外科医生的经验作为中耳手术后呕吐后遗症的一个因素。

Surgeon's experience as a factor for emetic sequelae after middle ear surgery.

作者信息

Honkavaara P, Pyykkö I

机构信息

Department of Anaesthesia, Helsinki University Central Hospital, Finland.

出版信息

Acta Anaesthesiol Scand. 1998 Oct;42(9):1033-7. doi: 10.1111/j.1399-6576.1998.tb05372.x.

DOI:10.1111/j.1399-6576.1998.tb05372.x

PMID:9809084

Abstract

PURPOSE

To test the hypothesis that an experienced surgeon is associated with less postoperative nausea and vomiting (PONV).

METHODS

A post hoc analysis was done on the data of 167 patients from 3 randomized studies on the prevention of PONV, with transdermal scopolamine, ondansetron and propofol, in middle ear surgery under general anaesthesia.

RESULTS

The patients in the residents' group suffered more from PONV (69% vs. 42%, P < 0.01) and from retching or vomiting (52% vs. 23%, P < 0.001) than those in the specialists' group. The proportion of patients needing droperidol was also higher in the residents' group (66% vs. 27%, P < 0.001). The durations of anaesthesia and surgery seemed to correlate positively with PONV. In matched-pair analysis, residentship was confirmed as a risk factor for emetic symptoms. In the residents' group, prophylaxis of PONV resulted in a decrease in retching and vomiting from 71% to 29% (P < 0.01), and in patients needing droperidol from 87% to 46% (P < 0.01).

CONCLUSION

The patients operated by residents need more aggressive prophylaxis for PONV than those operated by specialists in middle ear surgery.

摘要

目的

检验经验丰富的外科医生与较少的术后恶心呕吐（PONV）相关这一假设。

方法

对来自3项预防PONV的随机研究的167例患者的数据进行事后分析，这些研究涉及在全身麻醉下进行中耳手术时使用透皮东莨菪碱、昂丹司琼和丙泊酚。

结果

住院医生组的患者比专科医生组的患者更容易出现PONV（69%对42%，P<0.01）以及干呕或呕吐（52%对23%，P<0.001）。住院医生组中需要使用氟哌利多的患者比例也更高（66%对27%，P<0.001）。麻醉和手术时间似乎与PONV呈正相关。在配对分析中，住院医生身份被确认为呕吐症状的一个风险因素。在住院医生组中，预防PONV使干呕和呕吐发生率从71%降至29%（P<0.01），使需要氟哌利多的患者比例从87%降至46%（P<0.01）。