Shi Kai-Rui, Zhao Min, Liu Ke, Yu Da-Peng, Zhang Bing-Yuan, Hong Hua, Jiang Lin, Yang Chun
Department of Anesthesiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, Jiangsu 225300, China.
Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
iScience. 2025 Jul 31;28(9):113253. doi: 10.1016/j.isci.2025.113253. eCollection 2025 Sep 19.
Postoperative nausea and vomiting (PONV) remains highly prevalent in laparoscopic sleeve gastrectomy (LSG), with intraoperative opioid use being a key contributing factor. We conducted a prospective, double-blind, randomized trial to compare esketamine-based opioid-sparing anesthesia (OSA) to opioid-based anesthesia in adults undergoing LSG, The primary outcome was the incidence of PONV within 48 h postoperatively. OSA was associated with a significant reduction in the overall incidence of PONV within 48 h, while maintaining comparable analgesic efficacy or postoperative recovery. Additionally, OSA showed clinically significant reductions in both PONV incidence within the first 24 h and severity specifically during the 6-24-h period. Results suggest that OSA is an effective strategy for mitigating PONV following LSG.
术后恶心呕吐（PONV）在腹腔镜袖状胃切除术（LSG）中仍然非常普遍，术中使用阿片类药物是一个关键因素。我们进行了一项前瞻性、双盲、随机试验，比较在接受LSG的成人中，基于艾司氯胺酮的阿片类药物节省麻醉（OSA）与基于阿片类药物的麻醉，主要结局是术后48小时内PONV的发生率。OSA与术后48小时内PONV的总体发生率显著降低相关，同时保持了相当的镇痛效果或术后恢复情况。此外，OSA在前24小时内的PONV发生率以及特别是在6-24小时期间的严重程度方面均有临床显著降低。结果表明，OSA是减轻LSG术后PONV的有效策略。
