目的:总结全球成人患者围手术期恶心和呕吐管理的证据。
方法:这是成人术后恶心和呕吐的最佳证据的总结。
方法:数据库,如英国医学杂志最佳实践,科克伦图书馆,乔安娜·布里格斯研究所,国家健康与护理卓越研究所,苏格兰校际指南网络,国家准则信息交换所,国际网络准则,美国麻醉师协会(ASA),围手术期注册护士协会(AORN),安大略省注册护士协会,PubMed,护理和相关健康文献的累积指数,Embase,益买通临床指南,中国麻醉官方网站,SinoMed,中国国家知识基础设施,万方,和VIP进行检索,收集临床决策的相关指南,最佳实践,系统审查,证据摘要,关于围手术期恶心呕吐管理的专家共识。检索时间从数据库建立到2022年1月。两位作者独立评估了纳入文献的质量,并提取并总结了符合质量标准的证据。
结果:共22项研究,包括1个最佳实践,2篇临床决策文章,7证据摘要,1临床指南,9个系统审查,和2个专家共识,包括在内。从7个方面总结了37条证据:危险因素,评估方法,多模式预防战略,健康教育,非药物干预,药物预防,术后镇痛管理策略,和组织管理。
结论:医疗团队应根据科室特点和临床实践选择最佳证据,科学管理围手术期患者恶心呕吐,减少恶心和呕吐的发生率和严重程度,促进患者加速康复。
OBJECTIVE: To summarize the evidence on perioperative nausea and vomiting management in adult patients worldwide.
METHODS: This is a summary of the best evidence on postoperative nausea and vomiting in adults.
METHODS: Databases such as British Medical Journal Best Practice, Cochrane Library, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearing House, Guidelines International Network, American Society of Anesthesiologists (ASA), Association of periOperative Registered Nurses (AORN), Registered Nurses Association of Ontario, PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Yimaitong Clinical Guidelines,
China Anesthesia Official website, SinoMed,
China National Knowledge Infrastructure, Wanfang, and VIP were searched to collect the relevant guidelines for clinical decision-making, best practices, systematic review, evidence summary, and expert consensus about perioperative nausea and vomiting management. The retrieval time was from the establishment of the database to January 2022. Two authors independently evaluated the quality of the included literature and extracted and summarized the evidence that met the quality criteria.
RESULTS: A total of 22 studies, including 1 best practice, 2 clinical decision-making articles, 7 evidence summaries, 1 clinical guideline, 9 systematic reviews, and 2 expert consensuses, were included. The summary of 37 pieces of evidence from 7 aspects: risk factors, assessment methods, multimodal prevention strategy, health education, nondrug intervention, drug prevention, postoperative analgesia management strategy, and organization management.
CONCLUSIONS: The health care team should select the best evidence according to the characteristics of the department and clinical practice, scientifically manage perioperative nausea and vomiting of patients, reduce the incidence and severity of nausea and vomiting, and promote the accelerated rehabilitation of patients.