昂丹司琼联合小剂量舒芬太尼预防异丙酚注射痛的临床观察

目的观察昂丹司琼联合小剂量舒芬太尼预处理减轻异丙酚注射痛的临床效果。方法 120例拟行无痛肠镜的患者.随机分为对照组（I组）、舒芬太尼组（Ⅱ组）、昂丹司琼组（Ⅲ组）和昂丹司琼联合舒芬太尼（Ⅳ组）.每组30例。对照组患者给予生理盐水3mL.其它患者按其分组分别给予舒芬太尼0.1μg.kg-1、昂丹司琼4mg或昂丹司琼4mg和舒芬太尼0.1μg.kg-1混合液。30秒后按2mg.kg-1推注异丙酚,同时记录注射部位疼痛评分。结果 4组患者术中异丙酚注射痛发生率分别为：对照组86.7%,舒芬太尼组46.7%,昂丹司琼组40%,昂丹司琼联合舒芬太尼组20%。后3组注射痛发生率低于对照组（P〈0.05）.并且舒芬太尼组和昂丹司琼联合舒芬太尼组异丙酚用量明显少于对照组和昂丹司琼组（P〈0.05）。结论昂丹司琼联合舒芬太尼更好地减轻了异丙酚的注射痛,同时又减少了异丙酚的用量,还能预防术后的恶心、呕吐,是一种较为理想的减轻异丙酚注射痛的临床方法。     

鞘内注射硫酸镁和吗啡对切口痛大鼠脊髓背角p-αCaMK Ⅱ表达的影响

目的观察鞘内注射(it)硫酸镁(MgSO4)和吗啡对切口痛大鼠脊髓背角磷酸化钙—钙调蛋白依赖性蛋白激酶Ⅱα(p-αCaMKⅡ)表达的影响。方法所有大鼠术前8d鞘内置管,用机械缩足反射阈值、热缩足潜伏期和累计疼痛评分来评价大鼠疼痛行为学变化;用免疫组织化学和Western blot法来测定吗啡和硫酸镁对大鼠脊髓背角p-αCaMKⅡ表达的影响。结果术前或术后30minit吗啡5μg或MgSO4188μg和吗啡2.5μg使术后2h的机械性缩爪阈值(MWT)和热刺激缩爪阈值(TWL)明显延长(P<0.01),累积疼痛评分明显降低(P<0.01);术前30minitMgSO4375μg或吗啡5μg或MgSO4188μg和吗啡2.5μg使大鼠术后2h脊髓背角p-αCaMKⅡ表达明显减少(P<0.05)。结论在大鼠切口痛模型中,it吗啡5μg或MgSO4188μg和吗啡2.5μg具有确切的抗伤害作用,其抗伤害作用可能与抑制脊髓背角p-αCaMKⅡ表达有关。     

鞘内注射LY294002缓解大鼠骨癌痛

目的观察鞘内注射(intrathecal injection,i.t.)磷脂酰肌醇3-激酶(PI3K)抑制剂LY294002对骨癌痛大鼠疼痛行为学、脊髓背角磷酸化Akt(p-Akt)表达的影响。方法♀SD大鼠40只,体质量180~200 g,随机分为5组(n=8):假手术组(Ⅰ组)、假手术+LY294002组(Ⅱ组)、骨癌痛组(Ⅲ组)、骨癌痛+二甲基亚砜(DMSO)组(IV组)、骨癌痛+LY294002(V组),于大鼠左侧胫骨干骺端骨髓腔内注射Walker256乳腺癌细胞构建胫骨癌痛模型。术后d 7~9鞘内连续注射浓度为2.5 g·L-1的LY294002 10μL或10μL的5%DMSO。观测术前及术后d 7给药后每小时机械痛阈(至8 h)。术后d 9处死大鼠,取各组大鼠的L4~6脊髓组织进行免疫组化染色,检测脊髓背角PI3K活化标志p-Akt的表达。结果骨癌痛组大鼠(Ⅲ、Ⅳ、Ⅴ组)机械痛阈(MWT)明显低于假手术组(Ⅰ组)(P<0.01),V组在给药后2~4h痛阈明显升高(P<0.05),3 h达到峰值(P<0.01)。与Ⅰ组比较,Ⅲ、Ⅳ组脊髓背角p-Akt阳性细胞数明显增加,p-Akt表达增多(P<0.01)。与Ⅲ、Ⅳ组比较,Ⅴ组鞘内注射LY294002后能明显降低脊髓背角p-Akt的表达(P<0.05)。结论 PI3K/Akt通路可能参与大鼠骨癌痛的发生。     

