The Effect Of Bilateral Vertebral Artery Hemodynamic Changes On Postoperative Nausea And Vomiting After Gynecological Laparoscopic Surgery

Objective:To study the correlation between hemodynamic change in vertebral arteries and the occurrence of nausea and vomiting after gynecological laparoscopy.Methods:Patients receiving a surgery under general anesthesia were recruited, including patients receiving gynecological laparoscopy (gynecological laparoscopy group,n=37), patients receiving laparoscopic cholecystectomy (laparoscopic cholecystectomy group,n=40), and patients receiving gynecological laparotomy (gynecological laparotomy group,n=32). Color Doppler ultrasound was used to measure the diameters and average blood flow velocities of their left and right vertebral arteries 5 minutes after they entered the operating room (TO), when anesthesia induction was completed (T1), after pneumoperitoneum establishment or commencement of surgery (T2),20 minutes after the commencement of surgery (T3), upon completion of surgery (T4), and 10 minutes after the completion of surgery (T5), respectively. The average blood flow volumes in their left and right vertebral arteries were calculated. Grades and occurrence of patients’nausea and vomiting were observed.Results:At time points of T2, T3, T4 and T5, the average blood flow velocities and average volumes of left and right vertebral arteries of patients in the gynecological laparoscopy group were all higher than those of patients in the LC group and the gynecological laparotomy group. The differences were significant (P<0.05). During 1-6h,6-24h, and 24-48h after the surgery, the occurrence of nausea and vomiting in patients of the gynecological laparoscopy group was higher than those in patients of the LC group and the gynecological laparotomy group. The differences were statistically significant (P<0.05). During 0-48h and 6-24h after the surgery, the occurrence of nausea and vomiting in patients of gynecological laparoscopy group was higher than those in patients of the LC group and the gynecological laparotomy group. The differences were statistically significant (P<0.05).Conclusion:Hemodynamic change in vertebral arteries during gynecological laparoscopy may be related to the high occurrence of postoperative nausea and vomiting.