目的 探讨集束化麻醉管理策略是否能降低术后恶心呕吐(postoperative nausea and vomiting,PONV)风险.方法 回顾性收集2021年7月-11月四川大学华西医院日间手术中心收治的腹腔镜胆囊切除术患者的病例资料.根据是否按照集束化策略实施麻醉管理分为集束化策略组及对照组.分析比较两组患者的-般资料、术中麻醉管理方式、术后情况与PONV发生率.结果 共纳入患者314例.其中,集束化策略组124例,对照组190例;发生术后恶心呕吐52例,PONV发生率为16.6％(52/314).除手术时间、术毕切口浸润外(P＞0.05),两组患者的年龄、性别、体质量指数、麻醉时间、建立气道方式及术毕镇痛药使用比较,差异均有统计学意义(P＜0.05).集束化策略组和对照组发生PONV比较(17 vs.35例),差异无统计学意义(x2=1.205,P＞0.05).Logistic回归分析结果显示,PONV与性别[比值比=0.107,95％置信区间(0.030,0.375),P＜0.001]、采用集束化策略[比值比=0.388,95％置信区间(0.169,0.894),P=0.026]相关.结论 女性是日间腹腔镜胆囊切除术患者中发生PONV的高危人群.采用集束化麻醉管理策略发生PONV的风险更低.
Effect of bundled care on postoperative nausea and vomiting in patients undergoing day laparoscopic cholecystectomy
Objective To explore whether bundled care for anesthesia management can reduce the risk of postoperative nausea and vomiting(PONV).Methods The data of laparoscopic cholecystectomy patients admitted to the Day Surgery Center of West China Hospital,Sichuan University between July and November 2021 were retrospectively collected.Patients were divided into a bundled care group and a control group based on whether anesthesia management was implemented according to the bundled care.The demographic characteristics,intraoperative anesthesia management methods,postoperative conditions,and incidence of PONV between the two groups of patients were analyzed and compared.Results A total of 314 patients were included.Among them,there were 124 cases in the bundled care group and 190 cases in the control group;PONV occurred in 52 cases,the incidence of PONV was 16.6％(52/314).Except for surgical time and postoperative incision infiltration(P＞0.05),there were statistically significant differences in age,gender,body mass index,anesthesia time,airway establishment,and postoperative analgesic use between the two groups of patients(P＜0.05).There was no statistically significant difference in the occurrence of PONV between the bundled care group and the control group(17 vs.35 cases;x2=1.205,P＞0.05).The results of logistic regression analysis showed that PONV was correlated with gender[odds ratio=0.107,95％confidence interval(0.030,0.375),P＜0.00 1],and using bundled care[odds ratio=0.388,95％confidence interval(0.169,0.894),P=0.026].Conclusions Women are at high risk of PONV among patients undergoing day laparoscopic cholecystectomy.The risk of PONV is lower when using bundled care.
Postoperative nausea and vomitingday laparoscopic cholecystectomybundled careday surgery
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