雷莫司琼预防术后患者自控镇痛恶心呕吐的效果及安全性

Efficacy and safety of ramosetron for preventing nausea and vomiting during postoperative patient controlled intravenous analgesia

目的观察雷莫司琼预防术后患者自控静脉镇痛（PCIA）期间恶心呕吐的防治效果及安全性。方法全麻下择期腹部手术患者60例，ASAⅠ-Ⅱ级，随机分为雷莫司琼组（R组）和格拉斯琼组（G组），术毕待患者清醒后R组或G组分别静脉注射雷莫司琼0.3mg或格拉斯琼3mg，后接一次性微量止痛泵行PCIA 48h。R组或G组镇痛液配方为：芬太尼10μg/kg＋雷莫司琼0.3mg（或格拉斯琼3mg）＋生理盐水至100ml。采用VAS评价术后48h内患者的镇痛效果、恶心、呕吐及止吐药物不良反应的发生情况。结果两组患者术后各时点VAS评分均〈3，两组间比较差异无统计学意义（P〉0.05）；术后镇痛期间恶心、呕吐发生率R组显著低于G组（P〈0.05）；两组不良反应的发生率均较低。两组间比较差异无统计学意义（P〉0.05）。结论雷莫司琼能安全、有效地预防术后患者自控镇痛引起的恶心、呕吐，其效果优于格拉司琼。

Objective To observe the efiSeaey and safety of ramosetron for preventing nausea and vomiting during postoperative patient controlled intravenous analgesia（PCIA）. Methods Sixty patients（ASA Ⅰ-Ⅱ） scheduled for elective abdominal surgery under general anesthesia were randomly divided into two groups ： Ramosetron group （Group R） and Granisetron group （Group G） ,which received ramosetron 0.3mg or granisetron 3mg intravenously respectively at the end of surgery and then received PCIA. PCIA solution contained fentany 10μg/kg＋ramosetron 0.3mg or granisetron 3mg in 100ml of normal saline. VAS scores were recorded at 8h,24h and 48h postoperatively, the incidence rate of nausea and vomiting and the side effects of ramose- tron and granisetron were observed. Results The VAS scores in two groups were all less than 3 and there were no signiecant difference between two groups （P〉0.05）. The incidence rate of nausea and vomiting in Group R was lower than that in Group G and there were significant difference between two groups（P〈0.05）. The incidence rate of side effects was low and similar in these two groups. Conclusion Ramosetron can safely and effecfly prevent the nausea and vomiting during PCIA,the effcacy of ramosetron is better than that of granisetron.