昂丹司琼用于预防无痛人流术后恶心呕吐的临床观察

目的 探讨应用昂丹司琼预防恶习呕吐的机制,降低患者无痛人流术后恶习呕吐发生率,提高患者术后恢复舒适程度.方法 行静脉全麻无痛人工流产患者200例随机分为A、B两组,每组100例,A组术前半小时静脉点滴昂丹司琼8mg（4ml）,B组静脉点滴生理盐水4ml.记录患者基本资料;手术前、手术结束时MAP、HR、SpO2;手术时间;麻醉时间;手术用药量;恶心呕吐情况：孕期是否有怀孕呕吐,术后1、6小时电话回访是否有恶心呕吐.结果 两组患者术前、术中MAP、HR、SpO2及手术时间、麻醉时间及用药量无统计学差异（P＞0.05）;A组手术后恶心呕吐发生率明显低于B组（P＜0.05）.结论 手术前给予昂丹司琼预防术后恶心呕吐的发生有临床意义,提高了患者术后的舒适度感受,利于术后恢复,降低了麻醉后风险,值得临床推广应用.     

中药制剂与恩丹西酮治疗化疗后呕吐疗效的Meta分析

目的:运用Meta分析综合评价中药制剂与恩丹西酮治疗化疗后呕吐的疗效。方法:通过中国三大科技文献数据库,检索出有关本主题随机对照研究的全部文献,遴选出符合入选标准的文献7篇,对其研究结果进行Meta分析,得出合并后疗效的比值比OR及其95%的可信区间(CI)。结论:根据目前收集文献的Meta分析,中药制剂与恩丹西酮治疗化疗后呕吐疗效相仿,差异无显著性。但中药制剂治疗化疗后呕吐的副作用明显小于恩丹西酮。     

Lornoxicam and ondansetron for the prevention of intrathecal fentanyl-induced pruritus

Purpose In this randomized, double-blind study, we aimed to compare the effectiveness of lornoxicam and ondansetron for the prevention of intrathecal fentanyl-induced pruritus in patients undergoing cesarean section. Methods One hundred and eight parturients (American Society of Anesthesiologists [ASA] I-II status) requesting neuraxial analgesia by a combined spinal-epidural (CSE) technique were recruited for this study. A CSE technique was performed and anesthesia was achieved with fentanyl 25 μg and hyperbaric bupivacaine 12 mg. Patients were randomly allocated to three groups, each with 36 participants. Immediately following delivery, patients received either lornoxicam 8 mg IV (group L; n = 36), ondansetron 8 mg IV (group O; n = 36), or normal saline 2 ml IV (group P; n = 36). Pruritus, pain, and nausea and vomiting scores were recorded during the initial 24 h postoperatively. Results The incidence of pruritus was significantly lower in group O from 4 to 12 h postoperatively when compared to that in group L and group P. According to the pruritus grading system we used, the number of patients without pruritus was significantly higher in group O when compared to that in group L and group P. The number of patients experiencing moderate pruritus was significantly lower in group O when compared to that in group P. Conclusion We observed that the administration of 8 mg IV lornoxicam failed to prevent intrathecal fentanyl-induced pruritus in parturients. Also, our data confirmed that ondansetron is likely to attenuate intrathecal fentanyl-induced pruritus.     

昂丹司琼和氟哌利多及甲氧氯普胺联合预防妇科肿瘤患者术后恶心呕吐的效果

目的比较昂丹司琼、氟哌利多、甲氧氯普胺单用或合用在预防妇科肿瘤患者术后恶心呕吐(PONV)的效果。方法将160例妇科肿瘤患者随机分为4组,A组在发生PONV后给予昂丹司琼8mg,B组术后给予昂丹司琼8mg,C组术后给予氟哌利5mg 甲氧氯普胺20mg,D组先给予昂丹司琼8mg后给予氟哌利多5mg 甲氧氯普胺20mg,比较4组患者术后48h内PONV总发生率。结果4组患者术后48h内PONV总发生率分别为52.5%、25.0%、27.5%、7.5%;D组术后48h内PONV总发生率与A组、B组和C组间差异均有统计学意义(P<0.05)。结论甲氧氯普胺、昂丹司琼、氟哌利多联合应用预防妇科肿瘤患者硬膜外术后镇痛时PONV较单用或两种药物联用效果好。     

Clinical Efficacy of the 5-HT3 Antagonist Ondansetron in Alcohol Abuse and Dependence

Medications that act on the serotonergic system have been found to be of benefit in the treatment of alcohol-dependent individuals. In a randomized, placebo-controlled study, the efficacy of 6 weeks of ondansetron, a 5-HT₃ antagonist (0.25 mg bid or 2.0 mg bid), in the treatment of 71 nonseverely alcohol-dependent males was tested. The results showed reduction of drinking differences were steadily increasing toward the end of the treatment period approached significance at week 7 in the 0.25 mg group ( p = 0.06). Twice as many patients in this group showed >2 standard deviations decrease in drinking compared with the other groups. When patients drinking >10 drinks/drinking day at baseline ( n = 11) were excluded from the analysis, significant group differences were found at both treatment and follow-up, with the lower ondansetron dose producing the greatest reduction from baseline (i.e., 2.8 standard drinks; –35% compared with baseline and –21% compared with placebo; p < 0.02–0.001). Within this group, there was an almost 4-fold greater number of patients showing a clinically meaningful decrease in drinking. Lower baseline drinking and higher level of education were significant and strong predictors of drinking reduction during treatment. Ondansetron was very well tolerated; hence, further long-term studies with 5-HT₃ antagonists alone or in combination with other treatment components may offer promise for treatment of alcoholism.     

