PDF(Pubmed)
Abstract：
BACKGROUND: To observe the effect of using mild intraoperative hyperventilation on the incidence of postlaparoscopic shoulder pain (PLSP) in patients undergoing laparoscopic sleeve gastrectomy.
METHODS: Eighty patients undergoing laparoscopic sleeve gastrectomy, aged 22 to 36 years, with American Society of Anesthesiologists grade I or II, were divided into 2 groups according to method of random number table. A mild hyperventilation was used in group A with controlling pressure of end-tidal carbon dioxide (PETCO2) of 30 to 33 mm Hg, while conventional ventilation was used in group B with PETCO2 35 to 40 mm Hg during the operation. The incidence and severity of PLSP, dosage of remedial analgesia and adverse reactions such as nausea and vomiting at 12, 24, 48, 72 hours and 1 week after surgery were recorded. Arterial blood gas was recorded before anesthesia induction, 20 minutes after pneumoperitoneum, during suture skin, and 24 hours after surgery.
RESULTS: Compared with 12, 24, 48, and 72 hours after operation, the incidence of PLSP at 1 week decreased significantly (P < .01). Compared with group B, the incidence of PLSP, pain score, and dosage of remedial analgesic at 12, 24,48, 72 hours, and 1 week after surgery were significantly decreased (P < .01). There was no significant difference between the 2 groups in arterial blood gas analysis before anesthesia induction, 20 minutes after pneumoperitoneum, during suture skin, and 24 hours after surgery (P > .05). There were no significant difference of the occurrence of adverse reactions such as nausea and vomiting between the 2 groups within 1 week after surgery (P > .05).
CONCLUSIONS: Mild hyperventilation can reduce the incidence and severity of PLSP after laparoscopic sleeve gastrectomy without increasing the associated adverse effects.
METHODS: Eighty patients undergoing laparoscopic sleeve gastrectomy, aged 22 to 36 years, with American Society of Anesthesiologists grade I or II, were divided into 2 groups according to method of random number table. A mild hyperventilation was used in group A with controlling pressure of end-tidal carbon dioxide (PETCO2) of 30 to 33 mm Hg, while conventional ventilation was used in group B with PETCO2 35 to 40 mm Hg during the operation. The incidence and severity of PLSP, dosage of remedial analgesia and adverse reactions such as nausea and vomiting at 12, 24, 48, 72 hours and 1 week after surgery were recorded. Arterial blood gas was recorded before anesthesia induction, 20 minutes after pneumoperitoneum, during suture skin, and 24 hours after surgery.
RESULTS: Compared with 12, 24, 48, and 72 hours after operation, the incidence of PLSP at 1 week decreased significantly (P < .01). Compared with group B, the incidence of PLSP, pain score, and dosage of remedial analgesic at 12, 24,48, 72 hours, and 1 week after surgery were significantly decreased (P < .01). There was no significant difference between the 2 groups in arterial blood gas analysis before anesthesia induction, 20 minutes after pneumoperitoneum, during suture skin, and 24 hours after surgery (P > .05). There were no significant difference of the occurrence of adverse reactions such as nausea and vomiting between the 2 groups within 1 week after surgery (P > .05).
CONCLUSIONS: Mild hyperventilation can reduce the incidence and severity of PLSP after laparoscopic sleeve gastrectomy without increasing the associated adverse effects.
摘要：
背景：观察术中轻度过度通气对腹腔镜袖状胃切除术患者术后肩痛（PLSP）发生率的影响。
方法：80例腹腔镜袖状胃切除术患者，年龄22至36岁，美国麻醉师协会一级或二级，按随机数字表法分为2组。A组使用轻度过度通气，控制潮气末二氧化碳（PETCO2）的压力为30至33mmHg，B组术中采用PETCO235～40mmHg常规通气。PLSP的发生率和严重程度，记录术后12、24、48、72h及1周的镇痛镇痛剂量及恶心呕吐等不良反应。麻醉诱导前记录动脉血气，气腹后20分钟,在缝合皮肤期间，手术后24小时。
结果：与术后12、24、48和72小时相比，PLSP在1周时的发生率显着降低（P<0.01）。与B组相比,PLSP的发病率，疼痛评分,以及12、24、48、72小时时的镇痛剂量，术后1周明显下降(P<0.01)。2组麻醉诱导前动脉血气分析无显著差异,气腹后20分钟,在缝合皮肤期间，术后24小时（P>0.05）。两组患者术后1周内恶心、呕吐等不良反应发生率比较，差异无统计学意义（P>0.05）。
结论：轻度过度通气可以降低腹腔镜袖状胃切除术后PLSP的发生率和严重程度，而不会增加相关的不良反应。
方法：80例腹腔镜袖状胃切除术患者，年龄22至36岁，美国麻醉师协会一级或二级，按随机数字表法分为2组。A组使用轻度过度通气，控制潮气末二氧化碳（PETCO2）的压力为30至33mmHg，B组术中采用PETCO235～40mmHg常规通气。PLSP的发生率和严重程度，记录术后12、24、48、72h及1周的镇痛镇痛剂量及恶心呕吐等不良反应。麻醉诱导前记录动脉血气，气腹后20分钟,在缝合皮肤期间，手术后24小时。
结果：与术后12、24、48和72小时相比，PLSP在1周时的发生率显着降低（P<0.01）。与B组相比,PLSP的发病率，疼痛评分,以及12、24、48、72小时时的镇痛剂量，术后1周明显下降(P<0.01)。2组麻醉诱导前动脉血气分析无显著差异,气腹后20分钟,在缝合皮肤期间，术后24小时（P>0.05）。两组患者术后1周内恶心、呕吐等不良反应发生率比较，差异无统计学意义（P>0.05）。
结论：轻度过度通气可以降低腹腔镜袖状胃切除术后PLSP的发生率和严重程度，而不会增加相关的不良反应。
