昂丹司琼对蛛网膜下腔使用吗啡导致的皮肤瘙痒的预防作用  

Efficacy of Prophylactic Administration of Ondansetron for the Preveution of Intrathecal Morphine-induced Pruritus

作　　者：王丽秋[1] 郭亚忠[1] 陶玉娟 

机构地区：[1]鸡西矿业集团总医院麻醉科,黑龙江鸡西158100 [2]哈尔滨骨伤科医院

出　　处：《中国伤残医学》2009年第4期11-12,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:本随机、双盲、对照、前瞻研究的目的旨在了解昂丹司琼对蛛网膜下腔使用吗啡导致的皮肤瘙痒是否具有预防作用。方法选择70例拟在腰麻下行开腹全宫切除术或子宫肌瘤剔除术的ASAI-II级成年患者,分为2组:昂丹司琼组(O组)患者于腰麻前30分钟给予静脉注射昂丹司琼4mg;对照组(C组)患者在相同时间点静脉注射等体积生理盐水。于患者到达恢复室、术后2、4、8及24小时评价患者的皮肤瘙痒程度、静息VAS评分,并在两组之间进行比较,p<0.05为差异有统计学意义。结果:O组患者术后皮肤瘙痒总发生率及术后8h之内的各记录时间点的皮肤瘙痒程度显著低于C组患者(P<0.01)。严重的,需要药物治疗的皮肤瘙痒只发生于C组患者(11%)。两组患者术后各观察时间点的VAS评分之和无显著差异。结论:给予蛛网膜下腔应用吗啡的患者预先使用昂丹司琼可有效的降低术后皮肤瘙痒的发生率和严重程度,同时并未影响蛛网膜下腔应用吗啡的镇痛效果。Objectives：This prospective, randomized, double-- blind, placebo-- controlled study, we evaluated the efficacy of prophylactic administration of ondansetron for the prevention of intrathecal morphine--induced pruritus. Methods： 70 ASA physical status I--II patients undergoing elective transabdominal hysterectomy or myomectomy were randomized into two groups to receive either 4 mg ondansetron IV （group O） or 2 ml normal saline （group C） 30 min before intrathecal administration of 0. 25 mg morphine. Patients were evaluated for incidence and severity of pruritus, rest VAS scores at arrival to the postanesthesia care unit and at 2, 4, 8, and 24 h postoperatively. P〈0. 05 was considered significant. Results： The incidence of pruritus was significantly less frequent in the ondansetron groups compared with placebo （P〈0. 01） . Patients who received 5-HT3 antagonist reported significantly less total severity of pruritus compared with placebo during the first 8 h and the severe pruritus was observed only in patients within C group. Conclusion：We concluded that the prophylactic use of ondansetron helps to reduce the incidence and severity of intrathecal morphine--induced pruritus without affecting pain relief.

关 键 词：皮肤瘙痒 吗啡 昂丹司琼 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]