不同剂量托烷司琼预防术后患者自控镇痛相关恶心呕吐的效果观察  

Effects of Tropisetron on Postoperative Nausea and Vomiting Related to Patient-controlled Intravenous Analgesia with Tramadol

作　　者：柳杰铭[1] 邬海苏[1] 

机构地区：[1]浙江省肿瘤医院ICU,浙江省杭州市310022

出　　处：《中国全科医学》2009年第12期1103-1104,共2页Chinese General Practice

摘　　要：目的观察托烷司琼对曲马多术后静脉自控镇痛相关恶心、呕吐的防治作用。方法选择腹部外科手术且接受术后曲马多静脉自控镇痛患者300例,随机分为3组,每组100例。A组在镇痛泵中加用托烷司琼5mg,B组加用托烷司琼10mg,C组加用0.9%氯化钠溶液作为对照。观察各组术后24h内的恶心、呕吐发生情况。结果A、B、C3组患者术后发生恶心的例数分别为8、5、79例,术后发生呕吐的例数分别为8、6、63例;术后恶心程度评分为0、1、2、3分的患者A组分别为92、3、3、2例;B组分别为95、3、1、1例;C组分别为21、22、20、37例。术后呕吐程度评分为0、1、2、3分的患者A组分别为92、3、2、3例;B组分别为94、2、2、6例;C组分别为37、28、22、13例。A、B组患者术后恶心、呕吐的发生率及发生程度间差别无统计学意义(P>0.05);C组与A、B组患者术后恶心、呕吐的发生率及发生程度间差别均有统计学意义(P<0.05)。结论使用5mg或10mg托烷司琼对于全麻腹部术后静脉自控镇痛所引起的恶心、呕吐均较单用曲马多有较好的防治作用,是一种经济、有效、安全的止吐方法。Objective To investigate the effects of tropisetron on postoperative nausea and vomiting(PONV) related to patient-controlled intravenous analgesia(PCIA) with tramadol.Methods Three hundred patients experienced abdominal surgery were divided randomly into 3 groups,100 in each.Group A received 5 mg tropisetron to prevent PONV,Group B 10 mg tropisetron,Group C normal sodium(control group).PONV was observed within 24 h after operation.Results Groups A,B,C confronted with postoperative nausea(8,5,79 cases,respectively),and with vomiting(8,6,63,respectively).In Group A the number of patients gaining 0,1,2,3 scores of postoperative nausea degree were 92,3,3,2 respectively,in Group B 95,3,1,1,respectively,and in Group C 21,22,20,37,respectively.In Group A,the numbers of patients scored 0,1,2,3 of postoperative vomiting degree were 92,3,2,3,respectively;in Group B 94,2,2,6,respectively,and in Group C 37,28,22,13,respectively.There was not significant difference in incident and degree of nausea and vomiting between Groups A and B(P>0.05),but Group C different from Groups A,B(P<0.05).Conclusion Use of 5 mg or 10 mg tropisetron,which is superior to single use of tramadol in control of PONV caused by PCIA,is one of antiemetic approschs,economic,effective and worthy of popularization.

关 键 词：托烷司琼 曲马多 手术后恶心呕吐 镇痛 病人控制 

分 类 号：R614.2[医药卫生—麻醉学]