不同用药方式对昂丹司琼预防术后镇痛后恶心、呕吐疗效的影响

Effects of different administrations of ondansetron on postoperative nausea and vomiting during postoperative analgesia

目的 比较不同用药方式对中枢性镇吐药昂丹司琼预防术后镇痛治疗后发生恶心、呕吐的疗效差异。方法 择期妇科手术患者120例按昂丹司琼用药方式不同分为四组：镇痛泵联合静脉用药组（A组）、镇痛泵用药组（B组）、静脉用药组（C组）和对照组（D组），每组30例。记录手术结束后的不同时间点（0、1、3、6、12和24h）疼痛视觉模拟评分（VAS）以及不同时间段内（0～1h、1～3h、3～6h、6～12h、12～24h）恶心、呕吐发生例数。结果 不同时间点组内和组间VAS差异无显著意义。恶心、呕吐发生率在A组和C组间以及B组和D组间差别无显著意义。而A组和B组间以及C组和D组间差异有显著意义（P〈0．05）。结论 术后静脉注射昂丹司琼较其他用药方式可明显减少术后镇痛后恶心、呕吐的发生率。

Objective To compare the effect of ondansetron in different administrations for patient controlled intravenous analgesia（PCIA） on analgesic efficacy. Methods One hundred and twenty surgical patients were divided into 4 groups with 30 cases each. The patients in group A were given ondansetron 4 mg intravenously followed by PCIA with ondansetron 8 mg in 100 ml,in group B by PCIA with ondansetron 8 mg in 100 ml only, in group C ondansetron 4 mg IV injection only, and in group D PCIA without ondansetron. Ananlgesic outcome was evaluated by VAS at 0,1,3,6,12 and 24 h during PCIA,and nausea and vomiting were recorded at the same time points. Results There were not significant differences of VAS among the 4 groups. A significant increase of incidence in nausea and vomiting was observed in group B and D compared with that in group A and C. Conclusion Intravenous injection of ondansetron is better than continuous infusion of it in reducing postoperative nausea and vomiting during PCIA.