在择期剖宫产中，硬膜外使用昂丹司琼预防术后瘙痒和恶心比静脉使用昂丹司琼更有效。
Epidural ondansetron is more effective to prevent postoperative pruritus and nausea than intravenous ondansetron in elective cesarean delivery.
作者信息
Han Dong Woo, Hong Soon Won, Kwon Ja-Young, Lee Jae Woo, Kim Ki Jun
机构信息
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Korea.
出版信息
Acta Obstet Gynecol Scand. 2007;86(6):683-7. doi: 10.1080/00016340701302616.
BACKGROUND
Postoperative pruritus, nausea, and vomiting are common side effects of intrathecal or epidural opioids. Intravenous ondansetron has been used for postoperative emesis. However, there are no reports regarding epidural ondansetron. Two studies were conducted to evaluate the prophylactic effects of epidural ondansetron for opioid-induced pruritus, nausea, and vomiting.
METHODS
Neurotoxic signs were checked after epidural injection of ondansetron in rats. A clinical study was conducted to compare the prophylactic effects of epidural ondansetron with intravenous ondansetron for opioid-induced pruritus, nausea, and vomiting in cesarean delivery.
RESULTS
No neurotoxic evidence was found in rats. The incidence of pruritus and nausea was significantly lower in the epidural ondansetron group than in the intravenous ondansetron group at 24 and 48 h postoperatively.
CONCLUSIONS
Epidural ondansetron is more effective in preventing postoperative pruritus and nausea than intravenous ondansetron.
背景
术后瘙痒、恶心和呕吐是鞘内或硬膜外使用阿片类药物常见的副作用。静脉注射昂丹司琼已用于术后呕吐。然而，尚无关于硬膜外使用昂丹司琼的报道。开展了两项研究以评估硬膜外使用昂丹司琼对阿片类药物引起的瘙痒、恶心和呕吐的预防作用。
方法
在大鼠硬膜外注射昂丹司琼后检查神经毒性体征。进行了一项临床研究，比较硬膜外使用昂丹司琼与静脉注射昂丹司琼对剖宫产术中阿片类药物引起的瘙痒、恶心和呕吐的预防作用。
结果
在大鼠中未发现神经毒性证据。术后24小时和48小时，硬膜外使用昂丹司琼组的瘙痒和恶心发生率显著低于静脉注射昂丹司琼组。
结论
硬膜外使用昂丹司琼在预防术后瘙痒和恶心方面比静脉注射昂丹司琼更有效。
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