Department of Anesthesiology, Kitano Hospital, 2-4-20 Ogimachi, Kita-ku, Osaka-city, 530-0025, Japan,
J Anesth. 2013 Oct;27(5):725-30. doi: 10.1007/s00540-013-1621-9. Epub 2013 May 7.
Patients undergoing microvascular decompression surgery often experience postoperative nausea and vomiting (PONV). However, there is little information about the incidence of PONV after microvascular decompression. We hypothesized that microvascular decompression is an especially high-risk procedure for PONV in patients undergoing neurosurgery, and investigated risk factors related to PONV after neurosurgery.
All patients who underwent craniotomy in our institution during a period of 2 years were investigated retrospectively. Medical charts were reviewed to identify PONV during the 24-h postoperative period and related risk factors. Multivariate logistic regression analysis was conducted to elucidate the impact of microvascular decompression on PONV after craniotomy.
Among 556 craniotomy cases, 350 patients met the inclusion criteria. Multivariate logistic regression analysis showed that microvascular decompression was an independent risk factor for PONV after craniotomy (odds ratio 5.38, 3.02-9.60), in addition to female gender, non-smoker status, amount of intraoperative fentanyl administered, and cerebrovascular surgery.
In this retrospective study, microvascular decompression surgery was an especially high-risk factor for PONV in patients undergoing craniotomy. It may be necessary to adopt a combination of prophylactic methods to reduce the incidence of PONV after microvascular decompression.
微血管减压术患者常出现术后恶心呕吐（PONV）。然而，关于微血管减压术后 PONV 的发生率知之甚少。我们假设微血管减压术是神经外科患者 PONV 的高危手术，并研究了与神经外科手术后 PONV 相关的危险因素。
回顾性调查了我院 2 年内接受开颅手术的所有患者。查阅病历，以确定术后 24 小时内是否发生 PONV 及相关危险因素。采用多因素逻辑回归分析阐明微血管减压术对开颅术后 PONV 的影响。
556 例开颅手术中，350 例符合纳入标准。多因素逻辑回归分析显示，微血管减压术是开颅术后 PONV 的独立危险因素（比值比 5.38，3.02-9.60），此外，女性、非吸烟者、术中芬太尼用量和脑血管手术也是 PONV 的独立危险因素。
在这项回顾性研究中，微血管减压术是开颅术后 PONV 的高危因素。可能需要采用预防性综合措施来降低微血管减压术后 PONV 的发生率。
