مقایسه‌ی تأثیر تزریق کریستالوئید وریدی با حجم‌های متفاوت بر روی تهوع و استفراغ بعد از عمل در کله‌سیستکتومی لاپاراسکوپیک با بیهوشی عمومی

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استادیار ،گروه بیهوشی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران

2 دانشیار، گروه بیهوشی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران

3 استاد، گروه بیهوشی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران

4 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران

چکیده

مقدمه: تهوع و استفراغ بعد از عمل جراحی، از عوارض شایع و ناراحت کننده‌ی بعد از عمل است. به نظر می‌رسد که مایع‌درمانی حین عمل در بروز این عارضه مؤثر باشد. هدف از این مطالعه، مقایسه‌ی تأثیر تزریق 30 و 10 میلی‌لیتر/کیلوگرم کریستالوئید بر تهوع و استفراغ بعد از عمل کله‌سیستکتومی لاپاراسکوپیک با بیهوشی عمومی بود.روش‌ها: در این مطالعه، 146 بیمار که به طور تصادفی به دو گروه مساوی تقسیم شدند. یک گروه، 30 میلی‌لیتر/کیلوگرم و گروه دیگر 10 میلی‌لیتر/کیلوگرم رینگر بلافاصله قبل از عمل دریافت کردند. میزان و شدت تهوع و استفراغ و نیاز به داروی ضد استفراغ بعد از عمل توسط متخصص بیهوشی در ریکاوری و 6، 12 و 24 ساعت بعد از عمل توسط پرستار اندازه‌گیری و ثبت گردید؛ بدون آن که پرستار از تخصیص هر بیمار به گرو‌های مورد مطالعه آگاهی داشته باشد.یافته‌ها: میزان تهوع و استفراغ بعد از عمل در زمان‌های اندازه‌گیری شده بین دو گروه تفاوت معنی‌داری نداشت. شدت استفراغ در 12 ساعت بعد از عمل در گروه 30 میلی‌لیتر/کیلوگرم کریستالوئید به طور معنی‌داری کمتر بود (01/0 > P). میزان داروی ضد استفراغ مورد استفاده در گروه 30 میلی‌لیتر/کیلوگرم به طور معنی‌داری کمتر بود.نتیجه‌گیری: استفاده‌ از دز 30 میلی‌لیتر/کیلوگرم در برابر 10 میلی‌لیتر/کیلوگرم رینگر، میزان تهوع و استفراغ بعد از عمل جراحی کله‌سیستکتومی لاپاراسکوپیک را کاهش نداد، اما شدت آن در 12 ساعت بعد از عمل و میزان داروی ضد استفراغ در 24 ساعت بعد از عمل را کاهش داد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the Effect of Different Volumes of Intravenous Crystalloid Infusion on Postoperative Nausea and Vomiting in Laparoscopic Cholecystectomy under General Anesthesia

نویسندگان [English]

  • Mohammad Azad Majedi 1
  • Rahnam Abbasivash 2
  • Shahryar Sane 2
  • Alireza Mahoori 3
  • Ali Akbar Nasiri 2
  • Pooneh Monfared 4
1 Assistant Professor, Department of Anesthesiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
2 Associate Professor, Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
3 Professor, Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
4 General Practitioner, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
چکیده [English]

Background: Postoperative nausea and vomiting (PONV) is the most common and unpleasant postoperative complication. It seems that fluid-therapy during the surgery is effective on the onset of this complication. The aim of this study was to compare the effect of 30 and 10 ml/kg crystalloid infusion on PONV after laparoscopic cholecystectomy under general anesthesia.Methods: In this study, 146 patients who were randomly divided into two equal groups were evaluated. One group received 30 ml/kg and the other 10 ml/kg Ringer solution as a preoperative intravenous bolus. The incidence and intensity of PONV, and the need for a rescue antiemetic were recorded by anesthesiologist in recovery, and 6, 12, and 24 hours after surgery.Findings: The incidence of PONV was not significantly difference between the two groups. The intensity of vomiting in group 30 ml/kg was significantly lower 12 hours after surgery (P < 0.01). The antiemetic drugs were used significantly less in group 30 ml/kg than other group.Conclusion: Preoperative intravenous administration of 30 ml/kg crystalloid compared with crystalloid 10 ml/kg in patients undergoing laparoscopic cholecystectomy did not reduce the incidence of nausea and vomiting, but reduced the intensity of vomiting 12 hours after surgery, and antiemetic use 24 hours after surgery.

کلیدواژه‌ها [English]

  • Nausea
  • Vomiting
  • Crystalloid
  • Cholecystectomy
  • Laparoscopy
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