A Comparative Study Of PONV In Patients With Patient-controlled Intravenous Analgesia Between Gynecological Laparotomic And Laparoscopic Surgery

Object Postoperative nausea and vomiting (PONV) is one of the most commoncomplications and makes patients distressed. This study was designed to investigatethe differences of PONV between gynecological laparotomic and laparoscopicsurgeries, and to find out the incidences of PONV in gynecological patients under thepresent treatment.Methods One hundred and twenty ASA I or II patients under general anesthesia wereincluded in this study, laparotomy group (n=60) and laparoscopy group (n=60).Anesthesia was induced by propofol, fentanyl and midazolam, muscle relaxant wasrocuronium. Anesthesia was maintained with propofol, sevoflurane and remifentanil.After induction,2mg tropisetron and10mg dexamethasone were administrated todecrease PONV. Postoperative Opiods PCIA was administrated in all patients for24 hours. Patients were followed up post surgery for48hours in time periods of0–2hours，2–6hours,6–24hours, and24–48hours for nausea or vomiting. Episodes ofnausea and vomiting were recorded respectively. The score of PONV were evaluatedvia the4-point scale:no nausea and vomiting,0; nausea only,1; retching or vomiting,2;retching or vomiting2or more episodes. We compared the scores, PONV, PON andPOV between the two groups.Results1.58patients in laparotomy group and56patients in laparoscopy group completed thestudy. The PONV scores of the laparotomy group was higher than those of thelaparoscopy group in all the four periods(P＜0.05in the period6-24hours, P＜0.01in the other periods).2. There were no significant differences in the incidences of PONV between the twogroup in0-24hours periods,46.6%&33.9%respectively. The incidences of PONVin24-48hours periods of the laparotomy group was higher than that of thelaparoscopy group,36.2%&17.9%respectively (P＜0.05).3. There seemed to be no significant differences in PON between laparotomy groupand laparoscopy group in both periods of0-24hours and24-48hours.4. The incidence of POV of the laparotomy group was higher than that of thelaparoscopy group in24-48hours,(25.9%&10.7%, P＜0.05);there was no differencein POV in the period0-24hours between the two groups.Conclusion The incidences of PONV seemed to have no significant differencesbetween the laparotomy group and laparoscopy group, but symptoms of PONV inlaparotomic surgeries were more serious than those in laparoscopic surgeries.