雷莫司琼预防口腔颌面外科术后恶心呕吐的临床效果

Clinical effect of ramosetron for prevention of postoperative nausea and vomiting in patients undergoing oral and maxillofacial surgery

目的比较雷莫司琼与昂丹司琼预防口腔颌面外科术后恶心呕吐（PONV）的疗效。方法择期行口腔颌面外科手术的患者120例，美国麻醉医师学会分级Ⅰ～Ⅱ级，年龄23～72岁，随机分为3组，每组40例。雷莫司琼组在麻醉诱导前静脉注射雷莫司琼0．3mg／2mL，术后在患者静脉自控镇痛（PCIA）中加入0．3mg／2mL；昂丹司琼组在麻醉诱导前静脉注射昂丹司琼4mg／2mL，术后在PCIA中加入4mg／2mL；对照组在麻醉诱导前给予0．9％氯化钠溶液2mL，术后在PCIA中加入0．9％氯化钠溶液2mL。结果与对照组比较，雷莫司琼组和昂丹司琼组的PONV发生率和严重程度均显著降低（P值均〈0．05）。与昂丹司琼组比较，莫雷司琼组的PONV发生率和严重程度均显著降低（P值均〈0．05）。结论雷莫司琼能有效预防口腔颌面外科手术PONV。

Objective To compare the efficacy of ramosetron and ondansetron in prevention of postoperative nausea and vomiting （PONV） in patients undergoing oral and maxillofacial surgery. Methods A total of 120 patients, American Society of Anesthesiologists （ASA） Ⅰ～Ⅱ, aged from 23 to 72 years old, were randomly divided into 3 groups （n = 40）. All the patients received general anesthesia and patient-controlled intravenous analgesia （PCIA）. Ramosetron group： before anesthesia induction, the patients were intravenously given 0.3 mg/2 mL ramosetron, and another 0.3 mg/2 mL ramosetron was added into the micropump of POIA. Ondansetron group： 4 mg/2 mL ondansetron was intravenously given before anesthesia induction, then 4 mg/2 mL ondansetron was added in the micropump of PCIA. Placebo group： 2 mL normal saline was given before anesthesia induction, and another 2 mL normal saline was given into the micropump of POIA. Results The incidence and severity of PONV was significantly lower in the ramosetron group and ondansetron group than that in the placebo group （all P〈0.05）. Compared with ondansetron group, the incidence and severity of PONV in ramosetron group were markedly decreased （all P〈0.05）. Conclusion Ramosetron can effectively protect patients undergoing oral and maxillofacial surgery from PONV. （Shanghai Med J, 2011, 34： 753-755）