葡萄糖可降低腹腔镜胆囊切除术后恶心呕吐的发生率：一项随机对照双盲试验
葡萄糖可降低腹腔镜胆囊切除术后恶心呕吐的发生率：一项随机对照双盲试验
贵州医科大学 高鸿教授课题组
翻译：陈锐 修改/编辑：佟睿 审校：曹莹
术后恶心和呕吐 (PONV) 是最常见和最不希望发生的麻醉相关并发症，会导致患者不适、延长住院时间。本研究评估和比较术前/术中输注葡萄糖对腹腔镜胆囊切除术 （LC） 患者PONV的影响。
这项前瞻性、双盲、随机对照研究共纳入93名ASA I-II 拟接受LC的患者，并被分为三组。P组以10 mL/kg/h速度输注5%葡萄糖，术前应用 30 分钟，然后以相同速率输注乳酸林格氏液直至手术结束。I组术前以10 mL/kg/h速度输注乳酸林格氏液30分钟，术中以相同速度输注5%葡萄糖。对照组（C组）在术前和术中均以10 mL/kg/h的速度输注乳酸林格液。记录患者的人口统计学数据、PONV、血流动力学变量、疼痛评分、血糖（BG）值以及止吐和镇痛需求。
各组术前BG值相似，而P组和I组术中和术后BG水平分别高于C组（P=0.020，P=0.010）。与C组相比，P组与I组PONV发生率降低（分别为38.7%和25.8%）（P=0.015）。P组术后6小时止吐药用量显着降低（P=0.005）。
术前输注葡萄糖可作为LC术后PONV安全有效的预防方法。
Salman N, Aykut A, Sabuncu Ü, Şaylan A, Yağar S, Şekerci S. Dextrose administration may reduce the incidence of postoperative nausea and vomiting after laporoscopic cholecystectomy: a double blind randomized controlled trial. Minerva Anestesiol 2020;86:379-86. DOI: 10.23736/S0375-9393.20.13484-9
Dextrose administration may reduce the incidence of postoperative nausea and vomiting after laparoscopic cholecystectomy: a double blind randomized controlled trial
Abstract
BACKGROUND: Postoperative nausea and vomiting (PONV) is the most common and undesirable of the complications associated with anesthesia, leading to discomfort in patients and extended hospital stays. The present study evaluates and compares the effects of preoperative/intraoperative dextrose infusion on PONV in patients undergoing laparoscopic cholecystectomy (LC).
METHODS: This prospective, double-blind, randomized controlled study included 93 ASA I-II LC patients who were divided into three groups. Group P received a 10 mL/kg/h rate 5% Dextrose infusion, applied preoperatively for 30 minutes, followed by the same infusion rate of Ringer’s lactate until the end of surgery. Group I received a 10 mL/kg/h rate of Ringer’s lactate preoperatively for 30 minutes and the same infusion rate of 5% Dextrose during the operation. The control group (Group C) received a Ringer’s lactate solution infusion in the pre- and intraoperative periods at a rate of 10 mL/kg/h. The demographic data, PONV, hemodynamic variables, pain scores, blood glucose (BG) values, and antiemetic and analgesic requirements of the participants were recorded.
RESULTS: Preoperative BG values were similar in all groups, whereas intraoperative and postoperative BG levels were higher in Group P and Group I, respectively (P=0.020, P=0.010) than in Group C. The incidence of PONV was decreased in groups P and I (38.7% and 25.8%, respectively) compared to Group C (P=0.015). The antiemetic postoperative drug usage for 6 hours was significantly lower in Group P (P=0.005).
CONCLUSIONS: Preoperative dextrose infusion may be suggested for PONV prophylaxis as a safe and effective method following LC.
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