Вплив Малоопіоїдної Анестезії На Частоту Виникнення Післяопераційної Нудоти Та Блювання При Проведенні Лапароскопічних Оперативних Втручань На Нирках

Abstract

Background. The problem of postoperative nausea and vomiting has attracted the attention of specialists in various fields of surgery and anesthesiology for a long time and has not lost its relevance today, being the subject of active discussion in domestic and foreign literature. It can become an independent cause of other quite serious postoperative complications. The article presents the results of our own study of the use of multimodal low-opioid general anesthesia as one of the methods for the prevention of postoperative nausea and vomiting during anesthetic provision of laparoscopic kidney surgery. Materials and methods. The study involved 50 patients who underwent laparoscopic kidney surgery. To compare the incidence of postoperative nausea and vomiting, patients were randomly divided into three groups. Group 1 (control group) used multimodal general anesthesia with standard doses of opioids; group 2 used multimodal low-opioid general anesthesia with lidocaine, and group 3 used multimodal low-opioid anesthesia with dexmedetomidine. Results. The total average dose of fentanyl used during the entire time of anesthesia in the control group was 373.3 ± 50.8 μg (4.34 μg/kg/h). The total average dose of fentanyl used during the entire time of anesthesia in group 2 was 217.39 ± ± 49.1 μg (1.76 μg/kg/h). The total average dose of fentanyl used during the entire time of anesthesia in group 3 was 308.33 ± ± 51.49 µg (2.44 µg/kg/h). In group 1, vomiting in the postoperative period occurred in 4 patients out of 15 (26.7 % of cases), in group 2 — in 4 patients out of 23 operated (17.4 % of cases), in group 3 — in 1 patient out of 12 (8.3 % of cases). Conclusions. As a result of comparing the incidence of postoperative nausea and vomiting in the patients of the studied groups, it was found that a decrease in the dose of perioperative use of opioids helps to reduce the incidence of this complication, increases the safety of anesthesia, significantly facilitates and accelerates the rehabilitation of patients after laparoscopic surgery on the kidneys.