摘要
目的:观察格拉司琼应用于术后硬膜外自控镇痛(PCEA)复合液中,对恶心呕吐的影响及对PCEA 镇痛效能的影响。方法:选择75例ASA Ⅰ-Ⅱ级、年龄23岁-62岁的妇科择期手术患者,随机分为格拉司琼硬膜外组(GE组)、格拉司琼静脉组(GV组)及对照组(C组)等3个组,每组25例。硬膜外麻醉平面维持在T4以下,术毕行PCEA。分别于术后4小时、8小时、12小时、24小时和48小时采用VAS对镇痛效能进行评分。于术后 0小时-3小时、3小时-24小时、24小时-48小时三个时段记录病人48小时内的恶心呕吐情况。结果:三组患者镇痛作用于各观察时点的VAS评分均相似,评级均为优。术后24小时内GE组与GV组的止吐显效率与呕吐发生率十分相似,无统计学差异(P>0．05),此时段内GE组与GV组止吐效果均明显优于对照组(P<0．05)。术后 24小时-48小时,GE组仍有较高止吐效果,明显高于同期GV组(P<0．05),而此时段GV组与对照组相比均无明显差异(P>0．05)。结论:格拉司琼用于PCEA复合液并不影响PCEA的镇痛效能,其止吐作用与静脉应用相似且作用时间更长、更平稳。
Objective： To evaluate the antiemetie and analgesic effects of granisetron administered via patient-controlled epidural analgesia（PCEA）. Methods： 75 patients（aged 23-62 years with ASA Ⅰ～Ⅱ ） scheduled for radical hysterectomy under epidural anesthesia were randomized into 3 groups （25 cases each）. All patients received standard operation and epidural anesthesia with analgesic plane maintained below T4. After surgery all patients received basic PCEA which consisted of 0. 2% ropivacaine and morphine 0.2mg/ml. Group GE received 0. 02% granisetron via basic PCEA, group GV received basic PCEA and immediate intravenous granisetron 3rag and group C received basic PCEA alone. Results： The Changes of VAS in each of the observe time point were not singnifieantly different between the 3 groups（ P 〉 0. 05 ）. Within the first 24 hours, there were no singnificant ditterents（ P 〉 0. 05 ） between the CR rates in group GE and Group GV, but they were singnificantly higher than that in group C （ P 〈 0. 05 ）. During the second 24 hours, antiemetic effect was maintained in group GE, but not in other two groups（P 〈 0. 05）. Meanwhile no singnificant differences in CR rates were found bwtewwn group GV and group C （ P 〉 0.05）. Conclusion： Epidural administration of granisetron has more powerful antiemetic efficacy and lasting longer than intravenous and dose not effect the analgesic efficacy of PECA.
出处
《四川肿瘤防治》
2006年第2期97-99,103,共4页
Sichuan Journal of Cancer Control
关键词
格拉司琼
硬膜外
术后镇痛
恶心呕吐
Granisetron
Epidural
Postoperative Analgesia
Nausea
Vomiting
