶心的危险因素。
根据本研究,日本癌症中心 PONV 的发生率和风险因素与其他地方报道的相似。