Effect Of Perioperative Fluid Therapy On Nausea And Vomiting After Gynecological Endoscopic Surgery

Objective: Perioperative fluid therapy can reduce the incidence of postoperative nausea and vomiting(PONV),but the types and doses of fluids are controversial.The purpose of this study was to investigate the effects of different fluid types and infusion doses on PONV and postoperative recovery of gynecological laparoscopic surgery patients.Method: A total of 160 gynecological laparoscopic surgery patients under elective general anesthesia in the First Affiliated Hospital of Wannan Medical College were randomly divided into 4 groups.They were 10-20ml/kg all-crystal group(C10 group),20-30ml/kg all-crystal group(C20 group),10-20ml/kg crystal colloidal mix group(M10group)and 20-30ml/kg crystal colloidal mix group(M20 group).Monitor the changes of mean arterial pressure(MAP)and heart rate(HR)of patients in each group at T0(entering the operating room),T1(beginning of anesthesia),T2(beginning of surgery),T3(beginning of surgery for 1 hour)and T4(end of surgery).The incidence of nausea and vomiting and postoperative recovery of patients in each group,such as extubation time,postoperative PACU retention time,were recorded,and the differences of relevant indicators in each group were analyzed to explore the impact of perioperative liquid therapy on PONV.Results:(1)There was no statistical difference among the general data of the four groups(P > 0.05).(2)Hemodynamic comparison: at the same time,there was no statistical difference between MAP and HR among the four groups(P > 0.05).(3)Comparison of PONV incidence among four groups: the incidence of PONV in C10 group,C20 group,M10 group and M20 group was 52.5%,40%,58% and 70% respectively.The probability of PONV in C20 group was significantly lower than that in M20 group(40% vs 70%,P=0.007),while there was no significant difference between other groups(P>0.05).The incidence of late PONV in C20 group was lower than that in other groups,and the severity of PONV was lower than that in other groups.(4)There was no significant difference among the four groups in the extubation time and PACU retention time(P > 0.05).Conclusion:(1)At the infusion dose of 20-30ml/kg,PONV incidence was lower after single infusion of crystal solution than after mixed infusion of crystal solution and colloidal solution.(2)Perioperative crystal infusion of 20-30ml/kg can reduce the incidence of late PONV,but has no effect on the incidence of early PONV,and can reduce the severity of PONV.