Guo WenJun, Ding Jie, Jin XiaoJu, Li GaoJie
Department of Anesthesiology, Wannan Medical College, First Affiliated Hospital, Yijishan Hospital, Wuhu, Anhui, China.
Medicine (Baltimore). 2017 Oct;96(41):e8275. doi: 10.1097/MD.0000000000008275.
The purpose of this study was to investigate effect of cerebral oxygen saturation (SCTO2) on postoperative nausea and vomiting (PONV) in female patients who underwent laparoscopic surgery.
This study included 90 female patients who underwent laparoscopic surgery (60 cases of gynecological operations and 30 cases of gallbladder operations). All patients were allocated into 3 groups of 30 patients each: group A (gynecological laparoscopic surgery), group B (gynecological laparoscopic surgery with mannitol treatment) and group C (laparoscopic cholecystectomy surgery). Perioperative SCTO2, mean blood flow velocity of vertebral artery (VM), vascular resistance index of vertebral artery (RI), and PONV (within 48 hours after surgery) were investigated.
No differences in age, body weight, operation time, and hemoglobin levels were observed among the patients (P > .05). The SCTO2 values for groups B and C were lower than those for group A in both brain hemispheres at T4 and T5 (P < .05). The VM was higher in group B than in groups A and C at T3 (P < .05), but differences in VM were not observed between groups B and C at T4 or T5. However, the VM of group A was still lower than the other groups (P < .05), and no difference in VM was observed among the 3 groups at T6 (P > .05). The RI was higher in group C than in groups A and B at T4 (P < .05). The incidence of PONV within 48 hours after surgery was significantly higher in group A than in the other 2 groups (P < .05).
Strategies that maintain normal SCTO2 may reduce the incidence of PONV in female patients who underwent laparoscopy surgery by reducing perioperative intracranial pressure.
本研究旨在探讨脑氧饱和度(SCTO2)对接受腹腔镜手术的女性患者术后恶心呕吐(PONV)的影响。
本研究纳入90例接受腹腔镜手术的女性患者(妇科手术60例,胆囊手术30例)。所有患者被分为3组,每组30例:A组(妇科腹腔镜手术)、B组(妇科腹腔镜手术联合甘露醇治疗)和C组(腹腔镜胆囊切除术)。研究围手术期的SCTO2、椎动脉平均血流速度(VM)、椎动脉血管阻力指数(RI)以及术后48小时内的PONV情况。
患者间年龄、体重、手术时间和血红蛋白水平无差异(P>0.05)。在T4和T5时,B组和C组两个脑半球的SCTO2值均低于A组(P<0.05)。在T3时,B组的VM高于A组和C组(P<0.05),但在T4或T5时,B组和C组的VM无差异。然而,A组的VM仍低于其他组(P<0.05),在T6时,3组间VM无差异(P>0.05)。在T4时,C组的RI高于A组和B组(P<0.05)。术后48小时内,A组的PONV发生率显著高于其他两组(P<0.05)。
维持正常SCTO2的策略可能通过降低围手术期颅内压来降低接受腹腔镜手术的女性患者PONV的发生率。