预防性使用止吐药物对多模式镇痛下剖宫产术后恶心呕吐发生的影响  

Preventive use of antiemetic drugs on the incidence of nausea and vomiting after cesarean section under multi-mode analgesia

作　　者：谷寅 顾盼 许学兵 Gu Yin;Gu Pan;Xu Xuebing(Department of Anesthesiology,the University of Hongkong-Shenzhen Hospital,Shenzhen 518053,China)

机构地区：[1]香港大学深圳医院麻醉科,518053

出　　处：《中国医师杂志》2020年第7期977-980,985,共5页Journal of Chinese Physician

摘　　要：目的 探讨预防性使用止吐药物对多模式镇痛下剖宫产患者发生术后恶心呕吐(PONV)的影响.方法 回顾性收集本院2016年2月1日至2020年1月31日5 530例剖宫产患者的临床资料,根据术中预防性使用止吐药物的不同分成四组:昂丹司琼4 mg组(A组,2 712例)、地塞米松5 mg组(B组,39例)、昂丹司琼4 mg复合地塞米松5 mg组(C组,413例)、未给予任何药物(空白)组(D组,2 366例).所有药物在手术结束前给予.比较四组PONV的发生率.结果 四组患者身高、体重、年龄、术后24 h NRS≥6的比例、术后羟考酮使用比例比较差异均无统计学意义(P>0.05),具有可比性.四组术后恶心呕吐发生率分别为2.29% (62/2 712)、0(0/39)、1.45%(6/413)、1.90% (45/2 366),组间差异无统计学意义(P=0.463).结论 预防性地使用止吐药物似乎不能降低多模式镇痛下剖宫产术后恶心呕吐的发生率.Objective To investigate the effect of preventive use of antiemetic drugs on postoperative nausea and vomiting(PONV)in patients with cesarean section(CS)under multi-mode analgesia.Methods The clinical data of 5530 patients with cesarean section in the University of Hong Kong-Shenzhen Hospital(HKU-SZH)from February 1,2016 to January 31,2020 were retrospectively collected and divided into four groups:Ondansetron 4 mg group(group A,n=2712),Dexamethasone 5 mg group(group B,n=39),Ondansetron 4 mg combined with Dexamethasone 5 mg group(Group C,n=413),and blank group(Group D,n=2366).All drugs were given before the end of theoperation.The prophylactic effectiveness with different antiemetic prescription has been compared in this study.Results There were no significant differences in height,weight,age,the ratio of NRs≥6 at 24 h and oxycodone usage among the four groups(P>0.05).The incidence of postoperative nausea and vomiting was 2.29%(62/2712),0(0/39),1.45%(6/413)and 1.90%(45/2366),respectively.There was no significant difference between the four groups(P=0.463).Conclusions Prophylaxis antiemetic administration seems do not reduce the incidence of PONV after CS under this strategy of multi-mode analgesia.

关 键 词：止吐药 药物预防 剖宫产术 手术后恶心呕吐 

分 类 号：R714.3[医药卫生—妇产科学]