不同剂量氟哌利多预防术后PCA恶心、呕吐的临床观察

目的:比较不同剂量氟哌利多用于芬太尼静脉术后镇痛(PCA)中对恶心、呕吐的预防作用,并与万唯(阿扎丝琼)相比较。方法:150例择期行腹部手术患者,ASA-级,接受芬太尼术后自控镇痛,随机、双盲分为五组,PCA用药均为芬太尼(0.02mg/ml)。I组为对照组,、、组分别加入氟哌利多(0.0125mg/ml,0.025mg/ml,0.05mg/ml),V组加入万唯0.1mg/ml。观察记录各组患者镇痛后4、8、12、24h芬太尼用量、疼痛评分、恶心呕吐评分、镇静评分。结果:与对照组相比、、组病人恶心和呕吐发生率明显降低(P<0.05);组病人恶心和呕吐发生率虽然有所降低但与对照组相比无显著性差异(P>0.05);、组的恶心和呕吐发生率较组高,但无显著性差异(P>0.05)。组病人术后24h的镇静评分明显高于其它各组(P<0.05)。各组间疼痛、VAS评分及芬太尼用量无差异(P>0.05)。结论:中等剂量氟哌利多能有效地减少芬太尼术后PCA治疗中的恶心、呕吐,副作用少。

The antiemetic efficacy of multicenter dose droperidol during fentanyl patient-controlled analgesia

Objectie: To compare the effects of droperidol of different dosage in preventing nausea and vomiting induced by fentanyl intravenous patient controlled analgesia(PCA). Methods: 150 patients,ASA Ⅰ-Ⅱ,undergoing slective abdominal surgery under general anesthesia were randomized into 5 groups to receive patient-controlled analgesia with fentanyl : group I as control group;Ⅱ,Ⅲ,Ⅳ with mixture of fentanyl and droperidol 0.0125 mg/ml,0.025 mg/ml or 0.05mg/ml, group Ⅴ with mixture of fentanyl and azasetron 0.1 mg/ml .The score for nausea,vomiting,pain and sedation and visual analogne scale(VAS) was made at 4,8,12,24h postoperatively. Results: Incidence of nausea and vomiting was decreased significantly in group Ⅲ, Ⅳ and group Ⅴ compared with group I(P<0.05 ),but group Ⅱ had no diffrence compared with group I. Group IV has significantly higher sedation scores than the other groups(P<0.05 ).There was no difference between the groups at any time in the amount of fentanyl consumed or in pain score and visual analogne scale. Conclusion: Proper dose of droperidol can effectively reduce the incidence of nausea and vomiting induced by PCA intravenous fentanyl.