昂丹司琼和甲氧氯普胺对面神经微血管减压术后舒芬太尼镇痛恶心呕吐的防治

目的：观察昂丹司琼和甲氧氯普胺对面肌痉挛面神经微血管减压术成年患者舒芬太尼静脉自控镇痛恶心呕吐的防治作用。方法选择150例行面神经微血管减压术的成年患者,ASA分级Ⅰ或Ⅱ级,年龄35～65岁,随机分为3组。 A：昂丹司琼组,B：甲氧氯普胺组,C：昂丹司琼联合甲氧氯普胺组。术毕均连接病人静脉自控镇痛泵（ PCIA）。分别于术后的6,12,24,48h记录患者镇痛评分、恶心、呕吐和其他相关并发症的发生情况。结果术后各时间点疼痛评分无统计学差异,镇痛效果相同。术后24h内A,C组恶心的发生率及程度均低于B组（P＜0．01）,A,C两组之间无统计学差异。术后6h和12h呕吐发生率和术后6h呕吐程度C组低于A, B两组（P＜0．01）,且A,B组之间无统计学差异。24h C组呕吐发生率及程度低于B组（P＜0．01）,而A,C之间与A,B之间均无统计学差异。术后48h 3组之间恶心呕吐发生率及严重程度均无统计学差异（P＞0．05）。结论昂丹司琼对于舒芬太尼术后镇痛引起的恶心呕吐效果确切,联合甲氧氯普胺使用对呕吐的效果更佳。     

昂丹司琼不同时间和不同剂量给药预防妇科腹腔镜手术术后恶心呕吐的疗效分析

目的探讨给于妇科腹腔镜手术患者不同时间和不同剂量的昂丹司琼对术后恶心呕吐的预防作用。方法152例妇科腹腔镜手术患者随机分为A、B、C三个给药组和空白对照组,给药组各组给于昂丹司琼时间及剂量分别为麻醉诱导前给予8mg、结束时8mg、麻醉诱导前4mg。结果与对照组比较,A组、B组、C组的术后恶心发生率明显较低,差异具有统计学意义（P〈0．05）,A组与B组、A组与C组比较术后恶心呕吐发生率差异无著性（P〉0．05）。结论对于妇科腹腔镜手术患者不同时间和不同剂量给予昂丹司琼均能有效预防恶心呕吐的发生,麻醉诱导前与结束时给药、药量8mg与4mg给药差异较小。     

恩丹西酮对腹腔镜下妇科手术后预防恶心呕吐及对镇痛镇静影响的临床观察

目的 :观察恩丹西酮预防腹腔镜下妇科手术后恶心呕吐及对镇痛镇静影响。方法 :4 0例ASAⅠ级～Ⅱ级女性病人 ,随机分为两组 :对照组 (不含恩丹西酮 )和试验组 (含恩丹西酮 ) ,每组 2 0例 ,静吸复合全麻下实施腹腔镜下卵巢囊肿摘除或宫外孕手术 ,术毕给负荷量后接PCIA泵。结果 :术后 2 4h两组患者心率、血压平稳 ,未见呼吸抑制病例。两组各时点疼痛评分均小于 4分 ,且两组间VAS及镇静评分差别无显著性 (P >0 .0 5 ) ,两组均未用其他镇痛药。试验组恶心呕吐发生率明显低于对照组 (P <0 .0 5 )。结论 :预防应用恩丹西酮后有效减轻腹腔镜下妇科手术后的恶心呕吐 ,但不减弱PCIA的镇痛作用     

欧丹西酮预防曲马多硬膜外术后镇痛期间恶心、呕吐的定量研究

目的　寻找欧丹西酮 (Ondansetron)预防妇产科手术后曲马多连续硬膜外镇痛期间恶心和呕吐的最佳剂量。方法　ASAⅠ～Ⅱ级妇产科手术病人 12 0例 ,随机分为 4组 (n =30 ) ,于关腹后接镇痛泵前 (配方为曲马多 80 0mg+布比卡因 112 .5mg ,总量 10 0ml,泵速 2ml/h)分别接受欧丹西酮 2mg、4mg、6mg和生理盐水 2ml静注。观察镇痛期不同时点的VAS值和 0～ 2 4h的恶心、呕吐发生率。结果　 4组VAS均值无明显差异 (P >0 .0 5 )。在 0～2 4h ,恶心 :2mg组 30 .4 % (7) ,4mg组 3.3% (1) ,6mg组 3.3% (1)和生理盐水组 4 6 .7% (14 ) ;呕吐 :2mg组2 0 .0 % (6 ) ,4mg组 3.3% (1) ,6mg组 3.3% (1)生理盐水组 4 3.3% (13)。在预防恶心和呕吐两个事件方面 ,所有用药组与对照组相比均有显著差异 (P <0 .0 5 ) ;在用药组中 ,2mg组与 4mg和 6mg组间比较P <0 .0 5 ,而后 2个剂量组间无差别。结论　本文 3个剂量组的欧丹西酮均有预防妇产科手术后曲马多连续硬膜外镇痛期间恶心和呕吐的作用 ,其中以 4mg组最优。     

