昂丹司琼预防剖宫产术后曲马多持续镇痛所致的恶心呕吐被引量：26

Preventive effect of ondansetron on postoperative nausea and vomiting from continuous tramadol analgesia in cesarean patients

暂未订购

导出

摘要目的探讨昂丹司琼不同给药方式对剖宫产术后曲马多持续镇痛所致术后恶心呕吐(PONV)的防治效果。方法 80例腰-硬联合麻醉下行剖宫产手术的产妇随机均分为四组:A组昂丹司琼8mg加入曲马多镇痛泵持续输注;B组昂丹司琼8mg在胎儿娩出后缓慢静注;C组昂丹司琼4mg胎儿娩出后单次静注并4mg镇痛泵持续输注;D组胎儿娩出后静注生理盐水4ml,所有患者均行术后曲马多静脉自控镇痛(PCIA)。观察并记录四组术后1、6、8、12、24h时PONV评分及疼痛VAS评分。结果四组间不同时点疼痛VAS评分差异无统计学意义。术后1、6、8、12、24PONV评分A、B、C组明显低于D组(P<0.01),C组明显低于A、B组(P<0.05);A、B组间差异无统计学意义,与术后6h比较,术后1hA组及术后12、24hA、B后PONV评分明显降低(P<0.05)。结论昂丹司琼可有效预防曲马多术后镇痛引起的恶心呕吐,但在胎儿娩出后单次静注昂丹司琼4mg,并4mg于PCA中持续输注,其预防效果更佳。 Objective To explore the preventive effect of ondansetron administered with different regimen on postoperative nausea and vomiting from continuous tramadol analgesia in cesarean patients. Methods A total of 80 women scheduled for elective cesarean section under combined spinal-epidural anesthesia were randomly divided into four groups with 20 cases each. 8 nag of ondansetron added into tramadol PCIA pump in group A; 8 mg of ondansetron injected i. v. after delivery of the fetus group B; 4 nag of ondansetron i. v. injection plus 4 mg added into the tramadol PCIA pump group C; group D received 4 mlof normal saline after delivery of the fetus. All patients received post-operative pain control with tramadol intravenous PCA. The nausea and vomit and visual analogue pain scale were recorded at 1, 6, 8, 12 and 24 h after operation. Results No significant difference was observed in the pain scales among the four groups. The assessment of nausea and vomiting showed that scorings in the group D was higher than groups A, B and C（P〈0.01）, and in the group C that was lower than the groups A and B （P〈0. 05）, while no difference between the groups A and B. In the groups of A and B, VAS of pain sc0rings at 6 h after operation were higher than that at 12 and 24 h after operation points （P〈0.05）. Conclusion Ondansetron can prevent the incidence of nausea and vomiting during tramadol analgesia, and it would be better when it was given by combining 4 mg i. v. injection after delivery of the fetus and 4 mg into the PCIA pump of trmadol.

作者朱爱兵沈明坤徐志勇

机构地区南京医科大学附属无锡妇幼保健院麻醉科

出处《临床麻醉学杂志》 CAS CSCD 北大核心 2012年第11期1079-1081,共3页 Journal of Clinical Anesthesiology

关键词昂丹司琼曲马多术后恶心呕吐病人静脉自控镇痛剖宫产术 Ondansetron Tramadol Postoperative nausea and vomiting Patient-controlled intravenous analgesia Cesarean delivery

分类号 R614 [医药卫生—麻醉学]

引文网络
相关文献

参考文献8

1Gan TJ, Meyer TA, Apfel CC, et al. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2007, 105 (6) 1615-1628.
2Kovac AL. Prevention and treatment o postoperative nausea and vomiting. Drugs, 2000,59 (2) 213-243.
3Mattia C, Coluzzi F, Sarzi Puttini P, et al. Paracetamol/Tram- adol association., the easy solution for mild-moderate pain. Mi- nerva Med, 2008,99 (4) .. 369-390.
4Herbert MK, Weis R, Holzer P. The enantiomers of tramadol and its major metabolite inhibit peristalsis in the guinea pig small intestine via differential mechanisms. BMC Pharmaeol, 2007,7:5.
5Gan T, Sloan F, Dear Gde L, et al. How much are patients willing to pay to avoid postoperative nausea and vomiting? Anesth Analg, 2001,92 (2) : 393-400.
6White LA, Vanarase M, Brockbank K, et al. Patient-con- trolled analgesia and postoperative nausea and vomiting: effi- cacy of a continuous infusion of ondansetron. Anaesthesia, 2001, 56(4) : 365-369.
7Arcioni R, della Rocca M, Roman6 S, et al. Ondansetron in- hibits the analgesic effects of tramadol., a possible 5-HT (3) spinal receptor involvement in acute pain in humans. Anesth Analg, 2002,94(6) .. 1553-1557.
8Mert T, Gunes Y, Guven M, et al. Differential effects of lido- caine and tramadol on modified nerve impulse by 4-aminopyri- dine in rats. Pharmacology,2003, 69(2) 68-73.