• 제목/요약/키워드: 수술 후 오심과 구토

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수술 후 오심과 구토의 영향요인 (Influence Factors for Predicting Postoperative Nausea and Vomiting)

  • 조은아;장지선;김계하
    • 한국콘텐츠학회논문지
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    • 제17권6호
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    • pp.632-642
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    • 2017
  • 본 연구의 목적은 수술 후 24시간 동안 수술 후 오심과 구토의 영향요인을 파악하고자 시도되었다. 연구 대상은 G시에 소재한 일 대학병원 일반외과, 신경외과, 정형외과, 산부인과, 이비인후과 수술을 받은 332명의 환자였다. 자료수집은 2014년 12월부터 2015년 12월까지 이루어졌으며, 자료는 t-test, $x^2$-test와 logistic regression analysis를 이용하여 분석하였다. 대상자 중 수술 후 오심과 구토가 발생한 유발군은 41.0%였다. 다변량 분석으로 분석한 결과, 흡연을 하지 않는 경우(p=.009), 멀미 과거력이 있는 경우(p=.016), 수술 후 오심과 구토 과거력이 있는 경우(p=.006), 수술 후 통증(p=.001)이 수술 후 오심과 구토 발생의 영향요인으로 나타났다. 따라서 비흡연, 멀미 과거력, 수술 후 오심과 구토 과거력이 있는 경우 수술전부터 집중적인 관리가 필요하며 수술 후 통증에 대한 적극적인 중재가 필요하다.

Effectiveness of acupuncture-type interventions to prevent nausea and vomiting during and after cesarean delivery under spinal anesthesia : A systematic review

  • Kim, Eun-Sook;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Jin-Moo;Lee, Chang-Hoo;Lee, Kyung-Sub
    • 대한한방부인과학회지
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    • 제22권2호
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    • pp.209-221
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    • 2009
  • 목 적: 이 논문은 제왕절개 분만을 위한 척수마취로 인해 수술 중 또는 그 후에 발생할 수 있는 오심 및 구토에 대한 침관련 치료의 항구토 효과를 규명하기 위한 계통적 리뷰 논문이다. 방 법: 제왕절개 분만을 위한 척수마취로 인해 발생할 수 있는 오심 및 구토를 예방하기 위한 침관련 치료에 대한 randomized clinical trials(RCT's)를 검색하기 위해 2008년 3월까지 수록된 6개의 데이터베이스(MEDLINE, EMBASE, The Cochrane Library, CINAHL, AMED and PsycINFO)를 검색하였다. 논문의 선정 기준은 원저이며, 플라시보 대조군을 설정한 무작위 임상시험이고, 오심 또는 구토에 대한 결과가 실려 있는 것으로 하였다. 결 과: 총 5개의 논문을 선정하였으며 각 논문들의 연구방법은 일반적으로 좋은 편이었다. 5개의 논문들을 종합한 결과는 수술중 오심 발생률(OR=0.468, 95%CI:0.250 -0.876, P=0.018), 수술 후 오심 발생률(OR=0.616, 95%CI:0.042-0.942, P=0.026), 수술 후 구토 발생률(OR=0.640, 95%CI:0.432-0.948, P=0.026)이 침관련 치료군이 대조군에 비해서 통계적으로 의미있게 적었다. 결 론: 본 문헌 고찰을 통해 제왕절개 수술을 위해 시행한 척수 마취로 인해 수술중 또는 수술후 발생한 오심 및 구토에 대해 침관련 치료가 예방효과가 있음을 밝힐 수 있었다.

수술환자를 위한 웹 기반 근거중심 실무 가이드라인의 개발 및 평가 (Development and Evaluation of the Web-based Evidence-based Practice Guideline for the Operation Patients)

  • 홍성정;장재식;전영훈;이은주;김화선
    • 인터넷정보학회논문지
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    • 제12권1호
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    • pp.131-139
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    • 2011
  • 본 연구는 수술환자에게 적용할 수 있는 수술 후 통증, 수술 후 오심 구토, 체온관리에 대한 웹 근거중심 실무 가이드라인 시스템을 개발하여 이를 적용하고 수술 환자의 수술 후 통증, 오심/구토, 체온관리에 대한 의료인의 지식정도와 환자의 만족도를 평가하기 위한 것이다. 수집된 자료는 SPSS/WIN 17.0 프로그램을 이용하여 평균, 표준편차, t-test, Repeated ANOVA로 분석하였다. 웹으로 구축한 근거중심 실무 가이드라인 적용 전과 후의 수술 후 통증, 수술 후 오심/구토, 수술환자 체온관리에 대한 지식정도와 환자 만족도에 유의미한 차이가 있었다.