下丘脑室旁核ATP敏感性钾离子通道参与大鼠炎性痛调节的作用研究

目的探讨下丘脑室旁核ATP敏感性钾离子通道(KATP通道)在大鼠炎性痛中的作用。方法♂SD大鼠(250²80 g),采用随机数字法分为5组(每组6只):正常组(Normal组)、完全弗氏佐剂致炎性痛组(CFA组)、生理盐水组(Saline组)、KATP通道特异性激动剂组(Diaoxide组)和激动剂溶媒组(Vehicle组)。以热痛敏刺激仪检测各组大鼠热缩足潜伏期(TWL),观察痛行为学变化;以免疫荧光技术观察室旁核KATP通道和脊髓背角c-Fos阳性细胞数的变化。并观察KATP通道激动剂对大鼠痛行为和脊髓背角c-Fos表达的影响。结果 1与术前和Saline组相比,CFA组大鼠炎症侧后足术后d 1、d 3和d 7的TWL降低(P<0.05),CFA组术后d 3、d 7的KATP阳性细胞数减少(P<0.01),脊髓背角c-Fos阳性细胞数增加(P<0.01);2与Vehicle组相比,激动剂组大鼠热痛觉过敏减轻(P<0.01),脊髓背角c-Fos阳性细胞数减少(P<0.01)。结论下丘脑室旁核KATP通道可能与CFA所致炎性痛的发生机制相关。     

天麻素对化疗痛大鼠的作用及其在脊髓水平的作用机制

目的观察天麻素对化疗痛大鼠的治疗作用,并观察大鼠脊髓背角腰段GFAP表达的变化,研究其在脊髓水平的作用机制。方法用长春新碱隔日腹腔注射制作大鼠化疗痛模型,模型成功制备后腹腔注射天麻素治疗,用电子Von Frey测痛仪测定大鼠机械痛阈值,电子热板仪测定大鼠热刺激痛阈值;采用免疫组化方法检测脊髓背角星形胶质细胞特异性活化标志物GFAP的表达。结果实验第10天化疗痛大鼠模型成功建立,用不同剂量天麻素治疗模型大鼠1～2周后,治疗组大鼠的机械和热刺激痛阈值与模型组比较均有不同程度的提高,且呈剂量依赖性,以大剂量天麻素的作用最明显(P<0.01);模型组的脊髓背角灰质中可见GFAP表达明显增强,提示星型胶质细胞明显活化,而治疗组与模型组比较明显减弱。结论天麻素可减轻长春新碱诱导的大鼠化疗痛反应;其作用机制可能与在脊髓水平抑制星型胶质细胞活化有关。     

布托啡诺与舒芬太尼应用于静脉镇痛的临床效果比较

目的比较国产布托啡诺(诺扬)与舒芬太尼用于病人自控静脉镇痛(PCIA)的临床效应。方法选择ASAⅠ-Ⅱ100例患者,随机分成两组N组(诺扬组)、S组(舒芬太尼组),N组(诺扬组:n=50):诺扬8mg、昂丹司琼12mg、0.9%生理盐水稀释至100mL注入镇痛泵,S组(舒芬太尼组:n=50):舒芬太尼100μg、昂丹司琼12mg、0.9%生理盐水稀释至100mL注入镇痛泵,给药模式为负荷剂量 持续剂量2mL/h 单次剂量每小时0.5mL镇痛时间48h。负荷剂量N组给予诺扬1mg、昂丹司琼4mg静脉注射,S组给予舒芬太尼5μg、昂丹司琼4mg静脉注射。结果诺扬组与舒芬太尼组相比,镇痛评分(VAS)无显著差异性(P>0.05),两组不良反应主要为恶心、呕吐、头痛、嗜睡,N组均低于S组(P<0.05)。结论诺扬用于术后静脉镇痛,效果确切,不良反应少。     

