静注恩丹西酮预防腹腔镜胆囊切除术后恶心呕吐的临床观察

目的观察静注恩丹西酮对腹腔镜胆囊切除术后恶心呕吐(PONV)的影响.方法1 05例腹腔镜胆囊切除全麻病人,ASA Ⅰ～Ⅱ级,随机分为对照组(A组)、氟哌定组(B组)和恩丹西酮组(C组).每组35例.麻醉诱导气管内插管后接麻醉机控制呼吸,维持PaCO2在30～35 mmHg之间.吸人异氟醚麻醉,间断静注维库溴铵维持肌松.手术结束时A、B、C三组分别静脉注射生理盐水5 m1、氟哌定3 mg、恩丹西酮8 mg.观察每个病人用药前、用药后5min和1 0min的血压和心率与术后24、48和72 h内恶心呕吐发生率,同时记录用药后口渴、眩晕、皮疹、腹部不适等并发症.结果三组中恶心呕吐的发生率,B组和C组明显低于A组(P＜0.05);与B组比较,C组恶心呕吐发生率显著下降(P＜0.05).三组病人在注药前后血压和心率的变化无显著隆差异且不良反应少(P＞0.05).结论静脉应用氟哌定与恩丹西酮对循环功能无影响,用药后口渴、眩晕、皮疹、腹部不适等并发症极少,均可安全有效地应用于临床;氟哌定与恩丹西酮均降低腹腔镜胆囊切除术PONV的发生率,但恩丹西酮的作用明显优于氟哌定.

Effects of Ondanstron on PONV after laparocholecystectomy Department of Anesthesiology

Objective To study the effects of ondanstron on PONV after laparocholecystectomy. Methods 105 Patients, ASA score I-II, Scheduled for laparocholecystectomy were randomly allocated into three groups: Normal saline study group (group A), group Droperidol (group B), group Ondanstron (group C). Normal saline, Droperidol and Ondanstron were given to the patients after operation respectively. The change of BP and HR, the score and the side effects of PONV were studied respectively. Results The change of BP and HR in three groups was relatively stable , the score of PONV in group B and C were respectively lower than those in group A, P<0.05. But compared to group B, group C had lesser score of PONV, P <0.05. Three groups had minor side effects after observation, P >0.05. Conclusions Compared with normal saline, both Droperidol and Ondanstron had a better anti-PONV effect, but ondanstron had the better efficacy on preventing PONV of laparocholecystectomy than Droperidol.