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妇科腹腔镜手术患者中高维持剂量与低剂量瑞芬太尼对术后恶心呕吐（PONV）发生率影响的初步研究
Authors Liu ZY, Yang XY, Lv C, Ye L, Chen JJ, Chen XY, Wang SP, Wu L, Zhang WQ, Lu M, Guo XW
Received 18 January 2025
Accepted for publication 23 May 2025
Published 7 June 2025 Volume 2025:19 Pages 4885—4894
DOI https://doi.org/10.2147/DDDT.S518291
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Tin Wui Wong
Zao-Yu Liu,* Xin-Yu Yang,* Chen Lv, Ling Ye, Jia-Jia Chen, Xin-Yuan Chen, Shi-Ping Wang, Li Wu, Wei-Qiao Zhang, Man Lu, Xiao-Wen Guo
Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiao-Wen Guo, Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310003, People’s Republic of China, Email guoxiaowen1315@hotmail.com
Purpose: The aim of this trial was to investigate postoperative nausea and vomiting (PONV) incidence between low- and high-dose remifentanil with propofol for total intravenous anaesthesia (TIVA) in adult female patients with gynecologic laparoscopy.
Patients and Methods: The randomized clinical trial consisted of two groups: 0.1ug/kg/min remifentanil (L group) (n=39) and 0.4ug/kg/min remifentanil (H group) (n=40). Both of them was titrated with propofol to maintain bispectral index (BIS) values between 40 and 60. Forty-eight-hour PONV and postoperative visual analogue scale (VAS) and haemodynamic parameters and recovery quality and the concentrations of propofol TCI during the intraoperative periods were evaluated.
Results: PONV incidences at 2, 6, 24, and 48 hours were 12.5%, 15%, 20% and 20% in (H group) and 25.6%, 25.6%, 25.6%, and 25.6% in (L group), but no statistical difference between groups (all P values > 0.05). H group reduced propofol use and recovery time (6.5 ± 4.8 versus. 8.7 ± 4.4 P = 0.036) but increased norepinephrine requirements (0 (0, 8) vs 0 (0, 0) P = 0.005). PCA use and first analgesic request time were similar.
Conclusion: High-dose remifentanil regimens for TIVA would not increase the incidence of PONV, however, significantly reduce the demand for propofol, and promote rapid recovery of patients.
Keywords: high-dose remifentanil, propofol, postoperative nausea and vomiting, PONV, hyperalgesia, bispectral index, BIS