蛇床子素对髓核致炎神经根痛大鼠的保护作用

目的研究蛇床子素通过抑制脊髓背角胞外信号调节激酶(ERK)/丝裂原活化蛋白激酶(MAPK)通路对髓核致炎神经根痛大鼠的保护作用。方法将80只大鼠随机分为对照组(n=20)、模型组(n=20)及低(n=20)、高剂量实验组(n=20)。模型组及低、高剂量实验组大鼠均用手术在特定椎节(L_5-6)左侧建立髓核致炎神经根痛大鼠模型。造模后,低、高剂量实验组分别于L_5根周注射20,30 mg·kg^-1·d^-1蛇床子素,模型组与对照组注射等量生理盐水,连续干预7 d。用Up-Down法检测各组大鼠50%机械性撤足痛阈值(MWT);用酶联免疫吸附(ELISA)法检测血清一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平;用苏木精-伊红(HE)染色法观察大鼠脊髓背角组织病理变化;用蛋白质印迹(Wb)法检测脊髓背角磷酸化ERK(p-ERK)与磷酸化p38 MAPK(p-p38 MAPK)蛋白表达。结果对照组、模型组与低、高剂量实验组大鼠术后7 d时的50%MWT分别为24.31±1.79,10.12±1.36,17.33±2.15和26.96±3.11,各组大鼠脊髓背角p-ERK蛋白相对表达量分别为0.14±0.07,0.95±0.05,0.33±0.12和0.25±0.10,p-p38 MAPK蛋白相对表达量分别为0.38±0.11,0.93±0.07,0.69±0.14和0.47±0.09。各组的上述指标相比,差异均有统计学意义(均P<0.05)。结论蛇床子素可改善髓核致炎神经根痛大鼠的痛敏程度,抑制炎性反应,其机制可能与抑制脊髓背角ERK/MAPK通路的信号转导有关。     

利多卡因对致痛大鼠L4～5脊髓P物质分布影响的实验研究

目的研究鞘内(IT)利多卡因对福尔马林致痛大鼠脊髓P物质(SP)含量的影响,探讨其镇痛的可能机制.方法取雄性SD大鼠15只,分为三组假手术组、对照组和治疗组.后足皮下注射3%福尔马林50ml致痛造膜.对照组造膜前IT0.9%氯化钠20μl;治疗组造模前IT2%利多卡因20μl.采用免疫组织化学SABC法结合图像分析技术.结果大鼠脊髓背角Ⅰ层和Ⅱ层有密集SP分布,治疗组与对照组相比含量明显减少,差异非常显著(P＜0.01).结论在大鼠外周炎性疼痛模型中,超前鞘内给利多卡因的镇痛作用与其抑制SP在脊髓背角的释放有关.     

脊髓背角星形胶质细胞Cx43组成的半通道在大鼠急性切口痛中的作用

目的 研究脊髓背角星形胶质细胞Cx43半通道在大鼠急性切口痛中的作用。方法 成年雄性SD大鼠60只,随机分为对照组(C组)、切口痛组(I组)和Gap19组。Western blot分别检测大鼠急性切口痛术后脊髓背角的Cx43及星形胶质细胞GFAP的表达变化;术前30 min,鞘内应用Gap19测定术后大鼠50%机械缩足阈值(PWT)的变化,免疫荧光检测大鼠脊髓背角的Cx43及GFAP表达的变化,ELISA检测炎症因子的变化。结果 与C组相比,I组大鼠脊髓背角Cx43和GFAP表达在术后6 h明显增加,术后3 d和7 d无改变。I组和Gap19组大鼠在切口建立后2 h、6 h、24 h、3 d的PWT明显降低(P<0.01),术后7 d无变化。与I组比,Gap19组PWT在术后2、6、24 h明显增加(P<0.01),3 d和7 d无变化。免疫荧光结果显示,I组术后6 h脊髓GFAP和Cx43表达相较C组增加(P<0.01);与I相比,Gap19组GFAP和Cx43表达明显下降(P<0.05),但术后7 d各组间无统计学差异。ELISA显示,与C组相比,I组脊髓背...     

鞘内注射可乐定对切口痛大鼠脊髓背角PKA催化亚单位表达的影响

目的:观察鞘内注射(intrathecal injection IT)可乐定对切口痛大鼠脊髓背角PKA催化亚单位表达的影响.方法:选择鞘内置管成功的雄性SD大鼠80只,随机分为5组,每组16只,分别为假手术组,对照组,可乐定5μg组,可乐定10μg组和可乐定20μg组.按Yaksh法鞘内置管,按Brennan法制作大鼠...     

