昂丹司琼与格拉司琼预防心脏手术后恶心呕吐的随机对照研究

目的探讨预防心脏手术后恶心呕吐（PONV）的方法，对比研究昂丹司琼和格拉司琼对心脏PONV的影响。方法选择气管内插管全身麻醉下行心脏手术的患者90例，随机分成三组，每组各30例。以双盲方式按下述方法给药：Ⅰ组麻醉诱导前静脉注射昂丹司琼4mg（溶于0．9％NaCl溶液20ml）；Ⅱ组麻醉诱导前静脉注射格拉司琼3mg（溶于0．9％NaCl溶液20m1）；Ⅲ组麻醉诱导前静脉注射0．9％NaCl溶液20m。术后12、24h观察记录患者的PONV程度并进行比较。结果Ⅰ组术后12hPONV发生率为20．0％（6／30），术后24h发生率为26．7％（8，30）；Ⅱ组术后12hPONV发生率为20．0％（6／30），术后24h发生率为23．3％（7，30）；Ⅲ组术后12hPONV发生率为72．4％（21／29），术后24h发生率为79．3％（23／29）。Ⅰ、Ⅱ组术后12、24hPONV发生率显著低于Ⅲ组（P〈0．01），Ⅰ组和Ⅱ组比较差异无统计学意义（P〉0．05）。结论昂丹司琼和格拉司琼对预防心脏PONV均有较好效果，均能有效地降低心脏PONV的发生率，利于患者恢复。

Randomized,controlled trial of prevention of postoperative nausea and vomiting with ondansetron or granisetron in patients undergoing cardiac surgery

Objective To compare the effect of ondansetron and granisetron on preventing postoperative nausea and vomiting （PONV） after cardiac surgery. Methods Ninety patients （30 cases in each of three groups） who underwent cardiac surgery under general anesthesia with endotracheal intubation were enrolled in this randomized and double-blinded study. Group Ⅰ received ondansetron 4 mg （in normal saline 20 ml）at the beginning of anesthesia. GroupⅡ received granisetron 3 mg （in normal saline 20 ml） at the beginning of anesthesia. Group Ⅲ received normal saline 20 ml at the beginning of anesthesia. PONV episodes were recorded at 12 and 24 hours after surgery. Results The incidences of PONV at 12 and 24 hours after surgery in group Ⅰ 20.0%（6/30）, 26.7%（8/30）] and group Ⅱ 20.0%（6/30）, 23.3%（7/30）] were significantly lower than those in group Ⅲ 72.4%（21/29）, 79.3%（23/29） ] （P〈 0.01 ）. No significant differences were observed in the terms of complete inhibition rate of PONV between group Ⅰ and group Ⅱ （P 〉0.05）. Conclusions Both ondansetron and granisetron have significant effect on reducing the incidence of PONV after cardiac surgery. Intravenous ondansetron （4 mg） or granisetron （3 mg） before anesthesia induction can prevent PONV with similar efficacy and safety.