1.Department of Anesthesiology,the First People′s Hospital of Neijiang City in Sichuan Province,Neijiang 641000,China;
2.Department of Gastroenterology,the First People′s Hospital of Neijiang City in Sichuan Province,Neijiang 641000,China;
3.Department of clinical laboratory,the First People′s Hospital of Neijiang City in Sichuan Province,Neijiang 641000,China
Abstract：Objective To explore the effect of bile duodenogastric reflux on postoperative nausea and vomiting(PONV)in laparoscopic cholecystectomy by using gastroscope.Methods From March 2015 to May 2017,90 patients undergo laparoscopic cholecystectomy treated in our hospital were selected as the subjects,and divided into group A(gastroscope group A),group B(gastroscope group B)and group C(control group)by radom table method,30 cases in each group.They were all underwent general anesthesia.Gastroscope was inserted at the time of tracheal intubation (T1)and extubation(T2)immediately in group A and group B,the insertion time was less than 2 min.Bile duodenogastric reflux was observed in the two groups and the extracted reflux was biochemical analysed.The bile was sufficiently sucked if reflux occurred in group B at T2.No Gastroscope was inserted in group C.The VAS score of nausea and vomiting was recorded 6 h(T3),12 h(T4),24 h(T5)postoperative,the incidence rate of severe nausea and vomiting(VAS＞4)was also recorded.Results At T1,no bile duodenogastric reflux observed by gastroscope in group A and group B.At T2,the incidence rate of bile duodenal reflux was 100%,the incidence rate of bile gastric reflux between group A(83.3%)and group B(86.7%)had no significant difference(P＞0.05).Biochemical analyses showed no significant difference between group A and group B.At T3and T4,the incidence rate of nausea and vomiting VAS score in group B ([2.90±1.30],[1.63±1.03]points)was lower than group A([5.90±1.58],[3.80±1.42]points)and group C([5.73±1.48],[3.60±1.30]points)(P＞0.05).The incidence rate of severe nausea and vomiting in group B (13.3%,6.7%)were lower than group A (83.3%,40.0%)and group C(80.0%,30.0%)(P＜0.05).The nausea and vomiting VAS score had no difference at T5(P＞0.05).Conclusion Laparoscopic Cholecystectomy(LC)can cause acute bile duodenogastric reflux,thus causing more postoperative nausea and vomiting.
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