四种镇痛药物对兔脊髓的神经毒性实验研究

目的：对硬膜外术后镇痛用药是否对脊髓有神经毒性进行研究,以指导临床用药.方法：健康家兔50只,硬膜外穿刺成功后,随机分为5组,每组10只,生理盐水（0.5 ml/kg）对照组（S组）,格拉司琼（0.015 mg/kg）组（G组）,恩丹西酮（0.08 mg/kg）组（O组）,高乌甲素（0.12 mg/kg）组（L组）,来比林（18 mg/kg）组（A组）.5组均给药2次/d,间隔12小时,连续给药3天,继续观察至第7天处死兔作光镜和电镜检查.结果：电镜下各组均未见坏死性改变.光镜下L组和A组兔的脊髓病变较严重,脊髓灰质和白质分界不清,结构破坏,神经细胞减少.结论：常用浓度的格拉司琼、恩丹西酮注入硬膜外隙安全、可靠.高乌甲素、来比林注入兔硬膜外隙可见动物的脊髓有破坏性病变,建议临床慎用.     

Granisetron, tropisetron, and ondansetron in the prevention of acute emesis induced by a combination of cisplatin–Adriamycin and by high-dose ifosfamide delivered in multiple-day continuous infusions

 The antiemetic efficacy of granisetron, ondansetron and tropisetron was evaluated in patients treated with cisplatin–Adriamycin (CDP/ADM) and ifosfamide (IFO) by continuous infusion (CI). In all, 90 patients with osteosarcoma were randomly assigned to receive granisetron (2 mg/m²), or ondansetron (5.3 mg/m²), or tropisetron (3.3 mg/m²) plus dexamethasone 8 mg/m². Chemotherapy consisted of CDP (120 mg/m², 48-h CI) followed by ADM (75 mg/m², 24-h CI) and then, in the second cycle, delivered 3 weeks later, IFO 15 g/m² (120-h CI). Complete protection (CP) from emesis was obtained on 59% of the 717 days of treatment, without significant differences among the three study drugs. A significantly higher rate of CP was obtained during chemotherapy with IFO than with CDP/ADM (69% vs 44%; P<0.0001). The rate of CP declined from the first to the last day of treatment for both CDP/ADM (61% to 27%, P<0.0001) and IFO (95% to 43%) cycles (P<0.0001). When CDP/ADM and IFO are delivered on multiple days by CI, granisetron, ondansetron and tropisetron have the same antiemetic efficacy, which declines from the first day onward through successive days. Published online: 5 October 1999     

盐酸恩丹西酮缓释片的研制及体外释药特性

制备盐酸恩丹西酮缓释片并对影响释药的因素进行考察。以羟丙甲纤维素（HPMC）为骨架材料制备了盐酸恩丹西酮缓释片，通过正交设计试验优选最佳处方和工艺。对影响释药的因素，如HPMC的黏度和用量、填充剂的种类、制片工艺、润湿剂及释放介质pH等进行了考察。盐酸恩丹西酮缓释片体外释药符合Higuchi方程，HPMC的黏度、填充剂的种类及测定释放度的转速对该缓释片的释药几乎无影响，而制片工艺、润湿剂及释放介质pH值对缓释片释药影响较大。盐酸恩丹西酮缓释片在体外12h缓释效果较好。     

Comparison of ondansetron, dimenhydrinate versus placebo as PONV prophylaxis for outpatient gynecological laparoscopy

This is a study comparing ondansetron, dimenhydrinate versus placebo as PONV prophylaxis for outpatient gynecologic laparascopy. Postoperative nausea and vomiting (PONV) is very common following ambulatory gynecological laparoscopy. Prophylactic antiemetic therapy if safe, effective and affordable may reduce the incidence of PONV, expedite hospital discharge and improve patient satisfaction. After institutional review board approval, informed written consent was obtained form 87 ASA I–II women undergoing ambulatory gynecological laparoscopy. In a random and double blind fashion the women were divided into three groups receiving either ondansetron 8 mg, dimenhydrinate 50 mg or placebo. A standard anesthetic technique with propofol, fentanyl, mivacurium, nitrous oxide and isoflurane was used. Measurements of nausea, emesis, pain, drowsiness, and satisfaction and recovery milestones were recorded. Psychomotor recovery was evaluated using p deletion and digit symbol substitution (DSS) test. There was no difference in the groups with respect to demographic data. Dimenhydrinate prolonged immediate recovery and impaired psychomotor recovery, but there was no difference in postanesthesia care unit (PACU) or hospital discharge. The incidence of PONV was minimal. The visual analogue score (VAS) for nausea was only 1 on a scale from 0–10 cm in all groups. Only one patient in the placebo group experienced PACU emesis. The incidence and severity of PONV was so low, even in the placebo group that the use of prophylactic antiemetic therapy cannot be justified.