帕洛诺司琼与格拉司琼预防眼球摘除加义眼植入术术后恶心呕吐的效果比较  

Comparison between palonosetron and granisetron in preventing postoperative nausea and vomiting for patients undergoing orbital hydroxyapatite implant surgery

作　　者：胡潇[1] 谭放[1] 李文献[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院麻醉科,上海200031

出　　处：《上海医学》2014年第4期304-308,共5页Shanghai Medical Journal

摘　　要：目的比较2.5μg/kg的帕洛诺司琼与40μg/kg的格拉司琼对预防患者眼球摘除加义眼植入术术后恶心呕吐的效果。方法择期在全身麻醉下行眼球摘除加义眼植入术的患者80例,美国麻醉医师学会（ASA）分级Ⅰ或Ⅱ级,年龄18~70岁,随机分入帕洛诺司琼组、格拉司琼组,每组40例。两组患者于麻醉诱导前5min分别静脉注射帕洛诺司琼2.5μg/kg、格拉司琼40μg/kg,在预设的时间点观察恶心和呕吐的严重程度,并记录各组的治疗失败时间（TTF）。结果格拉司琼组在术后0~4h、〉4~24h、〉24~48h时的恶心评分均显著高于帕洛诺司琼组（P值均〈0.05）,而两组间在〉48~72h时的差异无统计学意义（P〉0.05）。格拉司琼组在0~4h、〉4~24h时的呕吐评分均显著高于帕洛诺司琼组（P值均〈0.05）,而两组间在〉24~48h、〉48~72h时的差异均无统计学意义（P值均〉0.05）。帕洛诺司琼组的TTF显著长于格拉司琼组（P=0.008 6）。结论相对于40μg/kg的格拉司琼,2.5μg/kg的帕洛诺司琼可明显降低术后恶心呕吐的严重程度,延长TTF,但对预防延迟性呕吐并无优势。Objective To compare the safety and efficacy between palonosetron （2. 5 μg/kg） and granisetron （40μg/kg） for preventing postoperative nausea and vomiting in patients undergoing orbital hydroxyapatite implant surgery. Methods Eighty patients （American Society of Anesthesiologists [ASA] I -II ） aged between 18 and 70 years and scheduled for orbital hydroxyapatite implant surgery were randomly divided into palonosetron group and granisetron group （n = 40）. Palonosetron （2.5 μg/kg） and granisetron （40 μg/kg） was intravenously injected at 5 minutes before induction of anesthesia in two groups, respectively. The severity of nausea and vomiting, and time to treatment failure （TTF） were evaluated during postoperative time intervals. Results The scores of nausea during the intervals of 0- 4 h, 〉4- 24 h and 〉24- 48 h in the granisetron group were significantly higher than those in the palonosetron group （all P〈0.05）. There was no significant difference in the score of nausea in the interval of 〉48- 72 h between two groups （P〉0.05）. The scores of vomiting during the intervals of 0 - 4 h and 〉 4 - 24 h in the granisetron group were significantly higher than those in the palonosetron group （both P〈0.05）. However, there was no significant difference in the score of vomiting in the interval of 〉24--48 h and 〉48-72 h between two groups （both P〉0.05）. TTF in the palonosetron group was significantly longer than that in the granisetron group （ P = 0. 008 6）. Conclusion Compared with granisetron 40 μg/kg, palonosetron 2.5 μg/kg can effectively decrease the patients undergoing implantation of ocular prosthesis. （Shanghai Med J, 2014, 37： 304-308） postoperative nausea and vomiting and prolong TTF in But palonosetron cannot prevent delayed vomiting.

关 键 词：帕洛诺司琼 格拉司琼 恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]