Nakata Ken, Mammoto Tadanori, Kita Takashi, Taniguchi Hiroshi, Kanbara Noriko, Akamatsu Tetsuya, Sakai Toshiko, Kishi Yoshihiko
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Nakamichi, Higashinari, Japan.
J Clin Anesth. 2002 Mar;14(2):121-5. doi: 10.1016/s0952-8180(01)00366-x.
To investigate whether continuous epidural droperidol and intravenous (IV) intraoperative droperidol inhibit pruritus and postoperative nausea and vomiting (PONV) during epidural morphine analgesia.
Randomized, double-blinded, controlled study.
Metropolitan cancer center.
120 ASA physical status I and II patients undergoing thoracic or abdominal surgery with general anesthesia combined with epidural anesthesia.
Patients received an intraoperative epidural injection of 2 mg morphine hydrochloride, followed postoperatively by a continuous epidural infusion of morphine hydrochloride 4 mg/day for 4 days. Patients were randomly allocated to four groups: Group A = control group, Group B = intraoperative single IV injection of droperidol (2.5 mg), Group C = postoperative continuous epidural droperidol infusion (2.5 mg/day), and Group D = intraoperative IV injection of droperidol (2.5 mg) and postoperative continuous epidural droperidol infusion (2.5 mg/day).
The frequency and severity of pruritus and PONV in each group were evaluated during the postoperative period. Continuous epidural infusion of droperidol significantly reduced the frequency and severity of pruritus and PONV induced by epidural morphine without causing significant side effects. Intraoperative single IV injection of droperidol was effective for PONV (p < 0.05) but not for pruritus.
Postoperative epidural droperidol infusion significantly decreased both the frequency and severity of pruritus and PONV during postoperative continuous epidural morphine analgesia. IV intraoperative droperidol significantly reduced the frequency and the severity of PONV but not pruritus.
探讨持续硬膜外注射氟哌利多和术中静脉注射氟哌利多是否能抑制硬膜外吗啡镇痛期间的瘙痒及术后恶心呕吐（PONV）。
随机、双盲、对照研究。
大城市癌症中心。
120例美国麻醉医师协会（ASA）身体状况为Ⅰ级和Ⅱ级、接受全身麻醉联合硬膜外麻醉的胸腹部手术患者。
患者术中接受2mg盐酸吗啡硬膜外注射，术后连续4天接受4mg/天盐酸吗啡硬膜外输注。患者被随机分为四组：A组=对照组；B组=术中单次静脉注射氟哌利多（2.5mg）；C组=术后持续硬膜外输注氟哌利多（2.5mg/天）；D组=术中静脉注射氟哌利多（2.5mg）及术后持续硬膜外输注氟哌利多（2.5mg/天）。
术后评估各组瘙痒及PONV的发生频率和严重程度。持续硬膜外输注氟哌利多可显著降低硬膜外吗啡引起的瘙痒及PONV的发生频率和严重程度，且未引起明显副作用。术中单次静脉注射氟哌利多对PONV有效（p<0.05），但对瘙痒无效。
术后硬膜外输注氟哌利多可显著降低术后持续硬膜外吗啡镇痛期间瘙痒及PONV的发生频率和严重程度。术中静脉注射氟哌利多可显著降低PONV的发生频率和严重程度，但对瘙痒无效。