盐酸格拉司琼防治含铂方案化疗引起恶心呕吐疗效观察

目的观察盐酸格拉司琼预防顺铂化疗呕吐的疗效。方法对128例接受顺铂方案化疗的患者,采用随机分组的方法,分别应用盐酸格拉司琼和恩丹西酮,观察两药止吐疗效。结果盐酸格拉司琼和恩丹西酮均能有效防治顺铂所致的恶心、呕吐,两药的止吐有效率分别为90%和86.8%,P<0.05。两药的副反应轻,主要为头痛、便秘等。结论盐酸格拉司琼能有效预防顺铂所致胃肠反应,不良反应轻,是良好的止吐药物。     

恩丹西酮用于术后硬膜外吗啡止痛患者的临床观察

目的 :观察了解国产恩丹西酮预防术后硬膜外吗啡止痛患者恶心、呕吐的情况。方法 :1 60例腹部手术患者随机平均分为两组 ,组 I为恩丹西酮组 ,组 为对照组。两组术毕均用吗啡注入硬膜外腔内止痛。组 I于术毕前 30 min静脉滴注国产恩丹西酮 8mg,组 围手术期不用任何止吐药。结果 :组 患者恶心、呕吐率明显低于组 ,P<0 .0 1 ,且无明显不良反应 ,对吗啡的止痛效果也无影响。结论 :国产恩丹西酮适用于术后硬膜外吗啡止痛患者恶心、呕吐的预防和治疗。     

利多卡因、曲马多和枢复宁对预防罗库溴铵注药痛的对比研究

目的观察罗库溴铵注药痛的发生率、致痛程度以及预先注射药物的预防效果。方法拟行全身麻醉的成年手术患者125例。麻醉诱导时用限时法给予肌松药。按静脉注射罗库溴铵前预先注射的药物将患者随机分为5组,每组25例。Ⅰ组生理盐水3ml、Ⅱ组利多卡因0．5mg／kg、Ⅲ组曲马多1．0mg／kg、Ⅳ组曲马多1．5mg／kg和Ⅴ组枢复宁0．07mg／kg。左上臂包裹气压止血带,加压至70mmHg阻断静脉回流后,以3ml／10s的速度在左侧手背静脉注入各组预先给予的药物,30s时松开止血带。立即10s注射罗库溴铵0．6mg／kg,观察并询问患者注药局部的痛感,并对疼痛反应评估分组。结果Ⅰ组罗库溴铵注药痛发生率达到88％,中、重度注药痛发生率为44％。Ⅱ组84％的患者无注药痛,16％的患者痛感轻微。Ⅲ组、Ⅳ组和Ⅴ组注药痛发生率分别为84％、76％和72％,与Ⅰ组相似;但Ⅲ组和Ⅴ组中、重度注药痛发生率(16％和4％)比I组明显减少。结论麻醉诱导时预先静脉注射利多卡因0．5mg／kg,能有效降低罗库溴铵注药痛的发生率和致痛程度;预注曲马多或枢复宁亦能降低中、重度注药痛的发生率。     

Comparison of the efficacy and side-effects of ondansetron and metoclopramide-diphenhydramine administered to control nausea and vomiting in children treated with antineoplastic chemotherapy: a prospective randomized study

Nausea and vomiting following antineoplastic therapy in patients receiving chemotherapy remains a problem. To prevent nausea and vomiting due to antineoplastic therapy, many types of drugs have been used. Ondansetron and the combination metoclopramide-diphenhydramine have been widely used in children. In this prospective randomized study these drugs were compared both for their efficacy and side-effects in children treated with antineoplastic chemotherapy (with and without cisplatin) the number of chemotherapy courses being equal in both groups. Ondansetron gave complete anti-emetic cover in five of nine courses in patients treated with cisplatin. Metoclopramide-diphenhydramine gave complete anti-emetic cover in one out of nine courses, and 17 out of 23 courses in patients treated without cisplatin. Metoclopramide-diphenhydramine produced side effects in nine courses whereas ondansetron produced side-effects in three courses. Conclusion Ondansetron appeared to be superior to metoclopramide-diphenhydramine in the control of emesis induced by chemotherapy regimens containing cisplatin. The results of the present prospective randomized study indicate that ondansetron is a useful anti-emetic in the treatment of chemotherapy-induced emesis. Received: 17 May 1996 / Accepted in revised form: 23 December 1997     

Comparative study of dexamethasone and ondansetron for prophylaxis of postoperative nausea and vomiting in laparoscopic gynecologic surgery

Objective

To compare intravenous dexamethasone and ondansetron for the prophylaxis of postoperative nausea and vomiting (PONV), a main complaint that affects almost 40%-75% of patients undergoing laparoscopic gynecologic surgery.

Methods

In a prospective study, 93 women were divided into 3 groups receiving 4 mg of dexamethasone, 8 mg of dexamethasone, or 4 mg of ondansetron. PONV score was used for assessment during the first 24 hours after surgery.

Results

The incidence of PONV during the 24-hour postoperative period was highest in the ondansetron group (61%). In the first 3 hours, the incidence of PONV in the ondansetron group was also higher: 51.6% as compared with 22.6% and 36.6% in the dexamethasone 4 mg and 8 mg groups, respectively. The overall incidence of PONV was highest in the first 3 hours as compared with later time periods, and there was a linear trend in decreasing PONV among the groups (P = 0.017). In the dexamethasone 4 mg group, the request for a rescue antiemetic was significantly lower: 0% as compared with 6.7% and 16.1% in the dexamethasone 8 mg and ondansetron 4 mg groups, respectively.

Conclusion

Dexamethasone was found to be an efficacious and cost-effective drug for the prophylaxis of PONV.