氟哌啶、枢丹预防病人静脉自控镇痛后恶心呕吐的临床比较

Clinical Comparison of Dorperidol and Ondansetron for the Prevention of Nausea and Vomiting After Patient Controlled Intravenous Analgesia

目的:比较氟哌啶、枢丹预防病人静脉自控镇痛（patient controlled intravenous analgesia,PCIA）后恶心呕吐的临床效果。方法:90例全麻手术患者随机分3组。组1:单纯芬太尼组;组2:芬太尼+氟哌啶;组3:芬太尼+枢丹。术后行PCIA,记录进药量、VAS评分、恶心呕吐及镇静评分。结果:全部患者镇痛满意。各组首日芬太尼用量、VAS评分、PCA持续时间无显著差异。恶心呕吐评分:组2、组3明显低于组1（P<0.05）。镇静评分:3组均无统计学差异。结论:芬太尼PCIA伍用氟哌啶、枢丹均可明显降低恶心呕吐的发生率,伍用氟哌啶未减少术后首日芬太尼用量。

Objective: Our aims were to evaluate and compare the effects of dorperidol and ondansetron for the prevention of nausea and vomiting following PCIA(patient controlled intravenous analgesia, PCIA). Methods: Ninety patients who underwent general anesthesia were randomly divided into 3 groups: group 1 with fentanyl ; group 2 with fentanyl and dorperidol;group 3 with fentanyl and ondansetron. After surgery, the patients were connected with the PCA pump through an intravenous line. Total dose , VAS, nausea, vomiting,and sedation score were recorded. Results: Satisfactory analgesia was achieved in all patients. There were no difference in dose of fentanyl,PCA duratoin.and VAS score in 3 groups. The scores of nausea and vomiting in group 1 was significantly higher than those in group 2 and group 3 ( P < 0.05 ). The score of sedation had no difference between 3 groups. Conclusion: Fentanyl combined with dorperidol or ondansetron for PCIA may decrease the severity of nausea and vomiting. The combination with dorperidolcan not decrease the dose of fentanyl on the first postoperative day.