Association between intra-operative fentanyl dosing and postoperative nausea/vomiting and pain: A prospective cohort study.

医学 麻醉 芬太尼 恶心 呕吐 前瞻性队列研究 术后恶心呕吐 加药
作者
Eckhard Mauermann,Damian Clamer,Wilhelm Ruppen,Oliver Bandschapp
出处
期刊:European Journal of Anaesthesiology [Lippincott Williams & Wilkins]
卷期号:36 (11): 871-880 被引量:10
标识
DOI:10.1097/eja.0000000000001081
摘要

Background Postoperative nausea and/or vomiting (PONV) is one of the anaesthesia-related effects most dreaded by patients and may delay hospital discharge. Although scores and risk factors are established, many were developed before contemporary anaesthesia regimens and without focussing on modifiable anaesthesia-related variables. Objective To examine whether, in association with a contemporary anaesthesia regimen, there is an association between intra-operative fentanyl dose and PONV, and, second, postoperative pain within the first 24 h. Design Prospective, observational cohort. Setting Single-centre university hospital. Patients Inclusion criteria were opioid-naive patients without chronic pain and with a simplified Apfel score at least 2 undergoing abdominal, gynaecological or otorhinolaryngological inpatient surgery. Intervention None. Main outcome measure With logistic regression, we examined three models of increasing complexity exploring the relationship between PONV and fentanyl dosing: Model 1, simplified Apfel score + intra-operative fentanyl; Model 2, Model 1 + pre-emptive antiemetic prophylaxis; Model 3, Model 2 + postoperative morphine. Model 1 was the primary analysis. Second, we explored whether or not postoperative pain scores were associated with intra-operative fentanyl dosing. Results From the 363 patients, 163 (45%) experienced PONV, despite the use of total intravenous anaesthesia with propofol in more than 80% of the cohort, and some 66% of patients receiving additional antiemetic agents. After adjusting for the simplified Apfel score, higher intra-operative fentanyl dose was associated with PONV: odds ratio per μg h, 1.006 [95% confidence interval (CI) 1.002 to 1.010]. Including intra-operative fentanyl in the simplified Apfel score also increased the area under the receiver operator characteristics curve [0.601 (95% CI 0.555 to 0.662) vs. 0.651 (95% CI 0.594 to 0.707); P = 0.016]. Finally, a higher intra-operative fentanyl dose was associated with higher 24 h pain scores (P = 0.001) and a trend towards higher 24 h morphine requirements (P = 0.055). Conclusion Even when using propofol and antiemetic agents, PONV within the first 24 h remained higher than expected. Intra-operative fentanyl, a modifiable risk factor, is associated with the incidence of PONV and postoperative pain. Trial registration ClinicalTrials.gov, NCT03201315.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Who1990完成签到,获得积分10
1秒前
李友健完成签到 ,获得积分10
2秒前
hhhhh完成签到 ,获得积分10
4秒前
可耐的乘风完成签到,获得积分10
6秒前
wangnn发布了新的文献求助20
6秒前
大橙子发布了新的文献求助10
7秒前
7秒前
7秒前
余慵慵完成签到 ,获得积分10
8秒前
奋斗的小土豆完成签到,获得积分10
9秒前
ZJJ静完成签到,获得积分10
9秒前
邢大宝完成签到,获得积分10
10秒前
尔玉完成签到 ,获得积分10
12秒前
memo完成签到,获得积分10
12秒前
12秒前
一路芬芳完成签到,获得积分20
12秒前
14秒前
一一一应助songvv采纳,获得10
14秒前
14秒前
SciKid524完成签到 ,获得积分10
16秒前
科研通AI2S应助hhh采纳,获得10
16秒前
QWE完成签到,获得积分10
16秒前
赛赛完成签到 ,获得积分10
18秒前
tinydog完成签到,获得积分10
20秒前
长情琦完成签到,获得积分10
20秒前
Mercury完成签到 ,获得积分10
22秒前
zx完成签到 ,获得积分10
23秒前
Dearjw1655完成签到,获得积分10
24秒前
123完成签到 ,获得积分10
24秒前
圆圆完成签到 ,获得积分10
25秒前
29秒前
哭泣笑柳发布了新的文献求助10
30秒前
张宁波完成签到,获得积分10
30秒前
OeO完成签到 ,获得积分10
30秒前
macboy完成签到,获得积分10
32秒前
biubiu完成签到,获得积分10
33秒前
咸鱼之王完成签到,获得积分10
34秒前
比比谁的速度快给ljm的求助进行了留言
34秒前
Can完成签到,获得积分10
35秒前
hhh完成签到,获得积分10
35秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038201
求助须知:如何正确求助?哪些是违规求助? 3575940
关于积分的说明 11373987
捐赠科研通 3305747
什么是DOI,文献DOI怎么找? 1819274
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022