全麻下日间斜视矫正术后恶心呕吐的发生率及危险因素

Incidence and risk factors of postoperative nausea and vomiting following ambulatory strabismus surgery under general anesthesia:A retrospective study analysis

目的分析全麻下日间斜视矫正术后恶心呕吐(PONV)的发生率及危险因素。方法对连续1 069例行日间斜视矫正手术患者(年龄> 3岁)进行回顾性分析。所有患者均在全麻诱导期静脉注射地塞米松复合5-HT3受体拮抗药预防PONV。结果 10例患者发生PONV,发生率仅0.94%。单因素回归分析发现下斜肌与下直肌手术操作、眼外肌肉数量、及手术时间与PONV发生密切相关。多因素回归分析进一步显示手术时间是PONV的独立危险因素。手术时间> 29.5 min能够预测PONV的发生,其灵敏度1.00,特异性0.64。结论地塞米松复合5-HT3受体拮抗药能够有效降低斜视矫正手术PONV发生率,且手术时间> 29.5 min能够预测PONV的发生。

Objective The study was aimed to determine the incidence and risk factors of postoperative nausea and vomiting(PONV)following ambulatory strabismus surgery under general anesthesia.Methods 1 069 consecutive patients(>3 years old)undergoing ambulatory strabismus surgery with general anesthesia were included for the analysis.All patients received prophylactic treatment using dexamethasone and 5-HT3 antagonist combinations to prevent PONV during the anesthesia induction.Results Treated with dexamethasone and 5-HT3 antagonist combinations,the incidence of PONV was decreased to 0.94% (10/1069).Univariate logistic regression analysis revealed the duration of surgery and inferior rectus muscle and inferior oblique muscle as well as number of muscles increased the likelihood of PONV following strabismus surgery.Multivariate logistic regression analysis further showed duration of surgery is one of independent risk factors in PONV,and the cut-off point is 29.5 minutes with a sensitivity of 1.00 and specificity of 0.64.Conclusions Pretreated with dexamethasone and 5-HT3 antagonist combinations effectively reduced the incidence of PONV following strabismus surgery.Surgery duration longer than 29.5 minutes can increase the occurrence of PONV.