수술후 오심구토에 대한 이침요법의 임상적 연구 (Effect of Auricular acupuncture on Postoperative Nausea and Vomiting)

  • 김용석;김창환;김건식
    • 대한한의학회지
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    • 제17권2호
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    • pp.331-336
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    • 1996
  • 본 논문은 수술후 오심, 구토증에 대한 이침요법의 효과를 연구하기 위하여 시도되었다. 경희대학교 의과대학 부속병원에서 전신마취하에 복식 자궁절제술을 받기로 예정된 100명의 환자를 두 군으로 나누어 이침요법을 하지 않은 대조군과 이침요법을 시행한 실험군을 대상으로 연구를 하였다. 대상환자의 연령, 체중, 신장, 마취시간은 두 군간에 통계적으로 유의성있는 차이는 없었다. 수술후 12시간이내에 한번이라도 오심, 구역 및 구토가 발생된 환자는 대조군이 68%, 실험군이 30%으로 실험군이 대조군에 비하여 유의성있는 효과를 보였다. 이침요법에 의한 부작용은 나타나지 않았다. 이침요법은 복식 자궁절제술 후 오심, 구토를 부작용없이 예방하는데 상당한 효과가 있는 것으로 사려된다.

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냉요법을 이용한 수술 후 구강간호가 복강경 자궁근종절제술 환자의 오심, 구토 및 구강 불편감에 미치는 효과 (Effects of Postoperative Oral Care Using Cold Therapy on Nausea, Vomiting and Oral Discomfort in Patients with Laparoscopic Myomectomy)

  • 정미영;최효선;박경연
    • 기본간호학회지
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    • 제19권3호
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    • pp.292-301
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    • 2012
  • Purpose: The purpose of the study was to evaluate the effects of postoperative oral care using cold therapy on nausea, vomiting and oral discomfort after laparoscopic myomectomy. Method: The study was conducted with an experimental group (n=29) and a control group (n=35) sampled from patients admitted to a women's hospital in a metropolitan city in Korea. Data were collected between October 10, 2011 and January 31, 2012 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANCOVA with SPSS/WIN 19.0. Results: After the intervention, postoperative nausea (p<.001) and oral discomfort for patients in the experimental group were significantly lower than in the control group. There were significant differences in the presence of vomiting between both groups at 12 hours (p<.001) and 24 hours (p=.003) after leaving the recovery room. Conclusion: Oral care using cold therapy was found to be an effective nursing intervention for reducing postoperative nausea, vomiting and oral discomfort up to 24 hours after recovery in patients with laparoscopic myomectomy.

고추파스를 이용한 수지요법 침점(K-D2) 자극과 예방적 항구토제의 병용요법이 부인과 복강경 수술 후 오심과 구토에 미치는 효과 (Combination Effects of Capsicum Plaster at the Korean Hand Acupuncture Points K-D2 with Prophylactic Antiemetic on Postoperative Nausea and Vomiting after Gynecologic Laparoscopy)

  • 정현정;박상연
    • 대한간호학회지
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    • 제43권2호
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    • pp.215-224
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    • 2013
  • Purpose: This study was done to evaluate the combination effects of capsicum plaster at the Korean hand acupuncture points K-D2 with prophylactic antiemetic on Postoperative Nausea and Vomiting (PONV). Methods: An experimental research design (a randomized, a double-blinded, and a placebo-control procedure) was used. The participants were female patients undergoing gynecologic laparoscopy; the control group (n=34) received intravenous prophylactic ramosetron 0.3mg, while the experimental group (n=34) had Korean Hand Therapy additionally. In the experimental group, capsicum plaster was applied at K-D2 of both 2nd and 4th fingers by means of Korean Hand Therapy for a period of 30 minutes before the induction of anesthesia and removed 8 hours after the laparoscopy. Results: The occurrence of nausea, nausea intensity and need for rescue with antiemetic in the experimental group was significantly less than in the control group 2 hours after surgery. Conclusion: Results of the study show capsicum plaster at K-D2 is an effective method for reducing PONV in spite of the low occurrence of PONV because of the prophylactic antiemetic medication.

