在手术后的潮二氧化碳水平和术后的恶心和吐之间存在关联:系统性审查和元分析
Thrivikrama P Tantry1, Shraddha Nuliyalu2, Madhura Rao2
1Department of Anaesthesiology, AJ Institute of Medical Sciences & Research Centre, Mangalore, India - drpttantry@yahoo.com.
Minerva anestesiologica
|September 22, 2025
概括
这次元分析没有发现强有力的证据表明,手术期间的潮尾二氧化碳 (EtCO2) 水平显著影响了手术后恶心和吐 (PONV) 发生率. 需要进一步的研究来澄清EtCO2和PONV风险因素之间的关系.
科学领域:
- 麻醉学 麻醉学
- 在外科手术期间的医学.
- 关键的护理关键的护理
背景情况:
- 手术后恶心和吐 (PONV) 是麻醉后的一个常见并发症.
- 在PONV的发展过程中,手术内终潮二氧化碳 (EtCO2) 水平在PONV发展中的潜在作用是一个正在进行的研究领域.
- 目前关于手术内EtCO2和PONV之间关联的现有证据是不确定的,需要进行全面的综合分析.
研究的目的:
- 系统地审查和对随机对照试验 (RCT) 进行元分析,调查手术期间的潮尾二氧化碳 (EtCO2) 水平与术后恶心和吐 (PONV) 发生率之间的关系.
- 解决关于EtCO2对PONV的影响的术后护理当前知识缺口.
- 评估EtCO2与PONV发病率,恶心严重程度以及救援抗药物的相关性.
主要方法:
- 对10项随机对照试验 (RCT) 进行了元分析,涉及1860名患者.
- 研究比较了不同的手术内潮尾二氧化碳 (EtCO2) 值 (<35对≥35 mmHg和<40对≥40 mmHg).
- 聚合风险比率 (RR),几率比率 (OR) 和平均差异 (MD) 用随机效应模型计算,以评估PONV发病率,恶心得分和抗药使用.
主要成果:
- 七项试验的元分析 (N.=475) 没有显示PONV发病率与EtCO2≥35mmHg (RR=0.80,P=0.60) 的显著差异.
- 对六项试验 (N.=1639) 的分析表明,在PONV发病率与EtCO2≥40 mmHg (RR=0.82,P=0.051) 之间没有显著差异的趋势.
- 在考虑患者和手术因素的元回归分析中,在手术内EtCO2水平和恶心得分,救援抗emetic使用或PONV发病率之间没有发现显著的关联.
结论:
- 目前的证据并不能强烈支持手术内末潮二氧化碳 (EtCO2) 水平作为术后恶心和吐 (PONV) 发生率的主要决定因素.
- 分析的共变量和因素没有显示出EtCO2和PONV之间的显著联系.
- 建议进行进一步的大规模,精心设计的研究,以确定EtCO2和PONV之间的关系,并探索与其他风险因素的潜在相互作用.
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