盐酸托烷司琼预防术后病人自控镇痛恶心呕吐的临床观察  

Clinical observation of the effects of tropisetron on prevention of nausea and vomiting in postoperative patients with PCA

作　　者：丁炜[1] 施伟[1] 庞科娜[1] 

机构地区：[1]杭州师范学院临床医学院,浙江杭州310036

出　　处：《杭州师范学院学报（医学版）》2006年第5期314-316,共3页Journal of Hangzhou Teachers College :Medical Edition

摘　　要：目的探讨不同止吐药预防术后吗啡静脉PCA恶心呕吐的效果。方法60例全麻下择期手术患者,随机分为三组:PCA用药均为吗啡(2mg/m l),Ⅰ组为对照组,Ⅱ组为吗啡药液中加入氟哌啶(0.05mg/m l),Ⅲ组在麻醉诱导时静注盐酸托烷司琼5mg。记录术后12、24、48h吗啡用量、疼痛评分、恶心、呕吐、镇静评分。结果Ⅲ组患者恶心和呕吐发生率显著低于Ⅰ组(P<0.05),但Ⅱ组和Ⅰ组间无显著性差异(P>0.05)。三组间吗啡用量和VAS评分无显著性(P>0.05)。结论静脉注射盐酸托烷司琼能有效地降低术后PCA治疗中恶心、呕吐的发生率,其效果优于氟哌啶。Objective To explore the effect of different prophylactic antiemetics on prevention of nausea and vomiting in postoperative patients with PCA. Methods 60 patients （ ASA Ⅰ - Ⅱ ） who underwent elective abdominal operations under general anesthesia were divided randomly into 3 groups： in Group I patients received patient-controlled analgesia （PCA） with morphine alone （2mg/ ml） as control; in Group Ⅱ patients received PCA with a mixture of morphine （2rag/ ml） and droperidol （0.05mg/ ml） ; in Group Ⅲ patients were administered 5mg tropisetron intravenously at induction of anesthesia and received PCA with morphine alone （2mg/ml） after operation. The scores for nausea, vomiting , pain, sedation and visual analogue scale （VAS） were evaluated at 4 , 8 , 12 , 24 , 48 hrs postoperatively. There was no difference bctween the groups at any time in the amount of morphine consumed or in pain scores. ResuIts The incidence of nausea and vomiting in the Group III was lower than that in the Group Ⅰ （ P 〈 0. 05） , whereas, the incidence of nausea and vomiting in the Group Ⅰ was similar to that in the Group Ⅱ （ P 〉 0. 05 ）. There were no differences of the consumed morphine amount and VAS among the three groups. Conclusion Intravenous tropisetron administration in postoperative patients receiving PCA can reduce the incidence of nausea and vomiting and its effect is better than that of droperidol.

关 键 词：术后镇痛 病人自控镇痛(PCA) 抗恶心呕吐药 氟哌啶 盐酸托烷司琼 

分 类 号：R971.2[医药卫生—药品]