Wagner Deborah, Pandit Uma, Voepel-Lewis Terri, Weber Monica
University of Michigan Health Systems, Department of Pediatric Anesthesia, Ann Arbor, MI, USA.
Paediatr Anaesth. 2003 Jul;13(6):522-6. doi: 10.1046/j.1460-9592.2003.01076.x.
Children undergoing strabismus surgery have a high incidence of postoperative vomiting (POV). The purpose of this study was to assess the efficacy and safety of dolasetron for the prevention of emesis comparing a single 0.35 mg.kg-1 or 12.5 mg dose with placebo.
Children aged 2-12 years with an ASA status of 1 or 2 undergoing strabismus surgery were randomized in a double-blind manner to one of three treatment groups. Patients were excluded with a history of previous postoperative vomiting or motion sickness, allergy to serotonin receptor antagonists or previous antiemetic administration within 24 h prior to enrollment. General anaesthesia was induced with sevoflurane and N2O/O2 and maintained with isoflurane and N2O/O2. The study medication was administered 15 min prior to the end of surgery. Patients experiencing two or more episodes of vomiting were rescued in the postanaesthesia care unit (PACU) with metoclopramide 0.15 mg.kg-1. A total of 118 patients were enrolled with documentation of the number and severity of vomiting episodes, time to awakening, PACU length of stay and postoperative agitation.
Patients with an acute complete response (ACR), defined as no emetic episodes and no rescue medication within 24 h of study drug administration were 62% (weight dose), 64% (fixed dose) and 33% (placebo, P < 0.05).
There was no statistical difference between the 0.35 mg.kg-1 dose and the fixed 12.5 mg dose of dolasetron with both reducing the incidence of POV.
接受斜视手术的儿童术后呕吐（POV）发生率很高。本研究的目的是评估多潘立酮预防呕吐的有效性和安全性，比较单次0.35mg/kg或12.5mg剂量与安慰剂的效果。
年龄在2至12岁、美国麻醉医师协会（ASA）分级为1或2级、接受斜视手术的儿童以双盲方式随机分为三个治疗组之一。有术后呕吐或晕动病史、对5-羟色胺受体拮抗剂过敏或在入组前24小时内曾接受过止吐药治疗的患者被排除。采用七氟醚和N2O/O2诱导全身麻醉，异氟醚和N2O/O2维持麻醉。研究药物在手术结束前15分钟给药。在麻醉后护理单元（PACU），对出现两次或更多次呕吐发作的患者使用0.15mg/kg甲氧氯普胺进行抢救。共纳入118例患者，记录呕吐发作的次数和严重程度、苏醒时间、PACU停留时间和术后躁动情况。
急性完全缓解（ACR）的患者，即给药后24小时内无呕吐发作且未使用抢救药物的患者，在体重剂量组为62%，固定剂量组为64%，安慰剂组为33%（P<0.05）。
多潘立酮0.35mg/kg剂量与固定的12.5mg剂量在降低POV发生率方面无统计学差异。
