Ar pacientēm saistītie sliktas dūšas un vemšanas potenciālie riska faktori pēc ķeizargrieziena operācijas
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Date
2021
Authors
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Spinālā anestēzija ir visbiežāk lietotā anestēzijas metode ķeizargrieziena operācijā, kuras bieža komplikācija ir pēcoperācijas slikta dūša un vemšana (PONV). Riska faktori PONV dzemdniecībā nav specifiski pētīti. Pētījuma mērķis bija noskaidrot ar pacientēm saistītos riska faktorus pēcoperācijas sliktai dūšai un vemšanai pēc ķeizargrieziena operācijas.
Metodes. Retrospektīvā pētījumā piedalījās 133 grūtnieces, kurām tika veikta ķeizargrieziena operācija ar spinālo anestēziju Rīgas Dzemdību Namā laikā no 2017. gada novembra līdz 2018. gada jūnijam. Dati, kas tika iegūti no atlasītām slimību vēsturēm, iekļāva mātes vecumu, grūtniecības ķermeņa masas indeksu, grūtniecību skaitu, dzemdību skaitu, ķeizargriezienu skaitu, ķeizargrieziena steidzamības kategoriju, smēķēšanas statusu un postoperācijas intervijas rezultātus par PONV 3, 6, 12, 24 stundas pēc ķeizargrieziena operācijas. Atpazīstos intratekāli saņemto morfiju kā jaucējfaktoru, statistiskai analīzei pacientes tika sadalītas 2 grupās: M50 (50 μg) un M100 (100 μg).
Rezultāti. Dati tika iekļauti no 133 slimības vēsturēm (M50 grupā 67; M100 grupā 66). Kopējā PONV incidence bija 22,5% (n=30) un tikai vemšanas incidence bija 17,2% (n=23). PONV incidence pēc 6 stundām bija lielāka pacientēm ar vairāk nekā vienu grūtniecību nekā pacientēm ar pirmo grūtniecību M100 grupā (31,9% vs 5,3%, p=0,027); lielāka multiparām nekā pacientēm, kurām pirmās dzemdības notika pētījuma laikā M100 grupā (35,9% vs 7,4%, p=0,008) un M50 grupā (19,5% vs 0%, p = 0,019); lielāka pacientēm ar otro un trešo ķeizargrieziena operāciju nekā pirmo ķeizargrieziena operāciju pētījuma laikā M100 grupā (35,5% vs 14,3%, p=0,045) un M50 grupā (22,6% vs 2,8%, p=0,020).
Secinājumi. Lielāks grūtniecību skaits, multiparitāte un lielāks ķeizargrieziena operāciju skaits pacientēm ir saistīts ar augstāku risku pēcoperācijas sliktai dūšai un vemšanai pēc ķeizargrieziena operācijas. Salīdzinoši mazs pacientu skaits var ietekmēt rezultātu ticamību.
Objectives. Spinal anaesthesia is the most common method in Caesarean section (CS) with postoperative nausea and vomiting (PONV) being a common complication of anaesthesia.Risk factors for PONV have not been specifically studied in obstetric patients. Aim of the study was to investigate patient-related potential risks factors for PONV after CS. Materials and Methods. A retrospective study was conducted on 133 pregnant women who had Caesarean section under spinal anaesthesia in Riga Maternity Hospital between 2017 November and 2018 June. Data used for analysis was taken from eligible charts and included maternal age, pregnancy body mass index, gravidity, parity, number of CS, category of CS urgency, smoking history and postoperative interview results about PONV 3, 6, 12, 24 hours after CS. Recognizing intrathecally received morphine as a confounding factor, patients were divided in 2 groups for statistical analysis: M50 (50 μg) and M100 (100 μg). Results. Data from 133 medical charts (M50 group 67; M100 group 66) were included. The overall incidence of PONV was 22,5% (n=30) and incidence of only vomiting was 17,2% (n=23). PONV incidence after 6 hours was higher among multigravida than primigravida in M100 group (31,9% vs 5,3%, p=0,027); higher among multiparous women than primiparous who had delivered during the study period in M100 group (35,9% vs 7,4%, p=0,008) and in M50 group (19,5% vs 0%, p=0,019); higher among women who had their second and third CS than first CS during the study period in M100 group (35,5% vs 14,3%, p=0,045) and in M50 group (22,6% vs 2,8%, p=0,020). Conclusions. Multigravidity, multiparity and higher number of Caesarean sections are associated with higher risk of PONV after CS. Relatively small sample size may influence result reliability.
Objectives. Spinal anaesthesia is the most common method in Caesarean section (CS) with postoperative nausea and vomiting (PONV) being a common complication of anaesthesia.Risk factors for PONV have not been specifically studied in obstetric patients. Aim of the study was to investigate patient-related potential risks factors for PONV after CS. Materials and Methods. A retrospective study was conducted on 133 pregnant women who had Caesarean section under spinal anaesthesia in Riga Maternity Hospital between 2017 November and 2018 June. Data used for analysis was taken from eligible charts and included maternal age, pregnancy body mass index, gravidity, parity, number of CS, category of CS urgency, smoking history and postoperative interview results about PONV 3, 6, 12, 24 hours after CS. Recognizing intrathecally received morphine as a confounding factor, patients were divided in 2 groups for statistical analysis: M50 (50 μg) and M100 (100 μg). Results. Data from 133 medical charts (M50 group 67; M100 group 66) were included. The overall incidence of PONV was 22,5% (n=30) and incidence of only vomiting was 17,2% (n=23). PONV incidence after 6 hours was higher among multigravida than primigravida in M100 group (31,9% vs 5,3%, p=0,027); higher among multiparous women than primiparous who had delivered during the study period in M100 group (35,9% vs 7,4%, p=0,008) and in M50 group (19,5% vs 0%, p=0,019); higher among women who had their second and third CS than first CS during the study period in M100 group (35,5% vs 14,3%, p=0,045) and in M50 group (22,6% vs 2,8%, p=0,020). Conclusions. Multigravidity, multiparity and higher number of Caesarean sections are associated with higher risk of PONV after CS. Relatively small sample size may influence result reliability.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Pēcoperācijas slikta dūša, vemšana, spinālā anestēzija, ķeizargrieziens, Postoperative nausea, vomiting, spinal anaesthesia, Caesarean section