Anesth:术中呼气末二氧化碳与术后恶心呕吐风险的关系

2020-07-15 “罂粟花”微信号 “罂粟花”微信号

接受妇科手术的患者被认为是术后恶心呕吐(PONV)的高危人群。本研究旨在评估术中呼气末二氧化碳(ETCO2)与妇科开腹手术患者发生PONV的风险之间的关系。

背景与目的

接受妇科手术的患者被认为是术后恶心呕吐(PONV)的高危人群。本研究旨在评估术中呼气末二氧化碳(ETCO2)与妇科开腹手术患者发生PONV的风险之间的关系。

方 法

在这项单中心回顾性观察研究中,我们纳入了20~60岁接受择期妇科开腹手术的患者。收集术后24小时内PONV发生率的数据。术中每分钟采集ETCO2,确定ETCO2最低值。比较PONV患者和无PONV患者的最低ETCO2。采用多变量Logistic回归分析评估ETCO2与PONV风险的独立相关性。

结 果

本次研究共纳入146名患者。术后24小时内发生PONV的患者为 81例。PONV患者ETCO2中位数最低值明显低于无PONV患者(31 vs. 33 mmHg,P=0.02)。在多因素Logistic回归模型中,我们发现最低ETCO2≤31 mmHg,与PONV风险增加独立相关(调整优势比=3.3 7,p=0.02)。

结 论

在这项回顾性观察研究中,术中低ETCO2被证明与PONV风险增加独立相关。然而,这一结果可能会因收集到的信息不全面而存在偏倚,包括术前的PONV、晕动病或其他未知的偏倚,因此结果尚需进一步论证。

原始出处:

Fujimoto D, Egi M, Makino S,et,al.  The association of intraoperative end?tidal carbon dioxide with the risk of postoperative nausea and vomiting[J]. Anesth. 2020 Apr;34(2):195-201. doi: 10.1007/s00540-019-02715-4.

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