格拉司琼用于硬膜外自控镇痛复合液对术后恶心呕吐及镇痛效能的影响  

The Antiemetic and Analgesic effects of Granisetron Administered Via Patient-Controlled Epidural Analgesia

作　　者：董击夫[1] 唐育民[1] 王志仪[1] 

机构地区：[1]四川省肿瘤医院麻醉科,四川成都610041

出　　处：《四川肿瘤防治》2006年第2期97-99,103,共4页Sichuan Journal of Cancer Control

摘　　要：目的:观察格拉司琼应用于术后硬膜外自控镇痛(PCEA)复合液中,对恶心呕吐的影响及对PCEA 镇痛效能的影响。方法:选择75例ASA Ⅰ-Ⅱ级、年龄23岁-62岁的妇科择期手术患者,随机分为格拉司琼硬膜外组(GE组)、格拉司琼静脉组(GV组)及对照组(C组)等3个组,每组25例。硬膜外麻醉平面维持在T4以下,术毕行PCEA。分别于术后4小时、8小时、12小时、24小时和48小时采用VAS对镇痛效能进行评分。于术后 0小时-3小时、3小时-24小时、24小时-48小时三个时段记录病人48小时内的恶心呕吐情况。结果:三组患者镇痛作用于各观察时点的VAS评分均相似,评级均为优。术后24小时内GE组与GV组的止吐显效率与呕吐发生率十分相似,无统计学差异(P>0．05),此时段内GE组与GV组止吐效果均明显优于对照组(P<0．05)。术后 24小时-48小时,GE组仍有较高止吐效果,明显高于同期GV组(P<0．05),而此时段GV组与对照组相比均无明显差异(P>0．05)。结论:格拉司琼用于PCEA复合液并不影响PCEA的镇痛效能,其止吐作用与静脉应用相似且作用时间更长、更平稳。Objective： To evaluate the antiemetie and analgesic effects of granisetron administered via patient-controlled epidural analgesia（PCEA）. Methods： 75 patients（aged 23-62 years with ASA Ⅰ～Ⅱ ） scheduled for radical hysterectomy under epidural anesthesia were randomized into 3 groups （25 cases each）. All patients received standard operation and epidural anesthesia with analgesic plane maintained below T4. After surgery all patients received basic PCEA which consisted of 0. 2% ropivacaine and morphine 0.2mg/ml. Group GE received 0. 02% granisetron via basic PCEA, group GV received basic PCEA and immediate intravenous granisetron 3rag and group C received basic PCEA alone. Results： The Changes of VAS in each of the observe time point were not singnifieantly different between the 3 groups（ P 〉 0. 05 ）. Within the first 24 hours, there were no singnificant ditterents（ P 〉 0. 05 ） between the CR rates in group GE and Group GV, but they were singnificantly higher than that in group C （ P 〈 0. 05 ）. During the second 24 hours, antiemetic effect was maintained in group GE, but not in other two groups（P 〈 0. 05）. Meanwhile no singnificant differences in CR rates were found bwtewwn group GV and group C （ P 〉 0.05）. Conclusion： Epidural administration of granisetron has more powerful antiemetic efficacy and lasting longer than intravenous and dose not effect the analgesic efficacy of PECA.

关 键 词：格拉司琼 硬膜外 术后镇痛 恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]