昂丹司琼应用于全麻胆囊切除术后PCIA的止吐效果观察.docVIP

昂丹司琼应用于全麻胆囊切除术后PCIA的止吐效果观察 　　doi：10.3969/j.issn.1007-614x.2014.16.24 　　摘 要 目的：观察昂丹司琼在全麻胆囊切除术后PCIA的止吐效果。方法：ASAⅠ～Ⅱ级将择期行胆囊切除术的患者300例，随机分为试验组和对照组各150例。两组患者在手术结束后采取静脉泵镇痛，对照组采取190ml 0.9%氯化钠注射液加入舒芬太尼100μg、曲马多500mg，泵注速度4ml/小时；试验组采取180ml 0.9%氯化钠注射液加入舒芬太尼100μg、曲马多500mg、昂丹司琼8mg，泵注速度4ml/小时。记录两组术后24小时内恶心呕吐的发生数。结果：试验组恶心呕吐发生率12%，低于对照组的50.6%，差异有统计学意义（P0.05）。结论：昂丹司琼应用于胆囊切除术后静脉镇痛有明显的止吐效果。 　　关键词 昂丹司琼 胆囊切除 静脉镇痛 止吐 　　Observation of the antiemetic effect of ondansetron used in PCIA after cholecystectomy with general anesthesia 　　Mou Nan，Hu Guilin 　　Department of Anesthesiology，the First Peoples Hospital of Wanzhou District，Chongqing City 404040 　　Abstract Objective：To observe the antiemetic effect of ondansetron used in PCIA after cholecystectomy with general anesthesia.Methods：300 cases with ASAⅠ～Ⅱ undergoing cholecystectomy were randomly divided into the experimental group and the control group with 150 cases in each.All cases were took intravenous analgesia after the operation.The control group were given 190ml saline added sufentanil 100μg and tramadol 500mg，and the infusion rate was 4ml/hours.The experimental group were given 180ml physiological saline added sufentanil 100μg，tramadol 500mg and ondansetron 8mg，and the infusion rate was 4ml/hours.We recorded the number of nausea and vomiting happen within 24 hours after the operation in the two groups.Results：The incidence of nausea and vomiting in the experimental group was 12%，lower than that in the control group（50.6%），and the difference was statistically significant（P0.05）.Conclusion：The use of ondansetron in intravenous analgesia after cholecystectomy has an obvious antiemetic effect. 　　Key words Ondansetron；Cholecystectomy；Intravenous analgesia；Antiemetic 　　全麻胆囊切除术后恶心呕吐是常见的并发症，另外，术后静脉镇痛使用的舒芬太尼和盐酸曲马多也可以产生恶心呕吐的不良反应。昂丹司琼是5-HT3受体抑制剂，具有显著的药理学特性，现在被广泛地应用于术后恶心呕吐的预防和治疗。本研究旨在评价昂丹司琼应用在全麻下胆囊切除术后静脉镇痛的止吐效果和可行性研究，为同类手术静脉镇痛寻找更为合理的止吐方式。 　　资料与方法 　　选择本院住院胆囊切除患者300例，年龄25～60岁，ASAⅠ～Ⅱ级择期在全麻下行胆囊切除术（术前无恶心呕吐以及未接受止吐药物治疗，患者术前无药物滥用史，无阿片类、曲马多