盐酸托烷司琼预防舒芬太尼自控镇痛所致的恶心呕吐的疗效观察

目的:评价盐酸托烷司琼(tropisetron)在妇科手术后应用舒芬太尼自控静脉镇痛(PCIA)技术致恶心、呕吐(PONV)的预防和疗效。方法:选择术后安装止痛泵ASA分级Ⅰ~Ⅱ级的择期妇科手术患者120例,按照随机双盲对照原则分成三组。A组:舒芬太尼药液中加入盐酸托烷司琼5mg 40例患者,B组:舒芬太尼药液中加入氟哌利多5mg 40例患者,C组:舒芬太尼药液(对照组)。于术后2,12,24,48小时定时观察并记录患者的恶心,呕吐发生率;瘙痒,镇静,锥体外系症状的不良反应发生率。结果:患者的PONV发生率A组显著低于B组,B组与A组比较有统计学意义(P<0.01),A组显著低于C组,C组与A组比较有统计学意义(P<0.01);B组镇静,锥体外系反应发生率高于A,C组,有明显的副作用。结论:应用盐酸托烷司琼可有效降低术后舒芬太尼PCIA治疗中恶心、呕吐的发生率,效果优于氟哌利多,而且无明显的副作用。

Effect of Tropisetron to Prevent of Postoperative Nausea and Vomiting Caused by Patient-controlled Intravenous Analgesia (PCIA) with Sufentanil

Objective:To investigate the effect of tropisetron to prevent and treat postoperative nausea and vomiting(PONV) caused by Sufentanil applied in patient-controlled intravenous analgesia(PCIA) in patients undergoing gynecological surgery.Methods:We undertook a randomized,double-blinded,clinical trial.120 ASA Ⅰ~Ⅱ gynecological patients were assigned equally into 3 groups.All patients were installed with pain killer pumps after elective surgery.Patients in group A were treated with sufentanil combined tropisetron 5mg,group B with sufentanil combined droperidol 5mg,and group C with sufentanil only as control.Incidence of nausea and vomiting in 3 groups was observed at 2,12,24 and 48h.At the same time,side effects such as pruritus,degree of sedation and extrapyramidal symptoms resulted from experimental drugs were also included.Results:Significantly less number of patients required PONV in Group A than in group B(P<0.01),while incidence of PONV in group A is significantly less than in Group C(P<0.01).And the rate of sedation and extrapyramidal symptoms in group B was the highest.Conclusion:Compared to droperidol,tropisetron was associated with a significantly lower incidence of PONV caused by PCIA with sufentanil,what is more,it caused less serious adverse effects.