Antinociception induced by stimulating the anterior pretectal nucleus in two models of pain in rats

1. This study examined whether different parts of the rat anterior pretectal nucleus (APtN) may be involved in the spinal control of brief (tail flick test) or persistent (surgical incision of the plantar aspect of a hind paw) noxious inputs via activation of descending pathways. 2. We have confirmed that stimulation of the dorsal APtN produces a strong antinociceptive effect in the tail flick test, as opposed to a very weak effect obtained from the ventral APtN. Stimulation at the ventral APtN was the most effective part of the nucleus against a persistent incisional pain. 3. The incisional pain was significantly increased following injection of 1 or 2% lignocaine (0.25 microL) into the nucleus, but the effect was more intense after neural block of the ventral rather than the dorsal APtN. Injection of 2% lignocaine (0.10 microL) into the ventral, but not dorsal, APtN significantly increased the perception of the incisional pain. 4. We conclude that the effect of stimulating the APtN depends on the site of stimulation and model of pain used. Sustained noxious stimuli activate pathways from the ventral APtN to reduce further noxious spinal inputs. The noxious stimulation produced during the tail flick test may be not enough to activate the same circuitry, but electrical stimulation at the dorsal APtN is very effective in inhibiting brief thermal noxious inputs at the spinal level.     

Different patterns of spinal cyclooxygenase-1 and cyclooxygenase-2 mRNA expression in inflammatory and postoperative pain

Levels of cyclooxygenase-2 (COX-2) mRNA, but not those of COX-1, were reported to be raised significantly after peripheral inflammation in the rat spinal cord. The aim of the present study was to ascertain whether this pattern of COX-2 and COX-1 expression applies also to other pain conditions induced by surgical procedure. Experiments were performed on two types of pain models. In a model of postoperative pain, 1 cm longitudinal incision was made through skin, fascia and muscle of the plantar aspect of the right hind paw in anaesthetized rats. In the second model, peripheral inflammation was induced by unilateral, intraplantar injection of carrageenan in the right hind paw. Carrageenan injection or skin incision produced marked and significant reduction of paw withdrawal latencies to noxious radiant heat stimuli after 2 and 6 hr. Under the acute inflammation 2 and 6 hr after carrageenan injection levels of COX-2 mRNA were markedly raised (7.8 and 15.5 times; P<0.001, respectively) while spinal levels of COX-1 mRNA were not significantly altered (n.s.). In contrast, spinal levels of COX-2 mRNA were raised less markedly in a model of postoperative pain (4.9 times at 2 hr; P<0.001 and 2.9 times (n.s.) at 6 hr after surgery) whilst levels of COX-1 mRNA in the lumbar spine were increased significantly (2.3 times; P<0.001) 6 hr after surgery. The present findings indicate that expression of COX-2 mRNA in the spine is less dominant in postoperative pain than in inflammatory pain and that spinal COX-1 mRNA is upregulated in postoperative pain.     

Participation of brainstem nuclei in the pronociceptive effect of lesion or neural block of the anterior pretectal nucleus in a rat model of incisional pain

The anterior pretectal nucleus (APtN) participates in nociceptive process and controls spinal nociceptive inputs, and its integrity reduces the severity of the responses to persistent injury. In this study we examined whether the pedunculopontine tegmental nucleus (PPTg) or the gigantocellularis nucleus pars alpha (GiA), stations that relay APtN inputs to the spinal cord, can control the persistent pain induced by a hind paw incision in rats with disrupted APtN. The withdrawal threshold to mechanical stimulation of the incised paw measured with von Frey filaments was significantly reduced in rats with contralateral APtN lesion or neural block of this nucleus with 2% lidocaine. Intrathecal xylamine, an inhibitor of noradrenaline uptake, inhibited the neural block of the APtN-induced increase in the incisional pain. Injection of glutamate into the contralateral PPTg or ipsilateral GiA reduced the incisional pain. Neural block of the PPTg or GiA reduced the threshold, mainly in APtN-disrupted rats. We conclude that persistent noxious stimulation activates descending pathways involving the contralateral APtN and PPTg, and ipsilateral GiA. Disruption of the APtN allows the activation of alternative circuitry involving at least the PPTg and GiA as intermediary stations that might maintain the control of nociceptive inputs in the spinal cord, probably involving noradrenergic mechanisms.     

