摘要
目的探讨阿扎司琼预防硬膜外吗啡术后镇痛所致恶心、呕吐的有效剂量。方法选择硬膜外麻醉下妇科手术患者200例,分为5组,每组40例。取L_(1-2)或T_(12)-L_1间隙穿刺置管,予2%利多卡因,首次剂量13～15mL,手术结束前30min,A2.5组、A5组、A7.5组和A10组分别给予阿扎司琼2.5、5、7.5、10mg,D组给予氯化钠注射液。手术结束时皆硬膜外注入镇痛负荷量(0.25%罗哌卡因8mL+吗啡2mg),连接镇痛泵(0.15%罗哌卡因100mL+吗啡5mg)。观察并记录术后24h内恶心、呕吐发生情况。结果 A5组术后恶心呕吐发生率45%,低于D组(68%),差异有显著意义(P<0.05)。A10组和A7.5组术后恶心呕吐发生率均为10%,显著低于D组(P<0.05),A10组和A7.5组组间比较无显著差异(P>0.05)。结论手术结束前给予阿扎司琼对硬膜外吗啡术后镇痛所致恶心、呕吐有预防效果,推荐剂量为5～7.5mg。
AIM To observe the prevention effects of different doses of arasetron on morphine-related nausea and vomiting after epidural analgesia,and to find the minimum effective dose.METHODS Two hundred patients undergoing gynecological surgery with epidural anesthesia were divided into 5 groups（40 patients in each group）.Needle was inserted into the L_（1-2） or T_（12）-L_1 intervertebral space,and epidural anesthesia was induced by injection of 2%lidocaine 13 - 15 mL.Thirty minutes before the end of surgery,patients in observation groups were intravenously administered with azasetron 10 mg（group A10）,7.5 mg（group A7.5）,5 mg （group A5）,and 2.5 mg（group A2.5）,respectively,while patients in group D were intravenously administered with same amount of sodium chloride injection.At the end of the surgery,all patients were treated with a loading dose of 0.25%ropivacaine 8 mL and morphine 2 mg,and followed by a maintenance dose of 0.15% ropivacaine 100 mL and morphine 5 mg.Nausea and vomiting were recorded for the first 24 h postoperatively. RESULTS Compared with the group D（68%）,the incidence of postoperative nausea and vomiting decreased in the group A5（45%）,with significantly difference（P0.05）.The incidences of postoperative nausea and vomiting of group A7.5（10%） and group A10（10%） were lower than that of group D（P0.01）.But there was no significant difference between group A10 and group A7.5（P0.05）.CONCLUSION Azasetron can prevent morphine-related nausea and vomiting after epidural analgesia using before the end of the surgery,and the recommended dose is 5 - 7.5 mg.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2011年第4期306-308,共3页
Chinese Journal of New Drugs and Clinical Remedies
关键词
麻醉
硬膜外
手术后恶心呕吐
吗啡
阿扎司琼
anesthesia
epidural
postoperative nausea and vomiting
morphine
azasetron
