The Effects Of Cerebral Oxygen Saturation Change On Post-operative Nausea And Vomiting Of Female Laparoscopy Surgery

Objective: The aim of this study is to explore effects of Cerebral oxygen saturation(SCTO2)change on post-operative nausea and vomiting(PONV)of female laparoscopy surgery,and discuss the occurring mechanism of PONV after gynecological laparoscopy surgery.Methods: Ninety gynecological and thirty gallbladder surgery patients were included in our study.All the patients were allocated into four groups with thirty cases each.Group A,gynecological laparoscopy surgery;Group B,gynecological open surgery;Group C,gynecological laparoscopy surgery with mannitol treatment;Group D,female laparoscopic cholecystectomy surgery.Time point: SCTO2,VM,RI variation and postoperative PONV occurred within 48 hours were recorded at T1: 5 minutes after entering operation room;T2: 5 minutes after Laryngeal mask airway placement;T3: pneumoperitoneum started with position changed or open procedure started;T4: 15 minutes after pneumoperitoneum or 15 minutes after open procedure;T5: pneumoperitoneum stopped with position changed or abdomen closed;T6 10 minutes after pneumoperitoneum stopped or 10 minutes after abdomen closed.Determining the relationship between PONV occurs within 48 hours after surgery and parameters of perioperative saturation of cerebral oxygen(SCTO2),vertebral artery average blood flow velocity(VM)and vascular resistance(RI)change.Results: In perioperative,all patients with cerebral oxygen saturation is slowly rising.In two time points,T4 and T5,B,C,D three groups of intraoperative SCTO2 lower than group A,with statistical significance(P<0.05).Intraoperative VM is higher than in group A,group C was statistically significant(P < 0.05).T5 point in time,group D intraoperative VM is significantly higher than in group A,was statistically significant(P < 0.05).T4 point in time,group D RI,lower than the rest of the three groups was statistically significant(P < 0.05).Within 24 h after surgery,B,C,D,three groups of cases occurred nausea and vomiting are less than that in group A was statistically significant(P < 0.05).Nausea and vomiting were obviously lower in group C,than in B and D two groups was statistically difference(P < 0.05).Postoperative within 48 h,B,C,D three groups was lower than that in group A,incidence of nausea and vomiting,was statistically significant(P < 0.05).B,C,D no significant statistical differences between the three groups(P < 0.05).Conclusion: The decrease of SCTO2 induced by enhanced cerebral oxygen cons umption and increase of VM could reduce PONV occurrence rate after female l aparoscopy surgery,thus,reducing cerebral oxygen consumption may prevent PO NV in gynecological laparoscopy surgeries.