Department of Anesthesia and Pain Medicine, Korea University Ansan Medical Center, Ansan, Korea.
Surg Endosc. 2013 Apr;27(4):1321-5. doi: 10.1007/s00464-012-2607-7. Epub 2012 Dec 13.
Open thyroidectomy is associated with a high incidence of postoperative nausea and vomiting (PONV) in up to 70 % of cases. Use of the recently introduced robot-assisted endoscopic thyroidectomy using a gasless transaxillary approach has been increasing because of its several advantages over open thyroidectomy. This study compared the incidence of PONV in the women who underwent open or robot-assisted thyroidectomy.
This prospective, double-blinded study enrolled 170 women 20-60 years of age who were scheduled for conventional open thyroidectomy (group O) or robot-assisted thyroidectomy (group R). A standard anesthetic technique, including sevoflurane and air in oxygen, was used. During a 0-24-h postoperative period, the presence and severity of PONV (nausea, retching/vomiting), severity of pain, need for rescue antiemetics, and the degree of patient satisfaction were evaluated.
During the 0-6-h postoperative period, the incidence of PONV and mean pain score (40.0 vs. 51.8 %and 4.2 vs. 4.8 in groups R and O, respectively) were not significantly different. At 6-24 h postoperatively, the incidence of PONV (18.8 vs. 44.7 %), severe emesis (11.8 vs. 29.4 %) and mean pain score (2.8 vs. 3.8) were significantly lower in group R compared to group O, respectively. Overall, the incidence of PONV (42.4 vs. 63.5 %) and severe emesis (20.0 vs. 43.5 %) were significantly lower in group R compared to group O, respectively. The incidence of satisfied patients 6 and 24 h after the end of anesthesia (55.3 vs. 28.2 and 82.4 vs. 58.8 %) were significantly higher in group R compared to group O, respectively.
Robotic thyroidectomy reduces the incidence and severity of PONV compared to open thyroidectomy during a 0-24-h postoperative period.
开放式甲状腺切除术与高达 70%的术后恶心和呕吐（PONV）发生率相关。由于其优于开放式甲状腺切除术的几个优点，最近引入的无气经腋窝内镜甲状腺切除术的使用正在增加。本研究比较了接受开放式或机器人辅助甲状腺切除术的女性PONV 的发生率。
这项前瞻性、双盲研究纳入了 170 名年龄在 20-60 岁之间的女性，她们计划接受常规开放式甲状腺切除术（O 组）或机器人辅助甲状腺切除术（R 组）。使用包括七氟醚和氧气中的空气的标准麻醉技术。在 0-24 小时的术后期间，评估 PONV（恶心、呕吐/腹泻）的存在和严重程度、疼痛严重程度、需要抢救止吐药和患者满意度。
在 0-6 小时的术后期间，PONV 的发生率和平均疼痛评分（R 组和 O 组分别为 40.0%和 51.8%和 4.2 分和 4.8 分）没有显著差异。在术后 6-24 小时，R 组的 PONV 发生率（18.8%比 44.7%）、严重呕吐（11.8%比 29.4%）和平均疼痛评分（2.8 分比 3.8 分）均显著低于 O 组。总体而言，R 组的 PONV 发生率（42.4%比 63.5%）和严重呕吐（20.0%比 43.5%）均显著低于 O 组。麻醉结束后 6 小时和 24 小时时，R 组的满意患者比例（55.3%比 28.2%和 82.4%比 58.8%）显著高于 O 组。
与开放式甲状腺切除术相比，机器人甲状腺切除术在 0-24 小时的术后期间降低了 PONV 的发生率和严重程度。
