School of Nursing, Shandong Second Medical University (J. Liu, Cheng, and Dr. Y. Liu), Weifang, China.
Department of Cardiology, Zibo Central Hospital (Zhang), Zibo, China.
J Minim Invasive Gynecol. 2024 Apr;31(4):285-294. doi: 10.1016/j.jmig.2024.01.006. Epub 2024 Jan 17.
This study aimed to explore the relationship between intravenous 5% dextrose infusion during emergence from anesthesia to postoperative nausea and vomiting (PONV) in patients after gynecologic laparoscopic surgery.
This was a double-blind randomized controlled trial. Participants were randomized into the experimental group and control group using a computer-generated random number generator. Intervenors and measurers were blinded to group assignments of the study.
A single academic tertiary medical center.
Patients undergoing gynecologic laparoscopic surgery.
On completion of surgery, participants were randomized into the test group (receive 5% dextrose) and control group (receive Ringer's lactate solution).
The primary outcome of the present study was the incidence of PONV. Other outcomes included postoperative rescue analgesic and rescue antiemetic, postoperative pain response, and recovery time of postanesthesia care unit. Baseline characteristics were statistically similar between the 2 groups of participants. There were 49 of 105 patients experienced PONV within 24 hours postoperatively. The overall incidence of PONV within 24 hours postoperatively was not significantly different (45.5% vs 48%; relative risk [RR], 0.95; 95% confidence interval [CI], 0.67-1.37; p = .794). However, fewer patients experienced PONV in the test group than in the control group during 0 to 1 hours (6.0% vs 20.0%; RR, 0.85; 95% CI, 0.73-0.99; p = .024) and 1 to 3 hours (14.5% vs 32.0%; RR, 0.80; 95% CI, 0.64-0.99; p = .033) postoperatively. In addition, recovery time in the postanesthesia care unit was less in the test group (17.07 ± 6.36 vs 22.04 ± 7.33; mean difference, -4.97; 95% CI, -7.62 to -2.32; p <.001) and pain score was lower in the test group during 0 to 0.5 hours postoperatively (2.29 ± 1.74 vs 3.08 ± 1.64; mean difference, -0.79; 95% CI, -1.45 to -0.13; p = .019).
In patients after gynecologic laparoscopic surgery, postanesthesia 5% dextrose infusion may be useful in improving the early management of PONV and pain response and may warrant further study.
本研究旨在探讨妇科腹腔镜手术后患者麻醉苏醒期间静脉输注 5%葡萄糖与术后恶心呕吐（PONV）的关系。
这是一项双盲随机对照试验。参与者使用计算机生成的随机数发生器随机分为实验组和对照组。干预者和测量者对研究的分组均不知情。
一家学术性三甲医院。
接受妇科腹腔镜手术的患者。
手术完成后，将参与者随机分为试验组（接受 5%葡萄糖）和对照组（接受林格氏乳酸盐溶液）。
本研究的主要结局是 PONV 的发生率。其他结局包括术后解救镇痛和解救止吐、术后疼痛反应以及麻醉后恢复室的恢复时间。两组参与者的基线特征在统计学上相似。术后 24 小时内，有 49 名 105 名患者发生 PONV。术后 24 小时内 PONV 的总体发生率无显著差异（45.5% vs 48%；相对风险 [RR]，0.95；95%置信区间 [CI]，0.67-1.37；p =.794）。然而，试验组在 0 至 1 小时（6.0% vs 20.0%；RR，0.85；95%CI，0.73-0.99；p =.024）和 1 至 3 小时（14.5% vs 32.0%；RR，0.80；95%CI，0.64-0.99；p =.033）时发生 PONV 的患者少于对照组。此外，试验组在麻醉后恢复室的恢复时间更短（17.07 ± 6.36 vs 22.04 ± 7.33；平均差值，-4.97；95%CI，-7.62 至-2.32；p <.001），术后 0 至 0.5 小时疼痛评分更低（2.29 ± 1.74 vs 3.08 ± 1.64；平均差值，-0.79；95%CI，-1.45 至-0.13；p =.019）。
在妇科腹腔镜手术后的患者中，麻醉后输注 5%葡萄糖可能有助于改善 PONV 和疼痛反应的早期管理，值得进一步研究。