복강경하 담낭절제술환자에서의 마취방법에 따른 수술 후 오심과 구토의 비교 (The Comparison of the Effects of Two Anaesthetic Techniques on Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy)

  • 서윤주;박효선;양인순
    • 임상간호연구
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    • 제15권2호
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    • pp.67-75
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    • 2009
  • Purpose: Postoperative nausea and vomiting(PONV) is a common problem after general anesthesia. The aim of this prospective, double-blind randomized study was to compare the effect of Propofol-Remifentanil vs. Sevoflurane inhalational anesthetics on PONV after laparoscopic cholecystectomy. Methods: Forty patients (ASA physical status 1, 2) scheduled for elective surgery participated in the study. Twenty of them received total intravenous anesthesia (TIVA group) with Propofol-Remifentanil, and the rest were given Sevoflurane inhalational anesthetics (inhalation group). The TIVA group was induced with Propofol 5mcg/ml and Remifentanil 3~4mcg/ml. The anesthesia was maintained with the continuous infusion of Propofol 2~3mcg/ml and Remifentanil 2~3mcg/ml IV. The inhalation group was induced with Pentotal Sodium 5mg/kg and 3~4mcg/kg/hr IV Remifentanil. Maintenance was obtained with 1.5~2.0 vol% Sevoflurane. Results: The subjects in TIVA group reported less PONV than those in Sevoflurane inhalation anesthesia group. Conclusion: Propofol-Remifentanil anesthesia (TIVA group) was considered a satisfactory anesthetic technique in reducing PONV in patients with laparoscopic cholecystectomy.

손목밴드를 이용한 내관지압이 중이수술 후 오심과 구토에 미치는 효과 (Effects of the Nei-Guan Acupressure by Wrist Band on Postoperative Nausea and Vomiting after Middle Ear Surgery)

  • 이명윤;민혜숙
    • 대한간호학회지
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    • 제38권4호
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    • pp.503-512
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    • 2008
  • Purpose: This study was to identify the effects of Nei-Guan accupressure using a wrist band on postoperative nausea and vomiting after middle ear surgery. Methods: The study design was a nonequivalent control group non-synchronized posttest design. Forty patients were assigned into two groups of 20 patients, the wrist band group and the control group. In the wristband group, acupressure was applied with a wrist band on the P6 point at both wrists from 30 min before to 24 hr after anesthesia. Results: The 1st hypothesis 'Applied wrist band groups will have a greater reduction in the nausea & vomiting grades by INVR than the control group' was accepted (t=2.303, p=.028). The 2nd hypothesis 'The Applied wrist band groups will have a greater reduction in the occurrence of nausea & vomiting than the control group' was partly accepted. The 3rd hypothesis 'The applied wrist band group will have a greater reduction in injection of antiemetics for 24 hr. post anesthesia than the control group' was rejected. Conclusion: Acupressure on the P6 point using a wrist band is effective to alleviate nausea for middle ear surgery patients.

Ondansetron과 Dexamethasone의 병합 투여가 복강경하 질식 전자궁 적출술 환자의 수술 후 오심 및 구토, 통증에 미치는 효과 (Effect of Ondansetron combined with Dexamethasone on Postoperative Nausea & Vomiting and Pain of Patients with Laparoscopic Hysterectomy)

  • 남미옥;윤혜상
    • 대한간호학회지
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    • 제39권1호
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    • pp.44-52
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    • 2009
  • Purpose: The purpose of this study was to compare the effects of ondansetron combined with dexamethasone on Post-Operative Nausea and Vomiting (PONV) and pain with ondansetron alone in patients with laparoscopy assisted vaginal hysterectomy under general anesthesia. Methods: Data were collected from April 1 through September 30, 2005 using a double blind method. Ondansetron 4 mg and dexamethasone 10 mg were administered to the experimental group (25 patients), and ondansetron 4 mg only to the control group (25 patients). The medications were administered through an intravenous line at the beginning peritoneum suture. PONV by Index of Nausea Vomiting and Retching (INVR), nausea by Visual Analogue Scale (VAS), and pain (VAS) were assessed at postoperative 1 hr, 3 hr, 6 hr, 24 hr, and 48 hr. Data were analyzed using repeated measures ANOVA, and Bonferroni methods. Results: The experimental group that received ondansetron combined with dexamethasone had less PONV (p=.048), and nausea (p=.012) than control group that received ondansetron alone. However, there was no difference in pain (p=.557) between the patients in the two groups. Conclusion: We conclude that the administration of ondansetron combined with dexamethasone is more effective than the administration of ondansetron alone to reduce PONV in patients with laparoscopic hysterectomy.

복강경 수술 환자의 수술 후 오심과 구토 관리를 위한 근거중심 실무 가이드라인 적용 효과 (Effect of Evidence-based Clinical Practice Guidelines for Promotion of Postoperative Nausea and Vomiting of Patients with Laparoscopic Hysterectomy)

  • 이성희;홍성정;김화선;전영훈
    • 성인간호학회지
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    • 제27권5호
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    • pp.481-492
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.