托烷司琼预防吗啡静脉自控镇痛恶心呕吐的临床观察

目的：探讨不同剂量托烷司琼预防手术后吗啡静脉自控镇痛（PCIA）期间恶心呕吐的效果。方法：择期妇产科手术患者120例,根据镇痛配方不同随机双盲分成A组,吗啡40mg;B组,吗啡40 mg加氟哌利多5 mg;C组,吗啡40 mg加托烷司琼2.5 mg;D组,吗啡40 mg加托烷司琼5 mg,每组各30例,各组配方容量均用生理盐水稀释至为100 mL。术后接1次性微量泵行PCIA48 h。观察术后6、12、24和48 h的镇痛效果和恶心呕吐的发生情况以及不良作用的发生情况。结果：4组病例年龄、体重和手术时间及镇痛效果无统计学差异（P＆gt;0.05）。B、C、D组的恶心、呕吐的发生率显著低于A组,C组不良反应的发生率低于B、D组。结论：托烷司琼能安全、有效地预防术后病人吗啡静脉自控镇痛引起的恶心、呕吐,小剂量托烷司琼（2.5 mg）的副作用更小。

Effect of Tropisetron on Nausea and Vomiting During Patient Controlled Intravenous Analgesia with Morphine

Objective：To investigate the effects of Tropisetron with different administrations on postoperative nausea and vomiting（PONV） during patient-controlled intravenous analgesia with Morphine after abdominal surgery.Methods：120 cases of ASA I-Ⅱelective abdominal surgery were randomly divided into four groups： Morphine group（groupA）,group Dropridol（groupB）,group Tropisetron of 2.5mg（groupC）,group Tropisetron of 5mg（groupD）.The efficacy of analgesia and the numbers of patients with PONV,the scores of PONV and side effects in 6,12,24,48hrs after PCIA were investigated respectiveL Results：In groups B , C and D, the incidence of nausea and vomiting was significantly lower than in group A , especially in group D （ P 〈 0. 01 ）. Condusions：Tropisetron can safely and effecfly prevent PONV in PCIA with Morphine. Tropisetron of 2. 5mg had less side effects.