昂丹司琼预防剖宫产术后曲马多持续镇痛所致的恶心呕吐  

Preventive effect of ondansetron on postoperative nausea and vomiting from continuous tramadol analgesia in cesarean patients

作　　者：朱爱兵[1] 沈明坤[1] 徐志勇[1] 

机构地区：[1]南京医科大学附属无锡妇幼保健院麻醉科,214002

出　　处：《临床麻醉学杂志》2012年第11期1079-1081,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨昂丹司琼不同给药方式对剖宫产术后曲马多持续镇痛所致术后恶心呕吐(PONV)的防治效果。方法 80例腰-硬联合麻醉下行剖宫产手术的产妇随机均分为四组:A组昂丹司琼8mg加入曲马多镇痛泵持续输注;B组昂丹司琼8mg在胎儿娩出后缓慢静注;C组昂丹司琼4mg胎儿娩出后单次静注并4mg镇痛泵持续输注;D组胎儿娩出后静注生理盐水4ml,所有患者均行术后曲马多静脉自控镇痛(PCIA)。观察并记录四组术后1、6、8、12、24h时PONV评分及疼痛VAS评分。结果四组间不同时点疼痛VAS评分差异无统计学意义。术后1、6、8、12、24PONV评分A、B、C组明显低于D组(P<0.01),C组明显低于A、B组(P<0.05);A、B组间差异无统计学意义,与术后6h比较,术后1hA组及术后12、24hA、B后PONV评分明显降低(P<0.05)。结论昂丹司琼可有效预防曲马多术后镇痛引起的恶心呕吐,但在胎儿娩出后单次静注昂丹司琼4mg,并4mg于PCA中持续输注,其预防效果更佳。Objective To explore the preventive effect of ondansetron administered with different regimen on postoperative nausea and vomiting from continuous tramadol analgesia in cesarean patients. Methods A total of 80 women scheduled for elective cesarean section under combined spinal-epidural anesthesia were randomly divided into four groups with 20 cases each. 8 nag of ondansetron added into tramadol PCIA pump in group A; 8 mg of ondansetron injected i. v. after delivery of the fetus group B; 4 nag of ondansetron i. v. injection plus 4 mg added into the tramadol PCIA pump group C; group D received 4 mlof normal saline after delivery of the fetus. All patients received post-operative pain control with tramadol intravenous PCA. The nausea and vomit and visual analogue pain scale were recorded at 1, 6, 8, 12 and 24 h after operation. Results No significant difference was observed in the pain scales among the four groups. The assessment of nausea and vomiting showed that scorings in the group D was higher than groups A, B and C（P〈0.01）, and in the group C that was lower than the groups A and B （P〈0. 05）, while no difference between the groups A and B. In the groups of A and B, VAS of pain sc0rings at 6 h after operation were higher than that at 12 and 24 h after operation points （P〈0.05）. Conclusion Ondansetron can prevent the incidence of nausea and vomiting during tramadol analgesia, and it would be better when it was given by combining 4 mg i. v. injection after delivery of the fetus and 4 mg into the PCIA pump of trmadol.

关 键 词：昂丹司琼 曲马多 术后恶心呕吐 病人静脉自控镇痛 剖宫产术 

分 类 号：R614[医药卫生—麻醉学]