Zhang Ran, Zhang Wei Xin, Ma Xiao Ran, Feng Yi
Department of Anesthesiology and Pain Medicine, Peking University People's Hospital, Beijing, China.
Peking University People's Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Pain Ther. 2023 Oct;12(5):1271-1281. doi: 10.1007/s40122-023-00546-6. Epub 2023 Aug 9.
Post-operative nausea and/or vomiting (PONV) is a common post-operative adverse reaction and has been associated with post-operative sufentanil injection. The assessment of the relationship between intraoperative opioid consumption and PONV has been understudied. This study examined the relationship between intraoperative sufentanil administration and PONV.
This was a single-center retrospective observational study. Patients who underwent video-assisted thoracoscopic surgery under general anesthesia with the preoperative thoracic paravertebral block between January 2017 and June 2020 at the Peking University People's Hospital were recruited for this study. Patients were grouped into two groups according to whether or not PONV occurred on postoperative day 1 (POD1). The factors associated with PONV were analyzed using logistic regression.
A total of 2733 patients, 1510 males and 1223 females, were included in this study. Among them, 143 patients developed PONV, a 5.2% (143/2733) PONV incidence. Logistic regression analysis showed that female, nonsmoking, sufentanil patient-controlled intravenous analgesia (PCIA), POD1 opioids consumption, and a time-weighted average of intraoperative sufentanil (twSuf) were associated with PONV. All patients were further divided into four subgroups based on intraoperative twSuf. Logistic regression analysis revealed that twSuf higher than 0.21 μg kg h was an independent risk factor for PONV.
Intraoperative sufentanil injection with a twSuf higher than 0.21 μg kg h increased the risk of PONV in patients undergoing thoracoscopic surgery under general anesthesia after a preoperative thoracic paravertebral block.
术后恶心和/或呕吐（PONV）是一种常见的术后不良反应，且与术后舒芬太尼注射有关。术中阿片类药物消耗量与PONV之间关系的评估研究较少。本研究探讨了术中舒芬太尼给药与PONV之间的关系。
这是一项单中心回顾性观察研究。选取2017年1月至2020年6月在北京大学人民医院接受全身麻醉联合术前胸椎旁神经阻滞的电视辅助胸腔镜手术患者纳入本研究。根据术后第1天（POD1）是否发生PONV将患者分为两组。采用逻辑回归分析与PONV相关的因素。
本研究共纳入2733例患者，其中男性1510例，女性1223例。其中，143例患者发生PONV，PONV发生率为5.2%（143/2733）。逻辑回归分析显示，女性、不吸烟、舒芬太尼患者自控静脉镇痛（PCIA）、POD1阿片类药物消耗量以及术中舒芬太尼的时间加权平均值（twSuf）与PONV相关。根据术中twSuf将所有患者进一步分为四个亚组。逻辑回归分析显示twSuf高于0.21μg·kg·h是PONV的独立危险因素。
术前胸椎旁神经阻滞后，全身麻醉下行胸腔镜手术的患者术中注射舒芬太尼且twSuf高于0.21μg·kg·h会增加PONV的风险。