HO-1/CO 信号通路对切口痛大鼠炎症因子的调控作用

目的 观察脊髓血红素氧合酶-1（HO-1）/CO 信号通路对切口痛大鼠炎症因子的调节作用及可能机制。方法 切口痛模型大鼠 36 只在实验即刻（0 h）, 术后 1、4、8、12 及 24 h 各处死 6 只, 取患侧脊髓腰膨大处, Western blot 法检测 HO-1 蛋白表达, 酶联免疫吸附试验（ELISA）法检测炎症因子肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1β、IL-6 和高迁移率族蛋白 1（HMGB1）。 另外, 对照（C）组 36 只大鼠不做切口痛模型;切口痛模型大鼠 144 只按处理方式不同分为切口痛（IP）组, 切口痛+HO-1 诱导剂（IP+hemin）组, 术前给予腹腔注射大鼠 100 mg/kg 血红素（hemin）; 切口痛+HO-1 抑制剂（IP+Znpp-IX）组, 术前给予腹腔注射大鼠 45 μmoL/kg 锌原卟啉（Znpp）-IX; 切口痛+ CO 释放剂（IP+CORM-2）组, 于术前经腹腔注射给予 10 mg/kg 一氧化碳释放分子（CORM）-2。 各组于实验即刻（0 h）, 术后 1、4、8、12 及 24 h 行机械缩足阈值（PWMT）和热缩足潜伏期（PWTL）的检测, 应用 ELISA 法检测各组 TNF- α、IL-1β、IL-6 和 HMGB1 的表达情况。 结果 与 0 h 比较, 术后 1、4、8、12 及 24 h HO-1 蛋白表达水平和 TNF-α、 IL-1β、IL-6 和 HMGB1 均增高（P＜ 0.05）。 与 C 组比较, 其余组大鼠各时间点 PWMT 值和 PWTL 值减少, TNF-α、 IL-1β、IL-6 和 HMGB1 表达增加（P＜ 0.05）; 与 IP 组比较, IP+hemin 组和 IP+CORM-2 组大鼠 1、4、8、12 及 24 h 时 PWMT 值和 PWTL 值均增高, 而 TNF-α、IL-1β、IL-6 和 HMGB1 表达减少, IP+Znpp-IX 组 PWMT 值和 PWTL 值降低, 但 TNF-α、IL-1β、IL-6 和 HMGB1 表达增加（P＜ 0.05）。 结论 切口痛可诱发大鼠 HO-1 表达增加, 而 HO-1/CO 信号通路在调控切口痛大鼠炎症因子的释放方面发挥重要作用。     

Repetitive Treatment with Diluted Bee Venom Attenuates the Induction of Below-Level Neuropathic Pain Behaviors in a Rat Spinal Cord Injury Model

The administration of diluted bee venom (DBV) into an acupuncture point has been utilized traditionally in Eastern medicine to treat chronic pain. We demonstrated previously that DBV has a potent anti-nociceptive efficacy in several rodent pain models. The present study was designed to examine the potential anti-nociceptive effect of repetitive DBV treatment in the development of below-level neuropathic pain in spinal cord injury (SCI) rats. DBV was applied into the Joksamli acupoint during the induction and maintenance phase following thoracic 13 (T13) spinal hemisection. We examined the effect of repetitive DBV stimulation on SCI-induced bilateral pain behaviors, glia expression and motor function recovery. Repetitive DBV stimulation during the induction period, but not the maintenance, suppressed pain behavior in the ipsilateral hind paw. Moreover, SCI-induced increase in spinal glia expression was also suppressed by repetitive DBV treatment in the ipsilateral dorsal spinal cord. Finally, DBV injection facilitated motor function recovery as indicated by the Basso–Beattie–Bresnahan rating score. These results indicate that the repetitive application of DBV during the induction phase not only decreased neuropathic pain behavior and glia expression, but also enhanced locomotor functional recovery after SCI. This study suggests that DBV acupuncture can be a potential clinical therapy for SCI management.     

