托烷司琼预防子宫全切术后镇痛恶心、呕吐疗效观察

目的比较托烷司琼的不同给药方式对术后芬太尼静脉镇痛患者恶心、呕吐的疗效差异.方法选择硬膜外阻滞麻醉下择期子宫全切术患者120例,ASAⅠ～Ⅱ级,随机分为3组.A组术毕静注托烷司琼6mg后连接静脉自控镇痛泵;B组术毕静注托烷司琼3mg,另给3mg加入静脉自控镇痛泵内;C组将6mg托烷司琼加入病人自控镇痛泵内.记录不同时间段内（0～1h、1～3h、3～6h、6～12h、12～24h、24～48h）恶心、呕吐发生情况.结果与C组比较,A组和B组术后2、4和8h恶心、呕吐的发生率明显降低（P〈0.05）;B组在术后48h呕吐的发生率明显降低（P〈0.05）.结论术毕静脉注射托烷司琼,并通过PCA泵持续输注较其他用药方式明显减少术后镇痛恶心、呕吐的发生率.

Preventive Effect of Tropisetron on Postoperative Nausea and Vomiting during Patient-Controlled Analyesia after Uterectomy

Objective To compare the preventive effects of tropisetron in different administrations on postoperative nausea and vomiting during patient-controlled analgesia with tramadol after uterectomy.Methods One hundred and twenty ASA classⅠ～Ⅱ uterectomy patients were divided into 3 groups：group A,group B and group C,forty cases in each group.In group A,patients were given tropisetron 6 mg IV injection only,patients in group B were given tropisetron 3 mg IV injection and tropisetron 3 mg in PCA pump,patients in group C were given tropisetron 4 mg in PCA pump.Nausea and vomiting were recorded in different periods（0～1 h,1～3 h,3～6 h,6～12 h,12～24 h,and 24～48 h） during PCA.Results In group A and group B,the incidences of vomiting at 2 h,4 h and 8 h after operation were reduced significantly compared with group C（P〈0.05）.The incidence of vomiting was reduced significantly in group B compared with group A at 48 h after operation（P〈0.05）.Conclusion The asministration of tropisetron by intravenous injection and PCA pump after operation has better preventive effects in reducing the incidence of postoperative nausea and vomiting during patient-controlled analgesia than other asministrations.