帕洛诺司琼对舒芬太尼胸腔镜术后镇痛期呕吐的防治

Post-operative nausea and vomiting prevention effect of palonosetron on thoracoscopy sufentanil analgesia

目的探讨帕洛诺司琼对舒芬太尼胸腔镜术后镇痛期恶心呕吐的防治效果。方法将80例胸腔镜手术患者按照随机数字表法均分为观察组和对照组,2组患者麻醉方法相同,观察组于切皮前10min静脉注射帕洛诺司琼0.25mg,对照组切皮前10min静脉注射托烷司琼5mg,比较2组患者手术的一般情况、血流动力学变化及术后恶心呕吐（PONV）发生率。结果 2组患者手术时间、麻醉时间和镇痛药用量等比较,差异均无统计学意义;2组患者手术各时段平均动脉压（MAP）和心率（HR）的变化差异无统计学意义。2组患者术后视觉模拟疼痛（VAS）评分呈先升高后降低趋势,其中2组t2、t3、t4时VAS评分显著高于t1时段（P〈0.05）,2组间术后各时段VAS评分比较,差异无统计学意义;2组患者t1-t4时PONV发生率逐渐升高,观察组t3、t4时PONV发生率显著低于对照组（P〈0.05）,2组t1、t2时PONV发生率比较,差异无统计学意义（P〈0.05）;2组患者不良反应发生率比较,差异无统计学意义（χ^2=2.222,P=0.136）。结论帕洛诺司琼和托烷司琼能够降低舒芬太尼胸腔镜术后镇痛期恶心呕吐的发生率,且不良反应发生率低;帕洛诺司琼对延迟性呕吐效果更明显。

Objective To explore the post-operative nausea and vomiting prevention effect of palonosetron on thoracoscopy sufentanil analgesia.Methods A total of 80 cases of thoracoscopy surgey patients treated in hospital from January 2015 to March 2016 were randomly divided into observation group 40 cases and control group 40 cases.The 2groups of patients were treated with same anesthesia method.The observation group were given intravenously palonosetron 0.25 mg before 10 min with anesthesia induction,while the control group were given intravenously tropisetron 5mg before 10 min with anesthesia induction.The general surgery information,hemodynamic changes and post-operative nausea and vomiting（PONV）incidence rates were compared between the 2groups.Results The 2groups of patients with operation time,anesthesia time,and analgesic dosage showd no statistical difference.The mean arterial pressure（MAP）and heart rate（HR）changes in each period of operation showed no significant difference.2groups of patients with postoperative visual analogue scale（VAS）score was first increased and then decreased,which in t2,t3,t4 period VAS score was significantly higher than that of t1period（P〈0.05）,there was no significant difference in VAS scores between the 2groups.The incidence of PONV was gradually increased in t1 to t4period,observation group PONV rates was significantly lower than that in the control group in t3,t4period（P〈0.05）.There was no significant difference in PONV rates in t1,t2 period between the 2groups（P〈0.05）.There was no significant difference in the incidence of adverse reactions between the 2groups（χ^2=2.222,P=0.136）.Conclusion Palonosetron and tropisetron can decrease the incidence of sufentanil thoracoscopy postoperative analgesia nausea and vomiting,with low incidence of adverse reactions.On delayed vomiting,palonosetron is better than tropisetron.