Effects of different ventilations during the induction of anesthesia on postoperative nausea and ;vomiting in patients undergoing laparoscopic cholecystectomy / 中国医师进修杂志

ABSTRACT

Objective To investigate the effects of different ventilations during the induction of anesthesia on postoperative nausea and vomiting in patients undergoning laparoscopic cholecystectomy. Methods One hundred and twenty patients undergoing laparoscopic cholecystectomy were randomly divided into M group and V group according to random number table, 60 patients each group. The patients in M group performed manual ventilation and the patients in V group performed mechanical ventilation. According to different tidal volume, V group were randomly divided into three groups (20 patients each groupV1,V2 and V3 group, respectively recieved body weight × 4, 6 and 8 ml/kg. After tracheal intubation,the operations were completed by maintaining the end of CO2 partial pressure (PETCO2)from 35 to 45 mmHg, 1 mmHg = 0.133 kPa. Tidal volume, peak airway pressure (Ppeak) and PETCO2 in anesthesia induction,and intraoperative gastric insufflation and postoperative nausea and vomiting were recorded and compared. Results The incidence rate of gastric insufflation, postoperative nausea and vomiting in V group were significantly higher than those in M group50.0%(30/60) vs. 21.7%(13/60), 45.0%(27/60) vs. 18.3%(11/60), 26.7%(16/60) vs. 10.0%(6/60), P<0.05. The level of Ppeak in M group, V2 group and V3 group were signicantly higher than that in V1 group (13.55 ± 1.95), (12.05 ± 1.23), (18.35 ± 3.71) cmH2O vs. (13.55 ± 1.95) cmH2O, 1 cmH2O = 0.098 kPa, P<0.05. The level of PETCO2 in M group, V2 group and V3 group were signicantly lower than that in V1 group(19.60 ± 4.31), (27.75 ± 1.94), (23.60 ± 4.45) mmHg vs. (29.90 ± 2.40) mmHg, P<0.05. Conclusions Manual ventilation during the induction of anesthesia in patients undergoning laparoscopic cholecystectomy is better than mechanical ventilation . Proper manual positive pressure ventilation and volume mechanical ventilation with low tidal (4 ml/kg) may allow for decreasing intraoperative gastric insufflation and postoperative nausea and vomiting.