托烷司琼复合氟哌啶醇与托烷司琼单用预防术后恶心呕吐的比较  

Tropisetron plus haloperidol versus tropisetron alone for prophylaxis of postoperative nausea and vomiting

作　　者：黎阳[1] 王建波[1] 

机构地区：[1]天津市第三医院麻醉科,300250

出　　处：《实用医学杂志》2011年第15期2817-2820,共4页The Journal of Practical Medicine

摘　　要：目的:比较托烷司琼复合氟哌啶醇与单独使用托烷司琼预防术后恶心呕吐(PONV)的效果。方法:选择全身麻醉下行上腹部手术患者266例,随机分为托烷司琼组(T组)和托烷司琼复合氟哌啶醇组(T+H组)。采用随机双盲法于手术结束前30min给每位受试者静脉注射托烷司琼2mg和试验用药1mL(可能是1mg氟哌啶醇或1mL生理盐水),术后采用视觉模拟评分法(VAS)评估PONV程度。手术结束后记录恶心、干呕、呕吐和两组止吐药物治疗的情况,同时记录有无烦躁、谵妄、肌张力障碍、不能静坐和锥体外系反应。结果:术后恶心发生率T组37.6%,T+H组12.0%,T+H组明显低于T组(P<0.05);术后呕吐或干呕的发生率T组11.3%,T+H组4.5%,T+H组明显低于T组(P<0.05)。T+H组预防PONV的疗效明显高于T组(P<0.05),只有少数恶心患者需给予止吐药物治疗。两组手术前后Q-T间期差异无统计学意义,两组中均未出现烦躁、谵妄、肌张力障碍、不能静坐和锥体外系反应患者。结论:托烷司琼复合氟哌啶醇对于预防PONV的效果和时程明显优于单独使用托烷司琼,且不增加不良反应的发生率。Objective Postoperative nausea and vomiting are observed in creased frequency after abdominal surgery. This study was performed to compare the efficacy of tropisetron 2 mg plus haloperidol ling with tropisetron alone to prevent postoperative nausea and vomiting after epigastric surgery. Methods 266 adults undergoing general anesthesia received 2 mg tropisetron plus ling haloperidol or tropisetron intravenously injection in this randomized, double-blind protocol. Tropisetron plus haloperidol or tropisetron was administered about 30 minutes before the end of surgery. Efficacy and safety date were obtained until 8 hours after postanesthesia care unit （PACU） entry. At PACU entry and every 30 minutes until discharge, the recorded nausea was evaluated （11 point visual analogue scale, 0 = ＂none＂, 10 = ＂worst possible＂）, retching or vomiting, and rescue treatment. The medieation-relateed side effects were recorded. Results The incidences of postoperative nausea in the T ＋ H group （12.0%） were significantly lower than those in the T group （37.6%, P 〈 0.05）. The incidences of postoperative emesis or retching in the T ＋ H group （4.5%） were significantly lower than those in the T group （11.3%, P 〈 0.05）. The combination had more complete responders （78.5% vs 62.3%）, less nausea, less rescue, and longer time to rescue. Sedation, time to postanesthesia care unit discharge, and Q-Tc prolongation were no difference. No subject had dystonia, akathisia, or occurrence ofexta-pyramidal symptoms. Conclusion Preventing postoperative nausea and vomiting with tropisetron plus haloperidol is more effective than tropisetron alone. There is no side effects.

关 键 词：手术后恶心呕吐 托烷司琼 氟哌啶醇 

分 类 号：R614[医药卫生—麻醉学]