托烷司琼与昂丹司琼预防单髋关节置换患者术后恶心呕吐的比较

目的:比较不同剂量托烷司琼和昂丹司琼在预防术后恶心呕吐(PONV)发生的效果,为临床应用提供参考。方法:选择单髋关节置换术患者178例,18~65岁,ASAⅠ或Ⅱ,随机分为4组。术毕均使用患者自控静脉镇痛(PCIA),PCIA药物配方为舒芬太尼2μg·kg-1+氟比洛芬酯4 mg·kg-1(最大至300 mg),加生理盐水至100 m L。其中,泵中止吐药方案,A组:托烷司琼10 mg,B组:托烷司琼15 mg,C组:昂丹司琼12 mg,D组:昂丹司琼16 mg。分别于6、12、24、48 h观察患者恶心、呕吐及相关并发症的发生情况。结果:术后6 h内,A组和B组呕吐发生率及呕吐程度明显低于C组;术后6~12 h内,A组恶心发生率明显低于C组和D组,A组呕吐发生率和呕吐程度明显低于C组(P<0.05)。结论:在单髋关节置换术后PCIA泵中持续输注托烷司琼10 mg可有效预防恶心呕吐。

Comparison of tropisetron and ondansetron for the prevention of postoperative nausea and vomiting (PONV) after single hip replacement surgery

OBJECTIVE To compare the effects of different doses of tropisetron and ondansetron in preventing postoperative nausea and vomiting (PONV). METHODS Totally 178 patients (aged 18-65 years old, American Society of Anesthesiologists (ASA) Ⅰ or Ⅱ) were scheduled for hip replacement. All patients were randomly divided into four groups. The scheme of PCIA was sufentanil 2 μg·kg^-1 + flurbiprofen 4 mg·kg^-1 (the maximum was 300 mg) + normal saline to 100 mL. The antiemetic of group A was tropisetron 10mg, group B was 15 mg, group C was ondansetron 12 mg, and group D was ondansetron 16 mg. The incidences of nausea, vomiting and other side effects were collected at postoperative 6 h, 12 h, 24 h, 48 h.RESULTS The incidence of nausea and the degree of vomiting were significantly higher in the group C than group A and group B at 0 6 hours after surgery. And the incidence of nausea was significantly lower in the group A than group C and group D, the incidence and degree of vomiting in group A were also lower than group C at 6 12 hours after surgery (P<0.05).CONCLUSION Postoperative patient-controlled intravenous analgesia (PCIA) with sufentanil 2 μg·kg^-1 combined with tropisetron 10 mg can achieve satisfactory incidence of PONV.