帕洛诺司琼联合地塞米松预防术后恶心呕吐的临床观察

CLINICAL OBSERVATION OF THE EFFECT OF SINGLE PALONOSETRON OR COMBINED WITH DEXAMETHASONE TO PREVENT POST-OPERATIVE NAUSEA AND VOMITING

目的观察单独使用帕洛诺司琼及联合地塞米松预防妇科手术术后恶心呕吐的有效性及安全性。方法选择在气管内全麻的妇科患者40例,ASAⅠ～Ⅱ级,均采用静脉镇痛,随机分为两组:帕洛诺司琼0.075 mg+生理盐水1 ml组(A组,n=20),帕洛诺司琼0.075 mg+地塞米松5 mg组(B组,n=20)。开始麻醉诱导前予以帕洛诺司琼和生理盐水或地塞米松,观察术后0～24、～72 h的治疗失败率与0～6、～72及0～72 h的完全缓解率(CR)、恶心程度及治疗失败时间(TTF)。结果①术后两组的完全缓解率无显著性差异;②两组恶心程度评分无显著性差异。③B组0～24 h的治疗失败率为15%,明显减少(p=0.041)。结论妇科手术前静脉注射单剂量的帕洛诺司琼0.15 mg联合地塞米松5 mg不能改善恶心呕吐的完全缓解率,但能降低0～24 h的治疗失败率。

Objective To observe the efficacy and safety of a single IV dose of palonosetron or combined with dexamethasone on the effectiveness and security of preventing postoperative nausea and vomiting （PONV） for gynecological surgery. Methods Forty patients （ASA I - II ） undergoing gynecological surgery with general anesthesia, scheduled for intravenous analgesia were divided into two groups randomly： Group A （palonosetron 0. 075mg ＋ saline 1 ml, n = 20） and Group B（palonosetron 0. 15 mg ＋ dexamethasone 5 rag, n = 20）. A single dose of palonosetron （0.075 rag） and saline or dexamethasone was administered immediately before induction of anesthesia. Complete response （CR： no emetic episodes and no rescue medication） ,nausea severity and TIT（ time to treatment fail- ure） were observed during the 0 to 24 h, 24 to 72 h,0 to6h ,6 to 72 h and 0 to 72 h postoperative time intervals. Resuits （1） CR rates were similar. （2）Nausea severity were similar. （3）The proportion of treatment failure is significantly decreased for the 0 to 24 h interval in Group B （p = 0. 041 ）. Conclusion A single 0. 15mg IV dose of palonosetron combined with dexamethasone 5 mg before gynecological surgery significantly decreased the proportion of treatment failure for 0 - 24 h without increasing the CR.