透皮东莨菪碱治疗术后恶心呕吐的观点。
Perspectives on transdermal scopolamine for the treatment of postoperative nausea and vomiting.
机构信息
Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
出版信息
J Clin Anesth. 2012 Jun;24(4):334-45. doi: 10.1016/j.jclinane.2011.07.019.
Transdermal scopolamine, a patch system that delivers 1.5 mg of scopolamine gradually over 72 hours following an initial bolus, was approved in the United States in 2001 for the prevention of postoperative nausea and vomiting (PONV) in adults. Scopolamine (hyoscine) is a selective competitive anatagonist of muscarinic cholinergic receptors. Low serum concentrations of scopolamine produce an antiemetic effect. Transdermal scopolamine is effective in preventing PONV versus placebo [relative risk (RR)=0.77, 95% confidence interval (CI), 0.61-0.98, P = 0.03] and a significantly reduced risk for postoperative nausea (RR=0.59, 95% CI, 0.48-0.73, P < 0.001), postoperative vomiting (RR=0.68, 95% CI, 0.61-0.76, P < 0.001), and PONV (RR 0.73, 95% CI, 0.60-0.88, P = 001) in the first 24 hours after the start of anesthesia.
透皮东莨菪碱贴剂系统，在最初的推注后 72 小时内逐渐释放 1.5 毫克东莨菪碱，于 2001 年在美国获得批准，用于预防成人术后恶心和呕吐（PONV）。东莨菪碱（莨菪碱）是毒蕈碱型乙酰胆碱受体的选择性竞争性拮抗剂。东莨菪碱的血清浓度低可产生止吐作用。与安慰剂相比，透皮东莨菪碱预防 PONV 有效[相对风险（RR）=0.77，95%置信区间（CI），0.61-0.98，P=0.03]，并显著降低术后恶心（RR=0.59，95% CI，0.48-0.73，P<0.001）、术后呕吐（RR=0.68，95% CI，0.61-0.76，P<0.001）和麻醉开始后 24 小时内 PONV 的风险（RR=0.73，95% CI，0.60-0.88，P=0.01）。
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