【罂粟摘要】 妇科腹腔镜手术术中呼气末二氧化碳与术后恶心呕吐的关系

妇科腹腔镜手术术中呼气末二氧化碳与术后恶心呕吐的关系

贵州医科大学麻醉与心脏电生理课题组

翻译：黄祥 

编辑：宋雨婷 

审校：曹莹

目的

妇科腹腔镜手术术后恶心呕吐（PONV）的发生率很高。研究表明，术中低呼气末二氧化碳 (EtCO2)与PONV发病率增加有关，但研究结果并不一致。本研究调查了在全身麻醉下接受妇科腹腔镜手术的患者术中EtCO2与PONV之间的关系。

方法

本研究为回顾性队列研究，纳入在京都大学医院接受全身麻醉下妇科腹腔镜手术的患者。我们将低EtCO2定义为EtCO2的平均值低于35mmHg。通过多元Poisson回归分析低EtCO2与术后2天PONV和术后住院时间(PLOS)的关系。

结果

739例患者中，120例(16%)EtCO2较低，430例(58%)术后2天内发生PONV。EtCO2较低与PONV发生率增加无显著相关性(95%CI：0.80~ 1.14; P=0.658)。此外，较低的EtCO2与较长的PLOS无明显联系（95%CI：-1.00 ~ 1.28;P=0.816)。

结论

术中EtCO2低于35 mmHg与PONV发生率的增加及PLOS的延长无明显相关性。

原始文献来源

Dong L,Takeda C,Yamazaki H, et al. Association between intraoperative end-tidal carbon dioxide and postoperative nausea and vomiting in gynecologic laparoscopic surgery. Sci Rep. 2022;12 (1):6865.

英文原文

Association between intraoperative end‑tidal carbon dioxide and postoperative nausea and vomiting in gynecologic laparoscopic surgery

Gynecologic laparoscopic surgery has a high incidence of postoperative nausea and vomiting (PONV). Studies suggest that low intraoperative end-tidal carbon dioxide (EtCO2) is associated with an increased incidence of PONV, but the results have not been consistent among studies. This study investigated the association between intraoperative EtCO2 and PONV in patients undergoing gynecologic laparoscopic surgeries under general anesthesia. This retrospective cohort study involved patients who underwent gynecologic laparoscopic surgeries under general anesthesia at Kyoto University Hospital. We defined low EtCO2 as a mean EtCO2 of < 35 mmHg. Multivariable modified Poisson regression analysis examined the association between low EtCO2 and PONV during postoperative two days and the postoperative length of hospital stay (PLOS). Of the 739 patients, 120 (16%) had low EtCO2, and 430 (58%) developed PONV during postoperative two days. There was no substantial association between low EtCO2 and increased incidence of PONV (adjusted risk ratio: 0.96; 95% confidence interval [CI] 0.80-1.14; P = 0.658). Furthermore, there was no substantial association between low EtCO2 and prolonged PLOS (adjusted difference in PLOS: 0.13; 95% CI - 1.00 to 1.28;P = 0.816). Intraoperative low EtCO2, specifically a mean intraoperative EtCO2 below 35 mmHg, was not substantially associated with either increased incidence of PONV or prolonged PLOS.

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