术中吸入80%氧浓度对预防术后恶心呕吐有效性的Meta分析

Effectiveness of Intraoperative Inhalation of 80% Oxygen Concentration in Preventing Postoperative Nausea and Vomiting:a Meta-Analysis

目的系统性评价术中吸入高浓度氧气是否能减少术后恶心呕吐(POVN)的发生。方法检索PubMed、Embase、Cochrane图书馆,检索时间均为建库至2021年11月,纳入研究术中吸入高浓度氧气对POVN影响的随机对照试验。采用RevMan 5.4软件进行Meta分析。评价术后24 h POVN和术后补救性使用止吐药人数。结果最终纳入11项随机对照试验,共1700例患者。在成人患者中,术中吸入80%或30%氧浓度对术后24 h POVN的发生率差异无统计学意义(P=0.35),术中吸入80%氧浓度增加术后补救性使用止吐药的人数(P=0.03);在儿童患者中,术中吸入80%氧浓度可以减少术后24 h POVN的发生(P=0.04),并减少补救性使用止吐药物的人数(P=0.02);在成年女性患者中,术中吸入80%或30%氧浓度对术后24 h POVN的发生率(P=0.10)和术后补救性使用止吐药的人数(P=0.71)差异均无统计学意义。结论术中吸入80%氧浓度不能预防成人患者POVN也不能减少补救性止吐药的使用,但可以预防儿童患者POVN并减少补救性止吐药的使用。

Objective To systematically evaluate intraoperative high inspired fraction of oxygen on preventing of postoperative nausea and vomiting(PONV).Methods PubMed,Embase and Cochrane libraries were searched from database establishment to November 2021.Randomized controlled trials investigating effects of intraoperative high-concentration oxygen inhalation on POVN were included.Meta-analysis was performed using RevMan 5.4 software.Postoperative 24-h POVN and postoperative rescue antiemetic use were evaluated.Results 11 randomized controlled trials with total 1700 patients were included.For adults,80%or 30% FiO_(2) had no significant difference in POVN incidence(P=0.35)and 80% FiO_(2) could increase numbers of patients requiring rescue antiemetics(P=0.03).For children,80% FiO_(2) could decrease POVN incidence(P=0.04)and numbers of patients requiring rescue antiemetics(P=0.02).For female patients,80% FiO_(2) could not decrease POVN incidence(P=0.10)and numbers of patients requiring rescue antiemetics(P=0.71).Conclusion Intraoperative high inspired fraction of oxygen cannot decrease POVN incidence and antiemetics in adults,but it could prevent POVN and reduce antiemetics in children.