Munro H M, D'Errico C C, Lauder G R, Wagner D S, Voepel-Lewis T, Tait A R
Section of Pediatric Anesthesiology, C.S. Mott Children's Hospital, Ann Arbor, MI 48109, USA.
Can J Anaesth. 1999 Jan;46(1):45-8. doi: 10.1007/BF03012513.
To determine the efficacy of oral granisetron in preventing postoperative vomiting (POV) following strabismus repair in children.
In a randomized, double-blind, placebo-controlled trial, 73 pediatric patients received either placebo, 20 micrograms.kg-1 or 40 micrograms.kg-1 granisetron po 20 min before induction of anesthesia. No premedication was given, induction was with halothane and all children breathed spontaneously via a laryngeal mask airway. Maintenance was with isoflurane without the use of opioids. Ketorolac and acetaminophen were used for analgesia. The number of episodes and the severity of vomiting and retching were recorded for the first 24 hr postoperatively, as was the use of rescue antiemetics.
Granisetron 20 micrograms.kg-1 and 40 micrograms.kg-1 were more effective than placebo in reducing the incidence of POV during the first 24 hr (29% in both the granisetron groups vs 84% in the placebo group, P < 0.05). In addition, the number of children experiencing severe vomiting (> or = 3 episodes) was reduced in the granisetron 20 micrograms.kg-1 and 40 micrograms.kg-1 groups compared with placebo (4%, 8% and 48% respectively, P < 0.05). Patients in the granisetron group were discharged home earlier (105 min vs 124 min, P = 0.04). There was no difference in the incidence of POV between the two granisetron groups.
Preoperative oral granisetron in a dose of 20 micrograms.kg-1 provided effective prophylaxis against POV in children undergoing stabismus repair.
确定口服格拉司琼预防儿童斜视修复术后呕吐（POV）的疗效。
在一项随机、双盲、安慰剂对照试验中，73例儿科患者在麻醉诱导前20分钟分别接受安慰剂、20微克·千克⁻¹或40微克·千克⁻¹格拉司琼口服。未给予术前用药，采用氟烷诱导，所有儿童通过喉罩气道自主呼吸。维持麻醉用异氟烷，不使用阿片类药物。使用酮咯酸和对乙酰氨基酚进行镇痛。记录术后首24小时内呕吐和干呕的发作次数及严重程度，以及急救止吐药的使用情况。
20微克·千克⁻¹和40微克·千克⁻¹格拉司琼在降低首24小时内POV发生率方面比安慰剂更有效（格拉司琼组均为29%，而安慰剂组为84%，P<0.05）。此外，与安慰剂相比，20微克·千克⁻¹和40微克·千克⁻¹格拉司琼组中出现严重呕吐（≥3次发作）的儿童数量减少（分别为4%、8%和48%，P<0.05）。格拉司琼组患者出院回家更早（105分钟对124分钟，P = 0.04）。两个格拉司琼组之间的POV发生率无差异。
术前口服20微克·千克⁻¹剂量的格拉司琼可有效预防接受斜视修复术儿童的POV。