昂丹司琼对异氟烷催眠和镇痛作用的影响

目的观察昂丹司琼对异氟烷催眠和镇痛作用的影响;探讨异氟烷的催眠、镇痛作用与5-羟色胺3受体(5-HT3)的关系。方法①催醒实验小鼠ip给予昂丹司琼1,2,4 mg·kg-1,15 min后ip给予异氟烷1.0 ml.kg-1催眠,检测翻正反射消失时间。②催眠半数有效量ED50测定小鼠ip给予昂丹司琼2 mg·kg-1,15 min后用序贯法ip给予异氟烷1.12,0.90,0.72,0.58和0.46 ml.kg-1,测定催眠ED50。③扭体法小鼠ip给予昂丹司琼1,2和4 mg·kg-1,10 min后sc给予异氟烷1.0 ml.kg-1镇痛,检测扭体次数。④热板法小鼠ip给予昂丹司琼1,2和4 mg·kg-1,10 min后,ip给予异氟烷0.4 ml.kg-1镇痛,检测小鼠热板法痛阈值(HPPT)。结果与正常对照组相比,昂丹司琼1,2和4 mg·kg-1组小鼠翻正反射消失持续的时间和ED50值均无明显变化。扭体实验中,与正常对照组比较,昂丹司琼4 mg·kg-1和异氟烷1.0 ml.kg-1可使清醒小鼠扭体次数减少(P<0.01),麻醉小鼠给予昂丹司琼1,2和4 mg·kg-1时,扭体次数有下降趋势,但无统计学差异。热板法中,ip昂丹司琼对清醒小鼠及异氟烷小鼠的HPPT均无明显影响。结论昂丹司琼对异氟烷催眠、抗热刺激伤害作用无明显影响,提示异氟烷的催眠镇痛作用可能与5-HT3受体无明显关系。     

Dissociation between post-surgical pain behaviors and spinal Fos-like immunoreactivity in the rat

Previous studies have demonstrated that Fos-like immunoreactivity is increased in spinal dorsal horn neurons in several pain models, and have suggested that Fos-like immunoreactivity could be used as a marker of neurons activated by painful stimulation. In the present study, we evaluated nociceptive behaviors and spinal Fos-like immunoreactivity in a rat skin incision model of post-operative pain. In this model, evoked and non-evoked pain behaviors were observed at least for 2 days after paw surgery, an increased number of Fos-like immunoreactive neurons was observed in the spinal dorsal horn at lumbar levels 4-5 two-hour post-surgery. The number of Fos-like immunoreactive neurons was significantly greater in animals with skin-muscle incision compared to animals with skin-alone incision. Interestingly, spinal Fos-like immunoreactivity was quickly normalized in rats with paw surgery at later time points (8 and 24 h post-surgery), whereas nociceptive behaviors were still observed. Furthermore, at 24 h post-surgery, spinal Fos-like immunoreactivity induced by thermal stimulation (42, 44, 46, 48, 52 degrees C for 15 s) was not significantly different between sham animals and animals with surgery. In both groups, an increase in spinal Fos-like immunoreactive neurons was observed with increasing temperatures, with similar laminar distribution. Finally, systemic morphine reduced post-operative pain and Fos-like immunoreactivity in a naloxone reversible manner, with greater potency and efficacy on behavioral endpoints than on Fos-like immunoreactivity. These results demonstrate a different profile of nociceptive behaviors and spinal Fos-like immunoreactivity in the rat skin incision model, suggesting a limited potential of spinal Fos-like immunoreactivity to study post-surgical pain and its pharmacology.     

昂丹司琼和氟哌利多预防胃癌根治术中恶心呕吐的比较

目的 :比较昂丹司琼和氟哌利多预防胃癌根治性手术中的恶心呕吐作用。方法 :6 7例男性胃癌根治性手术病人随机分 3组 ,昂丹司琼组 2 2例 ,氟哌利多组 2 2例 ,对照组 2 3例。术前所有病人肌内注射阿托品 0 .5mg、苯巴比妥 0 .1g ,选T 7～ 8椎间隙常规硬膜外穿刺置管 ,待麻醉平面满意后 ,昂丹司琼组静脉缓慢注射昂丹司琼 8mg ;氟哌利多组静脉注射氟哌利多 2 .5mg ;对照组不给药。切皮前病人均抽吸胃管以彻底清除胃液。结果 :昂丹司琼组预防恶心呕吐达 1级疗效病例占 86 % ,氟哌利多组为 5 5 % ,经 χ2 检验差异有显著意义 (P <0 .0 5 )。昂丹司琼组和氟哌利多组发生嗜睡反应病例分别为6例和 11例 ,氟哌利多组发生锥体外系反应 2例。结论 :昂丹司琼预防胃癌根治术中的恶心呕吐的疗效优于氟哌利多