摘要
目的比较托烷司琼的不同给药方式对术后曲马多静脉自控镇痛患者恶心、呕吐的预防作用。方法选择气管内全麻下择期腹部手术患者240例,ASAⅠ或Ⅱ级,随机均分为四组。Ⅰ组术毕静脉连接患者自控镇痛(PCA)泵;Ⅱ组术毕静注5mg托烷司琼后连接PCA泵;Ⅲ组术毕静注2mg托烷司琼后连接PCA泵(PCA泵内加托烷司琼3mg);Ⅳ组术毕连接PCA泵(PCA泵内加托烷司琼5mg)。PCA泵药物配制:900mg曲马多加生理盐水配至总容量为100ml。分别于术后2、4、8、20、36和48h观察患者恶心、呕吐的发生情况。结果(1)与Ⅰ组比较,Ⅱ组和Ⅲ组在术后2、4h恶心的发生率明显降低(P<0.05);与Ⅳ组比较,Ⅱ组和Ⅲ组术后2、4和8h恶心的发生率明显降低(P<0.05或P<0.01)。(2)与Ⅰ组比较,Ⅱ组在术后2、4、8和36h呕吐的发生率明显降低(P<0.05);Ⅲ组在术后2、4、8、36和48h呕吐的发生率明显降低(P<0.05);与Ⅱ组比较,Ⅲ组在术后48h呕吐的发生率明显降低(P<0.05);Ⅳ组在术后2、4、8h呕吐的发生率明显高于Ⅱ组(P<0.05);Ⅲ组在术后2、4和48h呕吐的发生率明显低于Ⅳ组(P<0.05)。结论术毕单次注射2mg托烷司琼,并通过PCA泵持续输注可在术后48h内有效预防恶心、呕吐的发生;术毕单次注射5mg托烷司琼,术后短时间内可预防恶心、呕吐,但术后48h已无此作用;而通过PCA泵中持续输注5mg托烷司琼不能预防恶心、呕吐。
Objective To evaluate the different methods of administering tropisetron in patientcontrolled analgesia（PCA） with tramadol in the prevention of postoperative nausea and vomiting. Methods Two hundred and forty ASA class Ⅰ or Ⅱ patients scheduled for selective abdominal surgery under general anesthesia were enrolled in this study. At the end of surgery, all patients received PCA with tramadol （9 mg/ml,bolus dose 18 mg, continuous dose 9 mg/h and lockout interval 15 min）. The patients were randomly divided into 4 groups with 60 cases each. Before commencement of PCA, the patients received no tropisetron （group Ⅰ ）, tropisetron 5 mg immediately（group Ⅱ ）, tropisetron 2 mg immediately and tropisetron 3 mg in PCA pump（group Ⅲ ）, and tropisetron 5 mg in PCA pump（group Ⅳ）. Incidence of nausea and vomiting and side effects were recorded at 2, 4, 8, 36 and 48 h after operation. Results （1）In group Ⅱ and group Ⅲ ,the incidences of nausea were reduced significantly compared with those in group Ⅰ （P〈0. 05）. （2） In group Ⅱ and group Ⅲ, the incidences of vomiting were reduced significantly compared with those in group I at 2, 4, 8 and 36 h（P〈0. 05）. In addition, the incidence of vomiting was reduced significantly in group Ⅲ compared with that in group Ⅱ at 48 h（P〈 0.05）. Conclusion The strategy of intravenous tropisetron 2 mg after the surgery and 3 mg in PCA pump is better than that of intravenous tropisetron 5 mg in reducing the incidence of PONV associated with the use of PCA tramadol. Tropisetron 5 mg given in PCA pump could not prevent postoperative nausea and vomiting.
出处
《临床麻醉学杂志》
CAS
CSCD
2007年第6期454-456,共3页
Journal of Clinical Anesthesiology
关键词
托烷司琼
术后镇痛
恶心
呕吐
Tropisetron
Postoperative analgesia
Nausea
Vomiting
