Effect of intrathoracic vagus nerve block on postoperative nausea and vomiting in patients undergo-ing lobectomy
Objective To evaluate the crucial role of gut-vagus-brain axis in postoperative nausea and vomiting(PONV)by investigating the effect of intrathoracic vagus nerve block on PONV in patients with lobectomy.Methods A total of 180 female patients undergoing elective thoracoscopic right lobectomy,aged 30-75 years,BMI 18-30 kg/m2,ASA physical status Ⅰ-Ⅲ,were selected.Patients were divided into two groups by random number table method:the intrathoracic vagus nerve block group(group VB)and the control group(group C),90 patients in each group.During the operation,the surgeons used 0.75％ropivacaine 2.5 ml to perform the right vagus nerve block in the lower part of the trachea under thoracoscopy in group VB,and no intrathoracic vagus nerve block was performed in the group C.The incidence of PONV within 24 hours after lobectomy was recorded.The first anal exhaust and defecation within 24 hours after sur-gery,the use of rescue antiemetic drugs,the numerical rating scale(NRS)score and the confusion assess-ment method-Chinese revision(CAM-CR)score at 24 hours after surgery were recorded.The occurrence of adverse reactions such as cough and hypotension within 24 hours after surgery was recorded.Results There was no significant difference in age,BMI,ASA physical status,motion sickness,PONV history,hyperten-sion and diabetes incidence between the two groups.There was no history of smoking or asthma in either group.Compared with group C,the incidence of PONV in group VB was significantly decreased within 24 hours after surgery[24(27％)vs 39(43％),P＜0.05].There was no significant difference in the first a-nal exhaust and defecation within 24 hours after surgery,the use of rescue antiemetic drugs,NRS score and CAM-CR score at 24 hours after surgery between the two groups.There was no cough,hypotension and other adverse reactions in the two groups within 24 hours after surgery.Conclusion Intrathoracic vagus nerve block during lobectomy can effectively reduce the occurrence of PONV,suggesting that the afferent vagus nerve plays a key role in mediating the occurrence of PONV.
LobectomyPostoperative nausea and vomitingVagusNerve blockGut-vagus-brain axis
万方数据
维普
