| 透皮东莨菪碱贴剂联合昂丹司琼对比单独应用昂丹司琼用于预防门诊手术后恶心呕吐的一项随机双盲多中心研究 |
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| 引用本文： | Tong J. Gan,MD,Ashish C. Sinha,MD, PhD,Anthony L. Kovac,MD,R. Kevin Jones,MD, CPI,Stephen A.Cohen,MD,MBA,Jean P. Battildaa,MS,Jonathan S. Deutsch,MD,Joseph V. Pergolizzi,Jr., MD],TDS Study Group,王琦[译],李文志[校].透皮东莨菪碱贴剂联合昂丹司琼对比单独应用昂丹司琼用于预防门诊手术后恶心呕吐的一项随机双盲多中心研究[J].麻醉与镇痛,2010(5):34-40. |
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| 作者姓名： | Tong J. Gan MD Ashish C. Sinha MD PhD Anthony L. Kovac MD R. Kevin Jones MD CPI Stephen A.Cohen MD MBA Jean P. Battildaa MS Jonathan S. Deutsch MD Joseph V. Pergolizzi Jr. MD] TDS Study Group 王琦[译] 李文志[校] |
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| 作者单位： | [1]Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina [2]University of Pennsylvania, Philadelphia, Pennsylvania; ＊University of Kansas Medical Center, Kansas City, Kansas [3]Accurate Clinical Trials Inc./Saddleback Memorial Medical Center, Laguna Hills, California [4]Beth Israel Deaconess Medical Center, Boston, Massachusetts [5]Baxter Healthcare Corporation, New Providence, New Jersey [6]Departrnent of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland [7]The TDS Study Group consists of the following members： Gregory H. Adkisson （St. Agnes Healthcare Inc., Baltimore, MD, St. Agnes Healthcare Inc. Clinical Research Center, Baltimore, MD）, I（eith Candiotti（University of Miami School of Medidne, Jackson Health Systems, Miami, FL）, Stephen ＆ Cohen（Beth Israel Deaconess Medical Center, Boston, MA）, Nell R. Connelly（Baystate Medical Center, Springfield, MA）, Patricia L. Dalby（Magee Women＇s Hospital of UPMC, Pittsburgh, PA）, Robert D＇Angelo（Forsyth Medical Center, Winston-Salem, NC）, Albert R. Davis（Loyola University Medical Center, Chicago, IL）, David 1L Drover （Stanford Hospital and Clinics, Stanford, CA）, Tong J. Gan, Fernando Altermatt, Dianne Scott（Duke University Medical Center, Durham, NC, Duke Health Raleigh Hospital, Raleigh, NC, and Duke Center for Aesthetic Services, Durham, NC）, Joseph S. Gimbel（AZ Research Center, John C. Lincoln Hospital, North Mountain, and John C. Lincoln Hospital, Deer Valley, Phoenix, AZ）,R.Kevin Jones （Saddleback Memorial Medical Center, Laguna Hills, CA）, Anthony L. Kovac（University of Kansas Medical Center, Kansas City, Kansas, KS）, John B. Leslie（Mayo Clinic Hospital, Phoenix, AZ）, Roberta McI（inney, Jr. （Trinity Clinic, North Park, Mother Frances Hospital, and Tyler Square, Tyler, TX）, Tricia A. Meyer （ Scott and White Hospital, Temple, TX ）, Joseph Pergolizzi （Physicians Day Surgery Center, Naples, FL）, Beverly tC Philip （Brigham and Women＇s Hospital, Boston, MA）, Martin I. Redmond（State University of New York at Stony Brook Ambulatory Surgical Center, Stony Brook, NY）, Denise A. Scaringe （Cooper University Hospital, Camden, NJ, Cooper Surgery Center, Voorhees, NJ）, Ashish C. Sinha（Hospital of the University of Pennsylvania, Philadelphia, PA）, Jeffrey M. Varga（The Western Pennsylvania Hospital-Forbes Regional Campus, Monroeville, PA）, Eugene R Viscusi （Thomas Jefferson University Hospital and Jefferson Surgical Center, Philadelphia, PA）, Elliott