盐酸帕洛诺司琼预防硬膜外自控镇痛所致恶心呕吐的分析

【摘要】　目的 观察盐酸帕洛诺司琼预防术后硬膜外腔自控镇痛引起恶心呕吐副作用的效果。方法 选取择期硬膜外麻醉下开腹胆囊切除术后施行硬膜外腔自控镇痛(PCEA)的患者60例,PCEA采用吗啡6 mg+0.125%布比卡因混合液(100 mL)。将患者分为盐酸帕洛诺司琼组,氟哌啶组和对照组(每20例),在术前静脉给予盐酸帕洛诺司琼0.25 mg,氟哌啶2.5 mg和生理盐水100 mL。术后记录使用PCEA镇痛期间的恶心例数及其严重程度;呕吐例数及次数;出现呕吐后给予胃复安,非那根,地塞米松等药物止吐的控制率。结果 对照组13例出现Ⅰ~Ⅲ级恶心呕吐的不良反应,盐酸帕洛诺司琼组患者1例1级恶心呕吐的发生,与其他两组相比P<0.001;氟哌啶组出现5例Ⅰ~Ⅱ级恶心呕吐的,与对照组相比P=0.022。结论 术前预防性给予盐酸帕洛诺司琼可显著降低胆囊切除术后PCEA引起恶心呕吐副作用的发生。

Analysis of the effects of palonosetron hydrochloride on preventing nausea and vomiting caused by PCEA

Objective To observe the effect of palonosetron hydrochloride on preventing post-operative nausea and vomiting （PONV） in patients treated with patient-controlled epidural analgesia （PCEA）. Methods Sixty patients who had cholecystectomy under epidural anesthesia were randomly assigned into group C （palonosetron group,n =20）,.group B. （droperidol group,n =20）.or group A （control group,n=20）..Before operations,.0.25 mg of palonosetron hydrochloride ,.2.5 mg of droperidol or 100 mL of saline was intravenously administered to patients in group C ,.group B or group C,. respectively..5 mg of morphine plus 0.125% of bupivacaine in 100 mL of saline was used for PCEA. . During the period of PCEA,.the incidence and severity of nausea and vomiting were recorded ,.and when vomiting occurred,.the efficacy was evaluated after administrating antiemetics..Results The number of patients who had nausea and vomiting in group A , group B and group C was 13, 5 and one respectively. PONV incidence in group C was lower than that in group B or group A （P0.001）. There was significant difference between group B and group A （P=0.022）..Conclusion Preoperative administration of palonosetron hydrochloride can significantly decrease the incidence of PONV induced by PCEA in patients undergoing cholecystectomy.