Chen X, Tang J, White P F, Wender R H, Quon R, Sloninsky A, Naruse R, Kariger R, Webb T, Norel E
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Texas, 75390-9068, USA.
Anesth Analg. 2001 Oct;93(4):906-11. doi: 10.1097/00000539-200110000-00021.
Dolasetron (12.5 mg IV) is effective in both preventing and treating postoperative nausea and vomiting (PONV) after ambulatory surgery. However, the optimal timing of dolasetron administration and its effect on the patient's quality of life after discharge have not been established. One-hundred-five healthy, consenting women undergoing gynecologic laparoscopic procedures with a standardized general anesthetic technique were enrolled in this randomized, double-blinded study. Group 1 received dolasetron 12.5 mg IV 10-15 min before the induction of anesthesia; Group 2 received dolasetron 12.5 mg IV at the end of the laparoscopy (79 +/- 48 min later than Group 1); and Group 3 received dolasetron 12.5 mg IV at the end of anesthesia (93 +/- 52 min later than Group 1). The incidence of PONV, complete responses (defined as no emetic episodes and no rescue medication within the 24-h period after anesthesia), recovery profiles, and patient satisfaction were recorded. In the postanesthesia care unit and during the 24-h follow-up period, the incidence of nausea and vomiting, as well as the need for rescue antiemetics, did not differ significantly among the three groups. The percentages of patients with complete responses to the study drug within the first postoperative 24 h were also similar in all three groups (55%, 59%, and 52% for Groups 1, 2, and 3, respectively). The early and intermediate recovery profiles, including resumption of a normal diet and patient satisfaction with the control of PONV, were not different among the three study groups. Dolasetron 12.5 mg IV administered before the induction of anesthesia is as effective as dolasetron given at the end of laparoscopy or at the end of anesthesia in preventing PONV after outpatient laparoscopy.
The timing of dolasetron administration appears to have little effect on its efficacy when administered as a prophylactic antiemetic in the ambulatory setting.
多潘立酮（静脉注射12.5毫克）在预防和治疗门诊手术后的恶心和呕吐（PONV）方面均有效。然而，多潘立酮给药的最佳时机及其对出院后患者生活质量的影响尚未确定。105名接受标准化全身麻醉技术的妇科腹腔镜手术的健康、同意参与的女性被纳入这项随机、双盲研究。第1组在麻醉诱导前10 - 15分钟静脉注射12.5毫克多潘立酮；第2组在腹腔镜检查结束时（比第1组晚79±48分钟）静脉注射12.5毫克多潘立酮；第3组在麻醉结束时（比第1组晚93±52分钟）静脉注射12.5毫克多潘立酮。记录PONV的发生率、完全缓解情况（定义为麻醉后24小时内无呕吐发作且无需急救药物）、恢复情况及患者满意度。在麻醉后护理单元及24小时随访期间，三组之间恶心和呕吐的发生率以及急救止吐药的需求无显著差异。术后24小时内对研究药物完全缓解的患者百分比在三组中也相似（第1组、第2组和第3组分别为55%、59%和52%）。包括恢复正常饮食及患者对PONV控制的满意度在内的早期和中期恢复情况在三个研究组之间无差异。在门诊腹腔镜检查后预防PONV时，麻醉诱导前静脉注射12.5毫克多潘立酮与在腹腔镜检查结束时或麻醉结束时给药的效果相同。
在门诊环境中作为预防性止吐药使用时，多潘立酮的给药时间似乎对其疗效影响不大。
