一项多拉司琼、甲氧氯普胺、托烷司琼和昂丹司琼预防术后恶心呕吐的随机比较。

A randomized comparison of droperidol, metoclopramide, tropisetron, and ondansetron for the prevention of postoperative nausea and vomiting.

机构信息

Department of Anesthesiology, Haydarpaşa Numune Hospital for Research and Training, Istanbul, Turkey.

出版信息

Gynecol Obstet Invest. 2011;71(1):59-65. doi: 10.1159/000320747. Epub 2010 Dec 15.

DOI:10.1159/000320747

PMID:21160196

Abstract

BACKGROUND

Nausea and vomiting are the most common causes of postoperative complications, and they are seen most often after operations performed using general anesthesia and sedation. We designed this study to compare the effects of droperidol, metoclopramide, tropisetron, and ondansetron for the prevention of postoperative nausea and vomiting in patients undergoing gynecologic operations.

METHODS

One hundred patients were randomly assigned to 1 of 5 groups: group D was given 2.5 mg droperidol; group M, 10 mg metoclopramide; group T, 2.5 mg tropisetron; group O, 4 mg ondansetron 5 min after induction, and group C was the control group and received no prophylactic antiemetic treatment. All patients were observed for sedation and postoperative nausea and vomiting for 48 h.

RESULTS

Within 24 h after the operation, severe postoperative nausea and vomiting were seen in 4 patients (20%) in group D, 8 (40%) in group M, 5 (25%) in group T, 3 (15%) in group O, and 12 patients (60%) in the control group. Patients receiving droperidol, tropisetron, and ondansetron had significantly less serious emesis than the control group (p < 0.05). Sedation was seen in 5 patients receiving droperidol (4 patients score 2; and 1 patient score 3) and tropisetron (2 patients score 2; and 3 patients score 3) 15 min after surgery; this was significantly higher than in the control group (p < 0.05).

CONCLUSION

We conclude that metoclopramide is not effective in preventing postoperative nausea and vomiting after gynecologic operations. Droperidol, tropisetron, and ondansetron are effective; however, the sedating effects of droperidol and tropisetron should be considered.

摘要

背景

恶心和呕吐是术后最常见的并发症，它们最常发生在全身麻醉和镇静后进行的手术中。我们设计本研究旨在比较氟哌利多、甲氧氯普胺、托烷司琼和昂丹司琼预防妇科手术患者术后恶心和呕吐的效果。

方法

将 100 例患者随机分为 5 组：D 组给予 2.5mg 氟哌利多；M 组给予 10mg 甲氧氯普胺；T 组给予 2.5mg 托烷司琼；O 组在诱导后 5 分钟给予 4mg 昂丹司琼，C 组为对照组，不给予预防性止吐治疗。所有患者均观察镇静和术后 48 小时恶心呕吐情况。

结果

术后 24 小时内，D 组有 4 例（20%）患者出现严重术后恶心呕吐，M 组 8 例（40%），T 组 5 例（25%），O 组 3 例（15%），对照组 12 例（60%）。接受氟哌利多、托烷司琼和昂丹司琼的患者呕吐严重程度明显低于对照组（p<0.05）。术后 15 分钟，氟哌利多（4 例评分 2；1 例评分 3）和托烷司琼（2 例评分 2；3 例评分 3）组各有 5 例患者出现镇静；明显高于对照组（p<0.05）。