盐酸阿扎司琼预防胸外科术后镇痛恶心呕吐的临床观察

Preventive Azasetron Hydrochloride for Postoperative Nausea and Vomiting from Analgesia Following Thoracic Surgery

目的：观察普胸外科术后镇痛中，应用阿扎司琼、格拉司琼预防术后恶心呕吐的效果。方法：于2005年5月至12月选取本院住院120例美国麻醉医师协会体格情况分级（ASA）Ⅰ～Ⅱ级择期普胸外科手术患者，随机将病人分成3组，手术结束前静注阿扎司琼10mg（A组，n=40）、格拉司琼3mg（G组，n=40）和生理盐水10mL（C组，n=40），术毕以舒芬太尼进行静脉术后镇痛治疗。结果：3组患者镇痛效果差异无显著性。在术后恶心、呕吐方面，术后第1个12hA组和G组无显著性差异，A组、G组与C组差异有显著性；术后第2个12hA组恶心、呕吐发生率低于G组，G组恶心、呕吐发生率低于C组。结论：以舒芬太尼行普胸外科术后镇痛时．阿扎司琼和格拉司琼均有良好效果，而且阿扎司琼的效果优于格拉司琼。

Objective： To evaluate the prophylactic effect of azasetron and granisetron on postoperative nausea and vomiting （PONV） resulting from analgesia following thoracic surgery, Methods： between May and December, 2005, 120 selective patients scheduled for the general thoracic surgery, fulfilling the ASA Ⅰ-Ⅱ criteria, were randomized to receive intravenous azasetron 10 mg （group A, n = 40）, or granisetron 3mg （group G, n = 40） or normal saline 10 mL （group C, n = 40） immediately before the end of operation, and then were all given intravenous Fentanyl for postoperative analgesia. Results： No difference in analgesic effects was observed among the groups. During the first 12 postoperative hours, the incidences of PONV in azasetron group and granisetron group were similar, but significantly lower than that in the placebo group. During the second 12 postoperative hours, the incidence of PONV was the lowest in group A, followed by that in the group G, as compared with group C. Conclusion： Arasetron and granisetron can be used effectively to prevent PONV from postoperative analgesics using Fentanyl in patients with thoracic surgery. Azasetron appeared to show better efficacy than granisetron in PONV prevention.