Schnaider Taylor Brandão, Vieira Antônio Mauro, Brandão Antônio Carlos Aguiar
Centro de Ensino e Treinamento do Serviço de Anestesiologia do Hospital das Clínicas da Faculdade de Ciências Médicas de Pouso Alegre (HC-FCM-UNIVAS), Pouso Alegre, MG.
Rev Bras Anestesiol. 2008 Nov-Dec;58(6):614-22. doi: 10.1590/s0034-70942008000600006.
Prophylaxis of postoperative nausea and vomiting has been the subject of several studies. The objective of the present study was to compare anti-emetics, and their association, in the prevention of postoperative nausea and vomiting.
Seventy patients, ASA I and II, underwent epidural block associated with general anesthesia for gynecologic surgeries. Patients in the Metochlopramide Group (MG) received 20 mg of the drug; the Dexamethasone Group (DeG) received 8 mg; the Droperidol Group (DrG) received 1.25 mg; the Ondansetron Group (OG) received 8 mg; the Dexamethasone-Ondansetron Group (DeOG) received 8 mg and 4 mg, respectively; the Droperidol-Ondansetron Group (DrOG) received 1.25 mg and 4 mg, respectively; the Dexamethasone-Droperidol-Ondansetron Group (DeDrOG) received 8 mg, 0.625 mg, and 4 mg. The presence of nausea and vomiting was evaluated at 6, 12, 24, and 36 hours after the end of the surgery.
The total incidence of episodes of nausea per group is as follows: 4 in DeDrOG, 6 in OG, 6 in DrOG, 11 in DeG, 11 in DeOG, 18 in MG, and 22 in DrG. The Chi-square and Fisher exact tests indicated statistically significant differences between DrG and DeG, DOG, DrOG, DeOG, and DeDrOG; between MG and OG, DrOG, and DeDrOG; and between DeOG and DeDrOG. And the incidence of vomiting was: 3 in OG, 3 in DeDrOG, 6 in DrOG, 7 in DeG, 7 in DeOG, and 10 in DrG, and 13 in G. There was a statistically significant difference between DrG and OG and DeDrOG; and between MG and OG and DeDrOG.
The association dexamethasone-droperidol-ondansetron and ondansetron alone were more effective in the prophylaxis of nausea and vomiting.
术后恶心呕吐的预防一直是多项研究的主题。本研究的目的是比较不同止吐药及其联合使用在预防术后恶心呕吐方面的效果。
70例ASA I级和II级患者,在全身麻醉下行妇科手术并联合硬膜外阻滞。甲氧氯普胺组(MG)患者接受20mg该药物;地塞米松组(DeG)接受8mg;氟哌利多组(DrG)接受1.25mg;昂丹司琼组(OG)接受8mg;地塞米松 - 昂丹司琼组(DeOG)分别接受8mg和4mg;氟哌利多 - 昂丹司琼组(DrOG)分别接受1.25mg和4mg;地塞米松 - 氟哌利多 - 昂丹司琼组(DeDrOG)接受8mg、0.625mg和4mg。在手术结束后6、12、24和36小时评估恶心和呕吐的发生情况。
每组恶心发作的总发生率如下:DeDrOG组4例,OG组6例,DrOG组6例,DeG组11例,DeOG组11例,MG组18例,DrG组22例。卡方检验和Fisher精确检验表明,DrG组与DeG组、DOG组、DrOG组、DeOG组和DeDrOG组之间;MG组与OG组、DrOG组和DeDrOG组之间;以及DeOG组与DeDrOG组之间存在统计学显著差异。呕吐发生率为:OG组3例,DeDrOG组3例,DrOG组6例,DeG组7例,DeOG组7例,DrG组10例,MG组13例。DrG组与OG组和DeDrOG组之间;以及MG组与OG组和DeDrOG组之间存在统计学显著差异。
地塞米松 - 氟哌利多 - 昂丹司琼联合使用以及单独使用昂丹司琼在预防恶心和呕吐方面更有效。