Boonmak P, Boonmak S, Bunsaengjaroen P, Srichaipanha S, Poomsawat S, Nonlhaopol D
Khon Kaen University, Faculty of Medicine, Department of Anesthesiology, Khon Kaen, Thailand.
Eur J Anaesthesiol. 2007 Aug;24(8):664-7. doi: 10.1017/S0265021507000208. Epub 2007 Apr 11.
To study the effect of 0.2 mg mL-1 of ondansetron added to morphine patient-controlled analgesia solution after a 4 mg loading dose on the incidence and severity of postoperative nausea and vomiting.
One hundred and sixty patients scheduled for elective surgery, between 18 and 65 yr old, were studied. Patients who smoked, received antiemetics and hormonal therapy, had a history of motion sickness or gastrointestinal disease, a body mass index >35 or menstruation at the time of the study were excluded. Patients were assigned to the ondansetron and control groups by block randomization. At the end of anaesthesia, all patients received 4 mg of ondansetron intravenously and the same patient-controlled analgesia regimen of morphine. The ondansetron group (n = 80) received 0.2 mg of ondansetron per 1 mg of morphine. The nausea score, vomiting score and the requested ondansetron dose were evaluated at 1, 2, 6, 12 and 24 h. Patient-satisfaction for nausea/vomiting was recorded at the end of the study.
Patient characteristics and cumulative morphine consumption were similar but ondansetron group had higher pain scores (P = 0.006). The ondansetron group had a lower nausea and vomiting scores, and more patients were free from nausea and vomiting than the control group (41 vs. 26, respectively, P = 0.025). The ondansetron group had fewer cumulative ondansetron doses than the control group and better patient satisfaction than the control group (P < 0.05).
CONCLUSION(S): Ondansetron 4 mg plus 0.2 mg mL-1 given with PCA morphine can reduce nausea and vomiting thus improving patient satisfaction.
研究在给予4mg负荷剂量后，向吗啡患者自控镇痛溶液中添加0.2mg/mL昂丹司琼对术后恶心呕吐发生率及严重程度的影响。
研究对象为160例计划行择期手术、年龄在18至65岁之间的患者。排除吸烟、接受过止吐药和激素治疗、有晕动病或胃肠道疾病史、体重指数>35或在研究期间处于月经期的患者。通过区组随机化将患者分为昂丹司琼组和对照组。麻醉结束时，所有患者静脉注射4mg昂丹司琼，并采用相同的吗啡患者自控镇痛方案。昂丹司琼组（n = 80）每1mg吗啡中加入0.2mg昂丹司琼。在1、2、6、12和24小时评估恶心评分、呕吐评分及所需昂丹司琼剂量。研究结束时记录患者对恶心/呕吐的满意度。
患者特征及吗啡累积用量相似，但昂丹司琼组疼痛评分更高（P = 0.006）。昂丹司琼组恶心和呕吐评分更低，且无恶心呕吐的患者多于对照组（分别为41例和26例，P = 0.025）。昂丹司琼组累积昂丹司琼剂量少于对照组，患者满意度高于对照组（P < 0.05）。
4mg昂丹司琼加0.2mg/mL与PCA吗啡联合使用可减少恶心呕吐，从而提高患者满意度。
