Sharma Anish N G, Shankaranarayana Paniye
Department of Anaesthesiology, KVG Medical College and Hospital, Karnataka, India.
Oman Med J. 2015 Jul;30(4):252-6. doi: 10.5001/omj.2015.51.
Postoperative nausea and vomiting (PONV) is the most common complication seen following laparoscopic surgery. Our study sought to evaluate the efficacy of the newer drug palonosetron with that of ondansetron, in combination with dexamethasone, for PONV in patients undergoing laparoscopic hysterectomies. .
A total of 90 patients, aged between 30-50 years old, posted for elective laparoscopic hysterectomies under general anesthesia belonging to the American Society of Anesthesiologist (ASA) physical status I and II were included in the study. Patients were randomly divided into one of two groups (n=45). Before induction, patients in the first group (group I) received 0.075mg palonosetron with 8mg dexamethasone and patients in the second group (group II) received 4mg ondansetron with 8mg dexamethasone. Postoperatively, any incidences of early or delayed vomiting, requirement of rescue antiemetic, and side effects were recorded. Patient's hemodynamics were also monitored. Statistical analysis was done using Student's t-test, chi-square test, and Fisher's exact test. .
Preoperative, intraoperative, and postoperative heart rate, mean arterial pressure, peripheral capillary oxygen saturation were statistically not significant (p>0.050) in either group. In group II, eight patients had nausea in the first two hours and three patients had nausea in the two to six-hour postoperative period. In group I, three patients experienced nausea in the first six hours period. Eight patients in group II had vomited in the first two-hour period compared to one patient in group I (p=0.013). The requirement of rescue antiemetic was greater in group II than group I (20% vs. 4%). No side effects of antiemetic use were observed in either group. .
The combination of palonosetron with dexamethasone is more effective in treating early, delayed, and long term PONV compared to ondansetron with dexamethasone in patients undergoing elective laparoscopic hysterectomies under general anesthesia.
术后恶心呕吐（PONV）是腹腔镜手术后最常见的并发症。我们的研究旨在评估新型药物帕洛诺司琼与昂丹司琼联合地塞米松用于接受腹腔镜子宫切除术患者的PONV治疗效果。
本研究纳入了90例年龄在30至50岁之间、拟在全身麻醉下行择期腹腔镜子宫切除术的患者，这些患者属于美国麻醉医师协会（ASA）身体状况I级和II级。患者被随机分为两组之一（n = 45）。诱导前，第一组（I组）患者接受0.075mg帕洛诺司琼和8mg地塞米松，第二组（II组）患者接受4mg昂丹司琼和8mg地塞米松。术后，记录早期或延迟呕吐的任何发生率、抢救性止吐药的使用情况及副作用。还对患者的血流动力学进行了监测。采用学生t检验、卡方检验和Fisher精确检验进行统计分析。
两组患者术前、术中和术后的心率、平均动脉压、外周毛细血管血氧饱和度在统计学上均无显著差异（p>0.050）。在II组中，8例患者在术后前两小时出现恶心，3例患者在术后两至六小时出现恶心。在I组中，3例患者在术后前六小时出现恶心。II组有8例患者在术后前两小时呕吐，而I组为1例患者（p = 0.013）。II组抢救性止吐药的使用需求高于I组（20%对4%）。两组均未观察到使用止吐药的副作用。
在全身麻醉下接受择期腹腔镜子宫切除术的患者中，与昂丹司琼联合地塞米松相比，帕洛诺司琼联合地塞米松在治疗早期、延迟和长期PONV方面更有效。
