氟哌啶醇联合地塞米松预防甲状腺手术后恶心呕吐与托烷司琼联合地塞米松的效果比较  

The Combination of Haloperidol or Tropisetron with Dexamethasone for Prophylaxis of Postoperative Nausea and Vomiting in Thyroid Surgery

作　　者：吴婷婷[1] 殷伟[1] WU Ting-ting;YIN Wei(Department of Anesthesiology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院,江苏苏州215006

出　　处：《中国血液流变学杂志》2019年第3期307-310,共4页Chinese Journal of Hemorheology

摘　　要：目的比较氟哌啶醇与地塞米松联合应用预防甲状腺手术后恶心呕吐(postoperative nausea and vomiting,PONV)与托烷司琼联合地塞米松的效果.方法将180例ASA分级Ⅰ-Ⅱ级择期行甲状腺手术的女性患者随机分为三组:A组:氟哌啶醇联合地塞米松组(n=60);B组:托烷司琼联合地塞米松组(n=60);C组(对照组):生理盐水与地塞米松组(n=60).所有患者麻醉诱导前静脉给予地塞米松5 mg,手术中静脉给予氟哌啶醇1 mg或托烷司琼3 mg,对照组予以2 mL生理盐水.观察两组指标:安全性指标,有效性指标.有效性指标是指患者进入麻醉恢复室后1 h、6 h及24 h发生的恶心呕吐、补救性应用抗呕吐药物及完全有效人数;安全性指标是指患者离开麻醉恢复室时,镇静程度评分、出室时间、术后Q-T间期、及锥体外系不良反应等.结果A组与B组的效果相似,差异均无统计学意义(P>0.05);C组与A组或B组相比,有效性指标差异有统计学意义(P<0.05),安全性指标差异无统计学意义(P>0.05).结论氟哌啶醇与地塞米松联合应用对预防甲状腺手术后的PONV的作用与托烷司琼联合地塞米松的效果相似,且无明显不良反应,价格低廉,在临床上可优先选用氟哌啶醇.Objective To compare the effect of the combination of haloperidol or tropisetron with dexamethasone for prophylaxis of postoperative nausea and vomiting(PONV)in thyroid surgery.Methods 180 patients,scheduled for elective thyroid surgery,were randomly divided into three groups:haloperidol group(Group A),tropisetron group(Group B),normal saline group(control group,Group C).All patients received dexamethasone 5 mg i.v just before the anesthesia induction.Group A,Group B and Group C respectively received intravenous haloperidol 1 mg or tropisetron 3 mg or nonnal saline 2 mL after the beginning of surgery.Efficacy indicators and safety indicators were evaluated with a third-party blind design.Efficacy indicators included nausea,vomiting,need for rescue and complete responders.These indicators were evaluated at three time points:1 h after entry in postanesthesia care unit(PACU),6 h after PACU entry,and 24 h after PACU entry.Safety indicators included sedation,time to eligible for PACU discharge,extrapyramidal effects,and postoperative QTc intervals.Results The two antiemetic regimens have a similar effect for prophylaxis of PONV,and there was no significant difference for the efficacy indictors or safety indicators between the two groups(P>0.05).Conclusion Compared with tropisetron plus dexamethasone,haloperidol,plus dexamethasone has the same efficacy and safety for prophylaxis of PON V.Because of its inexpensiveness,haloperidol plus dexamethasone may be a better choice.

关 键 词：氟哌啶醇 托烷司琼 手术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]