Bi Yanmei, Zhong Ruihan, Huang Jinxiang, Huang Han
Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, China.
Int J Gynaecol Obstet. 2022 May;157(2):283-288. doi: 10.1002/ijgo.13742. Epub 2021 Jun 9.
To investigate whether continuous infusion of propofol at a subhypnotic dose prevents nausea and vomiting following carboprost administration at cesarean delivery.
A prospective, randomized, double-blind, placebo-controlled trial conducted at West China Second University Hospital, from June 28, 2017 to January 30, 2018. Pregnant women were randomly allocated to propofol or saline infusion immediately before receiving carboprost at cesarean delivery under combined spinal-epidural (CSE) anesthesia. Propofol was given at an infusion rate of 1.0 mg/kg/h following a loading dose of 0.3 mg/kg. Primary outcome was incidence of intraoperative nausea and vomiting (IONV). Potential sedative effect of propofol infusion was assessed using Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scoring and continuous Bispectral Index (BIS) monitoring.
The incidence of IONV was lower in patients who received propofol compared with saline (46.7% vs 76.7%, OR 0.27; 95% CI, 0.092-0.78, P = 0.016 for nausea; 26.7% vs 53.3%, OR 0.50; 95% CI, 0.25-0.95, P = 0.032 for retching; 10.0% vs 50.0%, OR 0.11; 95% CI, 0.03-0.44, P < 0.001 for vomiting). There were no differences in MOAA/S scoring or BIS between the two groups.
A subhypnotic dose of propofol reduces the incidence of nausea and vomiting following carboprost administration at cesarean delivery under CSE anesthesia, without measurable effect on patients' consciousness or alertness. ClincalTrials.gov: NCT03185156.
探讨在剖宫产术中以亚催眠剂量持续输注丙泊酚是否能预防卡前列素给药后出现的恶心和呕吐。
于2017年6月28日至2018年1月30日在四川大学华西第二医院进行一项前瞻性、随机、双盲、安慰剂对照试验。在腰硬联合麻醉下行剖宫产术的孕妇，于接受卡前列素前即刻被随机分配接受丙泊酚或生理盐水输注。丙泊酚在给予0.3mg/kg负荷剂量后，以1.0mg/kg/h的输注速率给药。主要结局为术中恶心和呕吐（IONV）的发生率。使用改良的观察者警觉与镇静评分（MOAA/S）和持续脑电双频指数（BIS）监测评估丙泊酚输注的潜在镇静效果。
与生理盐水组相比，接受丙泊酚的患者IONV发生率更低（恶心：46.7% 对76.7%，OR 0.27；95%CI，0.092 - 0.78，P = 0.016；干呕：26.7% 对53.3%，OR 0.50；95%CI，0.25 - 0.95，P = 0.032；呕吐：10.0% 对50.0%，OR 0.11；95%CI，0.03 - 0.44，P < 0.001）。两组间MOAA/S评分或BIS无差异。
在腰硬联合麻醉下行剖宫产术时，亚催眠剂量的丙泊酚可降低卡前列素给药后恶心和呕吐的发生率，且对患者意识或警觉无明显影响。ClinicalTrials.gov：NCT03185156。
