麻醉诱导前扩容对腹腔镜术后恶心呕吐发生率的影响  

Effect of Volume Expansion before Induction of Anesthesia on the Incidence of Nausea and Vomiting after Laparoscopic Surgery

作　　者：汤海俊 张红[1] 夏晶[1] 朱玉梅[1] TANG Hai-jun;ZHANG Hong;XIA Jing;ZHU Yu-mei(Department of Anesthesiology,Jurong City Hospital of Traditional Chinese Medicine,Jurong,Jiangsu Province,212400 China)

机构地区：[1]江苏省句容市中医院麻醉科,江苏句容212400

出　　处：《中外医疗》2020年第11期31-33,共3页China & Foreign Medical Treatment

摘　　要：目的探讨麻醉诱导前扩容对腹腔镜术后恶心呕吐发生率的影响。方法方便选取60例2016年5月—2018年12月该院进行腹腔镜手术的患者进行研究,按照数字随机法将所有患者平均分成研究组30例和对照组30例,研究组患者在接受麻醉诱导前的20 min使用15 mL/kg钠钾镁钙注射液静脉输注;对照组患者不接受扩容直接使用2 mL/kg钠钾镁钙注射液,完成麻醉诱导后的处理方式两组患者相同。对比观察组和对照组患者在手术前、手术后15 min以及手术结束时的血压水平,同时对比麻醉药物使用时间、补液量以及24 h内恶心呕吐的发生情况。结果在接受麻醉诱导后两组患者的收缩压都有所下降,但对照组患者低于研究组患者差异有统计学意义(t=10.497、9.085,P<0.05);观察组的补液量高于对照组(t=23.713,P<0.05);观察组患者的麻醉时间均低于对照组差异有统计学意义(t=17.110,P<0.05);研究组患者术后恶心呕吐的发生率为6.67%,明显低于对照组的26.67%,差异有统计学意义(χ2=4.320,P<0.05)。结论对进行腹腔镜手术的患者进行麻醉诱导前扩容能够显著降低术后恶心呕吐的发生,对于保证麻醉安全性具有重要作用。Objective To investigate the effect of pre-anaesthesia volume expansion on the incidence of nausea and vomiting after laparoscopic surgery.Methods A total of 60 patients undergoing laparoscopic surgery in our hospital from May 2016 to December 2018 were Convenient selection studied.All patients were divided into a study group of 30 and a control group in accordance with the digital random method.The patients in the study group were receiving anesthesia induction in the first 20 minutes,15 mL/kg sodium-potassium-magnesium-calcium injection was used for intravenous infusion;patients in the control group received 2 mL/kg sodium-potassium-magnesium-calcium injection directly without volume expansion.The blood pressure levels of patients in the observation group and the control group were compared before operation,15 minutes after the operation and at the end of the operation.At the same time,the time of anaesthetic,the amount of fluid replacement,and the occurrence of nausea and vomiting within 24 hours were compared.Results After the induction of anesthesia,the systolic blood pressure of both groups decreased,but the patients in the control group were lower than those in the study group,the difference was statistically significant(t=10.497,9.085,P<0.05);the amount of fluid replacement in the observation group was higher than that in the control group,the difference was statistically significant(t=23.713,P<0.05);the anesthesia time of the observation group was lower than that of the control group,the difference was statistically significant(t=17.110,P<0.05);the incidence of postoperative nausea and vomiting in the study group was 6.67%,which was significantly lower than the 26.67%of the control group,the difference was statistically significant(χ2=4.320,P<0.05).Conclusion Dilatation of patients undergoing laparoscopic surgery before induction of anesthesia can significantly reduce the incidence of postoperative nausea and vomiting,and plays an important role in ensuring the safety of anesthesia.

关 键 词：麻醉诱导前 腹腔镜 恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]