摘要
目的探讨超快通道麻醉(UFTA)下经右侧小切口改良Morrow术患者术后恶心呕吐(PONV)的独立危险因素。方法本研究为回顾性队列研究,选择2022年1月1日至2024年12月31日于浙江省人民医院择期行UFTA下经右侧小切口改良Morrow术的患者387例,年龄≥18岁,美国麻醉医师协会(ASA)分级Ⅱ~Ⅳ级。通过电子病历系统收集并比较患者的一般资料[年龄、性别、ASA分级、体重指数(BMI)、既往史(包括手术史、吸烟史、高血压史、肺动脉高压史、冠心病史)]、术中及术后情况(主动脉阻断时间,麻醉时间,手术时间,拔管时间,术中总入量,术中舒芬太尼用量,昂丹司琼、糖皮质激素及新斯的明的使用情况,术后数字分级评分法(NRS)评分>3分及术后补救性用药情况)。根据护理记录单上记录是否发生PONV将患者分为PONV组(82例)和非PONV组(305例)。将两组患者差异有统计学意义的指标纳入多因素logistic回归分析,计算比值比(OR)及95%置信区间(CI),分析UFTA下经右侧小切口改良Morrow术患者PONV的独立危险因素。结果有82例(22.1%)患者发生PONV。两组患者性别、BMI、吸烟史、新斯的明使用、主动脉阻断时间、术中舒芬太尼用量、麻醉时间,差异有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,女性(OR 2.855,95%CI 1.727~4.720,P<0.001)、新斯的明使用(OR 1.734,95%CI 1.037~2.900,P=0.036)是UFTA下经右侧小切口改良Morrow术患者PONV的独立危险因素。结论女性、新斯的明使用是UFTA下经右侧小切口改良Morrow术患者PONV的独立危险因素。
Objective To explore the independent risk factors for postoperative nausea and vomiting(PONV)in patients who undergoing modified Morrow surgery via right mini-thoracotomy under ultra-fast-track anesthesia(UFTA).Methods This study was a retrospective cohort analysis.A total of 387 patients,aged≥18 years,American Society of Anesthesiologists(ASA)gradesⅡ−Ⅳ,who underwent elective modified Morrow procedure via right mini-thoracotomy under UFTA at Zhejiang Provincial People's Hospital from January 1,2022 to December 31,2024 were enrolled.Data were collected from the electronic medical record system and compared,including demographic characteristics[age,sex,ASA grades,body mass index(BMI),and medical history(including surgical history,smoking history,history of hypertension,history of pulmonary hypertension,and history of coronary heart disease)],as well as intraoperative and postoperative parameters(aortic cross-clamp time,anesthesia duration,operative time,time to extubation,total intraoperative fluid intake,intraoperative sufentanil consumption,use of ondansetron,glucocorticoids,and neostigmine,postoperative Numerical Rating Scale(NRS)scores>3,and use of postoperative rescue analgesia).Based on the documentation in nursing records regarding the occurrence of PONV,patients were categorized into a PONV group(n=82)and a non-PONV group(n=305).Factors showing statistically significant differences between the two groups were included in a multivariate logistic regression analysis to calculate odds ratios(OR)and 95% confidence intervals(CI),in order to identify independent risk factors for PONV following the modified Morrow procedure via right mini-thoracotomy under UFTA.Results PONV occurred in 82 patients(22.1%).Statistically significant differences(all P<0.05)between the two groups were identified for sex,BMI,smoking history,neostigmine use,aortic cross-clamp time,intraoperative sufentanil consumption,and anesthesia duration.Multivariate logistic regression analysis revealed that female sex[OR 2.855(95%CI 1.727,4.720),P<0.001]and neostigmine use[OR 1.734(95%CI 1.037,2.900),P=0.036]were independent risk factors for PONV following the modified Morrow procedure via right mini-thoracotomy under UFTA.Conclusions Female sex and neostigmine use are independent risk factors for PONV following the modified Morrow surgery via right mini-thoracotomy under UFTA.
作者
徐林婷
严美娟
卫含伟
王浩舟
江甜
郭津辰
Xu Linting;Yan Meijuan;Wei Hanwei;Wang Haozhou;Jiang Tian;Guo Jinchen(Graduate School of Wannan Medical College,Wuhu 241002,China;Department of Anesthesiology,Zhejiang Provincial People's Hospital,Hangzhou 311121,China;Hangzhou Normal University Graduate School,Hangzhou 311121,China)
出处
《国际麻醉学与复苏杂志》
2026年第1期18-22,共5页
International Journal of Anesthesiology and Resuscitation
基金
浙江省卫生健康科技计划(2022KY039,2024KY009)
高校基本科研业务费基础科研计划(KYZD2024010)。
关键词
术后恶心呕吐
超快通道麻醉
改良Morrow术
Postoperative nausea and vomiting
Ultra-fast-track anaesthesia
Modified Morrow surgery
