Ogata Fumika, Nakamura Tina, Hoshijima Hiroshi, Doi Katsushi, Nagasaka Hiroshi, Mieda Tsutomu
Anesth Prog. 2024 Dec 4;71(4):163-170. doi: 10.2344/611198.
This study aimed to determine whether PONV rates differed over time and to identify potential differences in PONV risk factors for oral surgery patients undergoing general inhalational anesthesia (IA) or propofol-based total intravenous anesthesia (TIVA).
This retrospective cohort study included patients between 16 and 85 years of age and who received intubated general anesthesia with either IA or TIVA for minor oral surgery between January 2021 and July 2022. Primary outcomes were PONV overall (onset at 0-24 hours), early (onset at 0-2 hours), and late (onset at 2-24 hours). Known PONV risk factors as identified from existing literature were included for analysis.
Data were obtained from 188 patients. A total of 41 (21.8%) patients developed overall PONV, 35 patients (18.6%) had early PONV, and 14 patients (7.4%) had late PONV. Any PONV that occurred across 2 periods was categorized in each period. IA compared with TIVA had higher overall PONV (29.6% vs 13.3%; P = .008) and early PONV (25.5% vs 11.1%; P = .034). Female sex and increased Apfel scores were associated with increased overall, early, and late PONV. Per multivariate analysis, females were 2.5 to 6 times higher than males to have overall, early, and late PONV (P < .05), and IA was 3 times higher than TIVA to have overall and early, but not late, PONV (P < .05).
Our results suggested that the method of anesthesia may impact the incidence of overall and early PONV and that female sex and increase Apfel scores correlated with increased PONV through all times.
本研究旨在确定术后恶心呕吐(PONV)发生率是否随时间变化,并确定接受全身吸入麻醉(IA)或丙泊酚全静脉麻醉(TIVA)的口腔外科手术患者PONV危险因素的潜在差异。
这项回顾性队列研究纳入了年龄在16至85岁之间、于2021年1月至2022年7月期间因小型口腔外科手术接受IA或TIVA气管插管全身麻醉的患者。主要结局为总体PONV(0至24小时内发作)、早期PONV(0至2小时内发作)和晚期PONV(2至24小时内发作)。分析中纳入了现有文献中确定的已知PONV危险因素。
获取了188例患者的数据。共有41例(21.8%)患者发生总体PONV,35例(18.6%)患者发生早期PONV,14例(7.4%)患者发生晚期PONV。在两个时间段内发生过的任何PONV均在每个时间段进行分类。与TIVA相比,IA组总体PONV发生率更高(29.6%对13.3%;P = 0.008),早期PONV发生率更高(25.5%对11.1%;P = 0.034)。女性和Apfel评分增加与总体、早期和晚期PONV发生率增加相关。多因素分析显示,女性发生总体、早期和晚期PONV的可能性比男性高2.5至6倍(P < 0.05),IA组发生总体和早期PONV的可能性比TIVA组高3倍,但晚期PONV并非如此(P < 0.05)。
我们的结果表明,麻醉方法可能影响总体和早期PONV的发生率,并且女性和Apfel评分增加与各时间段PONV发生率增加相关。