C. Wohlner （St. Anthony Central Hospital, Denver, CO）, and Mark C. Ziegler （Mercy Hospital Anderson and Mercy Anderson Ambulatory Surgery Center, Cincinnati, OH） [8]不详, Baltimore, MD, St. Agnes Healthcare Inc. Clinical Research Center, Baltimore, MD）, I（eith Candiotti（University of Miami School of Medidne, Jackson Health Systems, Miami, FL）, Stephen ＆ Cohen（Beth Israel Deaconess Medical Center, Boston, MA）, Nell R. Connelly（Baystate Medical Center, Springfield, MA）, Patricia L. Dalby（Magee Women＇s Hospital of UPMC, Pittsburgh, PA）, Robert D＇Angelo（Forsyth Medical Center, Winston-Salem, NC）, Albert R. Davis（Loyola University Medical Center, Chicago, IL）, David 1L Drover （Stanford Hospital and Clinics, Stanford, CA）, Tong J. Gan, Fernando Altermatt, Dianne Scott（Duke University Medical Center, Durham, NC, Duke Health Raleigh Hospital, Raleigh, NC, and Duke Center for Aesthetic Services, Durham, NC）, Joseph S. Gimbel（AZ Research Center, John C. Lincoln Hospital, North Mountain, and John C. Lincoln Hospital, Deer Valley, Phoenix, AZ）,R.Kevin Jones （Saddleback Memorial Medical Center, Laguna Hills, CA）, Anthony L. Kovac（University of Kansas Medical Center, Kansas City, Kansas, KS）, John B. Leslie（Mayo Clinic Hospital, Phoenix, AZ）, Roberta McI（inney, Jr. （Trinity Clinic, North Park, Mother Frances Hospital, and Tyler Square, Tyler, TX）, Tricia A. Meyer （ Scott and White Hospital, Temple, TX ）, Joseph Pergolizzi （Physicians Day Surgery Center, Naples, FL）, Beverly tC Philip （Brigham and Women＇s Hospital, Boston, MA）, Martin I. Redmond（State University of New York at Stony Brook Ambulatory Surgical Center, Stony Brook, NY）, Denise A. Scaringe （Cooper University Hospital, Camden, NJ, Cooper Surgery Center, Voorhees, NJ）, Ashish C. Sinha（Hospital of the University of Pennsylvania, Philadelphia, PA）, Jeffrey M. Varga（The Western Pennsylvania Hospital-Forbes Regional Campus, Monroeville, PA）, Eugene R Viscusi （Thomas Jefferson University Hospital and Jefferson Surgical Center, Philadelphia, PA）, Elliott C. Wohlner （St. Anthony Central Hospital, Denver, CO）, and Mark C. Ziegler （Mercy Hospital Anderson and Mercy Anderson Ambulatory Surgery Center, Cincinnati, OH） |
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| 基金项目： | 致谢本文作者感谢EverlyMacario就此发表了社论综述. |
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| 摘 要： | 背景手术后恶心、呕吐（PONV）是门诊手术常见的并发症。本试验目的是观察透皮东莨菪碱贴剂（TDS）联合静脉注射昂丹司琼（OND）对门诊患者PONV的疗效是否优于单独应用昂丹司琼。方法此项随机双盲多中心的临床试验纳入了620例接受门诊腹腔镜或隆胸手术的PONV高危女性患者，进入手术室前2小时分别给患者贴上TDS贴剂或外观相同的空白贴剂。在全麻诱导前2—5分钟给所有患者静脉注射OND4mg。手术后24~48小时评估止吐是否完善（彻底止吐标准为无呕吐或干呕，且没有追加止吐药）。同时记录发生呕吐、干呕、恶心以及追加止吐药的患者比例，记录手术后首次发生PONV的时间及离院时间，记录呕吐、干呕、恶心的发作次数与严重程度及患者对于止吐治疗的满意度。结果TDS＋OND组与OND组相比，手术后24小时恶心、呕吐的发生率显著降低，但手术后48小时两者差异无显著性。TDS＋OND组没有呕吐、干呕且未追加过止吐药的患者占48％，而OND组占39％（P〈0．02）。TDS＋OND组的彻底止吐（无恶心、呕吐或干呕，且未追加止吐药）率显著高于OND组（分别为35％和25％，P〈0．01）。TDS＋OND组手术后首次发生恶心、呕吐、干呕及追加止吐药的时间明显晚于OND组（P〈0．05）。前者不良反应的总发生率也低于后者（分别为36．7％和49％，P〈0．01）。结论与单独应用OND相比。TDS＋OND能更大程度地减少PONV，主要是通过减少不良反应而获得。
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| 关 键 词： | 手术后恶心呕吐 东莨菪碱贴剂 多中心研究 昂丹司琼 门诊手术 随机双盲 应用 单独 |
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