The Correlation Study Between Gastric Volume And Postoperative Nausea And Vomiting In Patients Undergoing Laparoscopic Cholecystectomy

Objective:This study conducted a randomized controlled trial on the effect of ultrasonic measurement of gastric volume(GV)on postoperative nausea and vomiting(PONV),with a view to providing accurate evidence for the effect of ultrasonic measurement of GV on PONV,so as to improve the postoperative rehabilitation and quality of life of patients.Methods:Ultrasonic examination of gastric antrum was performed in 266 patients undergoing laparoscopic cholecystectomy(laparoscopic cholecystectomy,LC)before anesthesia induction,after anesthesia induction and after operation.The cross-sectional images of gastric antrum at rest(gastric peristaltic interval)were obtained.The head-tail diameter(D1)and anterior-posterior diameter(D2)of gastric antrum in different positions were measured,and the cross-sectional area of gastric antrum(cross-sectional area,CSA)was calculated.Gastric volume and the ratio of GV to body weight in SRD position after anesthesia induction were calculated by mathematical model,and the relationship between gastric antrum CSA,gastric volume the ratio of GV to body weight in SRD position after anesthesia induction and PONV was evaluated.Results:The study included 266 patients with LC,aged 18-65 years,ASA Ⅰ-Ⅱ,BMI<28kg/m2.Gender,age,operation time and anesthesia time were significantly related to the incidence of PONV.The most closely related to PONV was the ratio of GV and weight in the SRD position after anesthesia induction.The GV in the SRD after anesthesia induction>12.82ml(AUC=0.713)highly suggested the occurrence of PONV,and the ratio of GV to body weight in SRD position after anesthesia induction>0.42ml/kg(AUC=0.728)highly suggested the occurrence of PONV.The predictive effect of the ratio of GV to body weight in SRD position after anesthesia induction on postoperative nausea(AUC=0.724)and postoperative vomiting(AUC=0.695)at 6-24 hours was better than that on PONV at 0-6 hours.The ratio of GV to body weight in SRD position after anesthesia induction>0.42ml/kg highly suggests the occurrence of nausea 6-24 hours after surgery;the ratio of gastric volume to body weight in SRD position after surgery was significantly related to the occurrence of nausea and vomiting 0-6 hours after surgery,but the accuracy of ultrasonic measurement of gastric antrum CSA in predicting PONV did not meet our expectations(AUC=0.627).In addition,the subject working characteristic curve(AUC=0.865)of the binary logistic regression model composed of gender,history of motion sickness,smoking history and the ratio of GV to body weight in SRD position after anesthesia induction highly suggested the occurrence of PONV.Conclusion:The ratio of gastric volume to body weight in SRD position after anesthesia induction is of clinical value in predicting PONV,and the incidence of vomiting increases significantly with the increase of gastric volume per unit body weight.The gastric volume in SRD position after anesthesia induction>12.82ml highly indicates the occurrence of PONV,and the ratio of gastric volume to body weight in SRD position>0.42ml/kg after anesthesia induction indicates the occurrence of PONV.