格拉司琼(枢星)对芬太尼静脉术后镇痛所致恶心呕吐的影响

Influence of Granisetron on postoperative nausea and vomiting during patient-controlled analgesia with fentanyl

目的探讨格拉司琼(枢星)不同的应用方法对芬太尼静脉术后镇痛所致恶心呕吐的影响。方法随机选择全麻下腹部和胸部手术患者263例,术后均行芬太尼静脉术后自控镇痛(PCIA)。采用双盲法分为三组:A组(91例),术闭即静脉注射格拉司琼(枢星)3mg,行芬太尼静脉术后镇痛;B组(106例),将格拉司琼(枢星)6mg注入芬太尼静脉镇痛泵;C组(66例),不给予格拉司琼(枢星),仅在患者出现症状时行对症治疗。观察术后12h,12~72h内的恶心和呕吐次数及并发症。结果病人年龄、性别、体重、手术种类、时间、麻醉用药无统计学差异(P】0.05)。各组问术后镇痛VAs评分无显著差异性(P】0.05)。12h内恶心、呕吐发生率:A,B组差异无显著性(P】0.05);C组明显高于A,B组(P【0.05)。术后12~72h恶心,呕吐发生率:B组明显低于A和C组(P【0.05),但A组和C组无明显差异。结论格拉司琼(枢星)有效地减少了静脉术后镇痛芬太尼所致恶心呕吐,并且是安全的。将格拉司琼(枢星)注入芬太尼静脉镇痛泵比单次静脉注射作用时间更长。

OBJECTIVE To investigate the influence of the different way of granisetron on postoperative nausea and vomiting during patient-controlled analgesia.METHOD 263 patients scheduled for abdomen and breast surgery under general anaesthesia were double-blindly and randomly divided into 3 groups.All pations received PCIA with fentanyl.Group A(n =91) received Granisetron3 mg at the end of surgery;Group B(n = 106),Granisetron 6mg was plused into the pump of PCIA;Group C(n =66) was treated without granisetron just when patients were nausea and vomiting.Pain score,nausea and vomiting episodes and other complications were recorded within 12 h and 12 ~72h after surgery.RESULTS There were no differences among three groups at the ages,sex,weights of the patients,the kinds and time of the surgery(P >0.05).There were no diffrents between group A and B at the incidents of nausea and vomiting within 12h(P >0.05);The incidents of nausea and vomiting in group C were significantly increased compaired with group A and B(P<0.05).but there were no diffrents between group A and C from 12 ~72h,.The incidents of nausea and vomiting in group B were significantly decreased compaired with group A and C(P<0.05).CONCLUSION Granisetron can decrease the incidents of nausea and vomiting during PCIA with fentanyl and its safe.It acts longer that Granisetron was plused into the pump than Granisetron gived only once at the end of surgery.