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[昂丹司琼对下肢骨手术患者自控镇痛中吗啡和曲马多用量的影响]

[Effect of ondansetron in lower extremity bone surgery on morphine and tramadol consumption using patient controlled analgesia].

作者信息

Cubukçu Zeynep, Ozbek Hayri, Güneş Yasemin, Gündüz Murat, Ozcengiz Dilek, Işik Geylan

机构信息

Cukurova University Faculty of Medicine, Department of Anesthesiology, Adana, Turkey.

出版信息

Agri. 2007 Jan;19(1):36-41.

PMID:17457705
Abstract

In this study, we aimed to assess the effect of administration of ondansetron on morphine and tramadol consumptions. After approval by the ethics committee, 120 patients with ASA status I or II, who will undergo elective lower extremity surgery, were included in the study. Patients were randomly divided into 4 groups following the anesthesia induction. Group I received tramadol as PCA with an infusion of 0.3 mg/kg following a loading dose of 1.5 mg/kg administered 1 hour before the end of the surgery. Group II received ondansetron 0.1 mg/kg following induction of anesthesia, additionally. Group III received morphine as PCA with an infusion following a loading dose of 0.15 mg/kg administered 30 minutes before the end of surgery. Group IV received ondansetron 0.1 mg/kg following induction of anesthesia, additionally. Pain scores(VAS), nausea, vomitting and sedation scores, analgesic consumptions and adverse effects were recorded at 5th, 15th, 30th, 45th minutes and 4th, 8th, 12th and 24th hours postoperatively. Postoperative VAS, nausea, vomitting and sedation scores were similar among the groups. The analgesic consumption was found significantly higher at 4th, 8th, 12th and 24th hours in group II. No statistically significant difference was found in analgesic consumption between group III and IV at all times. We concluded that, ondansetron, when administered as nausea prophylaxis in patients receiving tramadol and morphine as PCA, did not effect morphine consumption whereas did increased tramadol consumption.

摘要

在本研究中,我们旨在评估给予昂丹司琼对吗啡和曲马多消耗量的影响。经伦理委员会批准后,120例ASA分级为I或II级、将接受择期下肢手术的患者被纳入研究。麻醉诱导后,患者被随机分为4组。第一组在手术结束前1小时给予1.5mg/kg负荷剂量后,以0.3mg/kg的输注速率接受曲马多作为自控镇痛(PCA)。第二组在麻醉诱导后额外给予0.1mg/kg昂丹司琼。第三组在手术结束前30分钟给予0.15mg/kg负荷剂量后,以输注方式接受吗啡作为PCA。第四组在麻醉诱导后额外给予0.1mg/kg昂丹司琼。在术后第5、15、30、45分钟以及第4、8、12和24小时记录疼痛评分(视觉模拟评分法[VAS])、恶心、呕吐和镇静评分、镇痛药物消耗量及不良反应。术后各组间VAS、恶心、呕吐和镇静评分相似。发现第二组在术后第4、8、12和24小时的镇痛药物消耗量显著更高。第三组和第四组在所有时间点的镇痛药物消耗量均未发现统计学上的显著差异。我们得出结论,在接受曲马多和吗啡作为PCA的患者中,当将昂丹司琼作为恶心预防用药给予时,它不会影响吗啡的消耗量,但会增加曲马多的消耗量。

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