Bailey P L, Streisand J B, Pace N L, Bubbers S J, East K A, Mulder S, Stanley T H
Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City 84132.
Anesthesiology. 1990 Jun;72(6):977-80. doi: 10.1097/00000542-199006000-00005.
The authors evaluated the effect of transdermal scopolamine on the incidence of postoperative nausea, retching, and vomiting after outpatient laparoscopy in a double-blind, placebo-controlled study. A Band-Aid-like patch containing either scopolamine or placebo was placed behind the ear the night before surgery. Anesthesia was induced with fentanyl (0.5-2 micrograms/kg iv), thiopental (3-5 mg/kg iv), and succinylcholine (1-1.5 mg/kg iv) and maintained with isoflurane (0.2-2%) and nitrous oxide (60%) in oxygen. Scopolamine-treated patients had less nausea, retching, and vomiting compared with placebo-treated patients (P = 0.0029). Severe nausea and/or vomiting was present in 62% of the placebo group but only 37% of those getting the scopolamine patch. Repeated episodes of retching and vomiting were also less frequent in the scopolamine group compared with the placebo group (23% vs. 41%; P = 0.0213) as was the need for additional antiemetic therapy (13% vs. 32%; P = 0.0013). Patients in the scopolamine group were also discharged from the hospital sooner (4 +/- 1.3 vs. 4.5 +/- 1.5 h; P = 0.0487). Side effects were more frequent among those patients treated with the scopolamine patch (91% vs. 45%; P less than 0.05) but were not troublesome. The authors conclude that transdermal scopolamine is a safe and effective antiemetic for outpatients undergoing laparoscopy.
作者在一项双盲、安慰剂对照研究中评估了透皮东莨菪碱对门诊腹腔镜检查术后恶心、干呕和呕吐发生率的影响。手术前一晚，将含有东莨菪碱或安慰剂的类似创可贴的贴片贴于耳后。麻醉诱导采用芬太尼（静脉注射0.5 - 2微克/千克）、硫喷妥钠（静脉注射3 - 5毫克/千克）和琥珀酰胆碱（静脉注射1 - 1.5毫克/千克），并以异氟烷（0.2 - 2%）和氧化亚氮（60%）加氧气维持麻醉。与安慰剂治疗的患者相比，东莨菪碱治疗的患者恶心、干呕和呕吐较少（P = 0.0029）。安慰剂组62%的患者出现严重恶心和/或呕吐，而接受东莨菪碱贴片治疗的患者中只有37%出现。与安慰剂组相比，东莨菪碱组干呕和呕吐的反复发作也较少（23%对41%；P = 0.0213），额外使用止吐治疗的需求也较少（13%对32%；P = 0.0013）。东莨菪碱组的患者出院也更快（4 ± 1.3小时对4.5 ± 1.5小时；P = 0.0487）。接受东莨菪碱贴片治疗的患者副作用更频繁（91%对45%；P＜0.05），但并不麻烦。作者得出结论，透皮东莨菪碱对接受腹腔镜检查的门诊患者是一种安全有效的止吐药。
