格拉司琼抗病人自控镇痛下术后恶心、呕吐作用的临床研究

Clinical Study of Granisetron Against Postoperative Nausea and Vomiting Under Patient Controlled Analgesisa

目的 :研究病人自控镇痛 (PCA)条件下盐酸格拉司琼抗术后恶心、呕吐 (PONV )的临床效果及输注该注射液快、慢对术中循环的影响。方法 :90名择期手术患者随机分为3组 :A组 ,恩丹西酮8mg ;B组 ,托烷司琼3mg ;C组 ,格拉司琼3mg(50ml)。格拉司琼分别在术毕前20、30、40、50、60min输完 ,记录输注中循环指标变化及术后4、8、12、24h及2、3d时恶心、呕吐情况。结果 :扩容基础上输注格拉司琼时间>20min ,对血压、心率无明显影响 (P>0 05) ,且无头痛等并发症 ;PCA条件下B、C组的抗PONV效果与A组存在显著性差异 (BvsA ,P<0 01 ;CvsA ,P<0 001) ,且C组较B组PONV发生率更低 (P<0 05) ,C组的价格效益比较B组显著提高 (P<0 01)。结论 :PCA条件下格拉司琼抗PONV作用较恩丹西酮、托烷司琼明显 ,且其价格效益比高 ,术中输注格拉司琼时间>

OBJECTIVE:To study the therapeutic effect of granisetron on postoperative nausea and vomiting(PONV) under patient controlled analgesia(PCA) and to observe the influence of infusion rate of granisetron on blood circulation during operation METHODS: 90 selective surgical patients were divided into 3 groups A group(control):ondonsetron 8mg;B group:tropiestron 3mg; C group:granisetron 3mg The solutions of granisetron hydrochloride were infusied at 20,30,40,50 and 60 min before the end of operation The change of the circulation condition and the status of nausea and vomiting were observed at infusion period and 4,8,12,24hs,2d and 3d postoperatively RESULTS:Under expansion of blood volume,if infusion duration was longer than 20 min for granisetron,the circulation condition(MAP,HR) were not affected during infusion period and no headache was found There were significant differences in PONV between group A and group B(P<0 01),and between group C and group A(P<0 001) The difference of PONV between group C and group B was also significant(C vs B,P<0 05) The cost and effect rate of group C were best CONCLUSION:The effect of granisetron against PONV under PCA is better than those of ondansetron and tropiesetron and its cost-effectiveness ratio is high If infusion period is longer than 20 min,the status of the circulation condition is not affected by infusion of the solution of granisetron hydrochloride