格拉司琼用于小儿静脉镇痛时抗呕吐作用的观察  

Antiemetic Efficacy of Granisetron in Pediatric Patients Undergoing Patient- Controlled Intravenous Analgesia

作　　者：陈依君[1] 尤新民[1] 马家骏[1] 

机构地区：[1]上海第二医科大学新华医院麻醉科,上海200092

出　　处：《上海第二医科大学学报》2005年第9期951-953,共3页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的比较盐酸格拉司琼和氟哌利多在小儿静脉自控镇痛(PCA)时的抗恶心呕吐作用.方法先天性髋关节脱位矫治手术患儿60例,ASA Ⅰ～Ⅱ级,随机分为A、B两组,每组30例,两组均采用芬太尼12 μg/kg,A组另加盐酸格拉司琼(50 μg /kg)和咪唑安定(100 μg /kg),B组另加氟哌利多50 μg /kg.术后4、12、24、48 h观察患儿疼痛、镇静程度评分,同时监测呼吸、心率、血压、脉搏氧饱和度的变化,记录恶心呕吐、锥体外系症状(多汗、肌强直、眼球上翻等)等不良反应.结果两组术后心率、血压、脉搏氧饱和度与术前相比,无统计学差异;两组镇痛效果和恶心呕吐的发生情况无统计学差异(P>0.05);B组有3例(10%)患儿出现较明显的锥体外系症状,与A 组相比,有统计学差异(P<0.05).结论盐酸格拉司琼由于其强效抗呕吐作用和无锥体外系副作用等优点,用于小儿静脉PCA优于氟哌利多,可安全用于小儿手术后镇痛.Objective To compare the antiemetic efficacy of granisetron with droperidol in pediatric patients undergoing patient-controlled intravenous analgesia. Methods Sixty children with congenital dislocation of hip（ASA Ⅰ -Ⅱ ）were allocated randomly into two groups： granisetron group （group A, n = 30） and droperidol group （group B, n = 30）. Group A received fentanyl 12 μg/kg ＋ midazolam 100 μg/kg ＋ granisetron 50 μg/kg and group B received fentanyl 12 μg/kg ＋ droperidol 50 μg/kg. The visual analgesia scale （VAS） and Ramsay （RSS） were assessed at 4,12,24,48 h after operation. Side effects such as nausea, vomiting and extrapyramidal reactions were observed. Results VAS and RSS were not significantly different in the two groups （P 〉 0.05）. But extrapyramidal reactions were increased in group B compared with those in group A （P 〈0.05）. Conclusion The antiemetic efficacy of ganisetron without extrapyramidal reactions of ganisetron make it effective and safe to be used for postoperative intravenous analgesia in pediatric patients.

关 键 词：格拉司琼 抗呕吐 静脉镇痛 小儿 

分 类 号：R726.1[医药卫生—儿科]