单用托烷司琼对硬膜外麻醉下子宫全切术患者围术期恶心、呕吐的影响

目的探讨单用托烷司琼不同给药对子宫全切术患者围术期恶心、呕吐的疗效差异。方法选择硬膜外阻滞麻醉下择期子宫全切术患者120例,ASAⅠ～Ⅱ级,随机分为四组。①对照组(control组)、②切皮前用药组(A组)、③切皮前和缝皮后联合用药组(B组)和④缝皮后用药组(C组)。分别记录术中以及术后24h内恶心、呕吐发生情况。结果与Control组比较,A组患者术中恶心、呕吐的发生率显著降低(P<0.05);A、B、C组术后24h恶心及呕吐发生率程度显著降低(P<0.05),同时与A、C组比较,B组术后24h恶心及呕吐发生情况进一步改善,差异具有显著意义(P<0.05)。结论托烷司琼分别通过术前、术毕前静注较其他用药方式能明显减少硬膜外麻醉子宫切除术患者围术期恶心、呕吐的发生率。

Objective To compare the preventive effects of tropisetron in different administrations on perioperative nausea and vomiting after hysterectomy via epidural anesthesia.Methods One hundred and twenty ASA class Ⅰ～Ⅱ hysterectomy patients were divided into four groups：Group control,Group A,Group B and Group C;forty cases in each group.In Group control,no tropisetron;In group A,patients were adminstered tropisetron 5 mg IV injection only in preoperative time.patients in group B were given tropisetron 2.5 mg IV injection in preoperative time and tropisetron 2.5 mg before postoperative time,patients in group C were given tropisetron 5 mg before postoperative time.Nausea and vomiting were recorded in different periods（intraoperative time or 24h within postoperative time）.Results With the Control group,the incidece of nausea and vomiting of patients in intraoperative time in group A was significantly lower（P0.05）,the incidece of nausea and vomiting of patients within 24h after surgery in Group A,B,C;compared with the group A,C,the difference of group B was significant（P 0.05）.Conclusion Compared with other Methods,the administration of ropisetron through the preoperative and before surgery end,respectively,can significantly reduce incidence of perioperative nausea and vomiting of patients with hysterectomy via epidural anesthesia.