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术前使用10毫克甲氧氯普胺和50毫克茶苯海明预防择期剖宫产术后恶心呕吐的前瞻性随机临床研究。

Preoperative Use of 10-mg Metoclopramide and 50-mg Dimenhydrinate in the Prophylaxis of Postoperative Nausea and Vomiting in Elective Caesarean Births: A Prospective Randomized Clinical Study.

作者信息

Hüseyinoğlu Ürfettin, Ülker Kahraman

机构信息

Department of Anesthesia and Reanimation, Kafkas University School of Medicine, 36200 Kars, Turkey.

Istanbul Memorial Hospital, Okmeydanı, Şişli, 3483 Istanbul, Turkey.

出版信息

J Obstet Gynaecol India. 2016 Aug;66(4):252-8. doi: 10.1007/s13224-015-0679-8. Epub 2015 May 9.

Abstract

BACKGROUND

The purpose of this study was to assess the efficacy and outcomes of preoperative prophylactic metoclopramide and dimenhydrinate use in elective cesarean births.

METHODS

Participants (n = 84) scheduled for elective cesarean births were randomized equally into placebo (10 cc 0.9 % NaCl), 10-mg metoclopramide or 50-mg dimenhydrinate groups. Oral alimentation was prohibited 8 h before the surgery; however, patients continued drinking water until 4 h before surgery. Placebo and antiemetics were administered 1 h before the anticipated procedure in a 5-ml syringe. In metoclopramide and dimenhydrinate group, an ampoule of the agents was completed to 5 ml by adding 0.9 % NaCl. In the control group 5 ml of 0.9 % NaCl was used. All prophylactic agents were administered intramuscularly. All patients received a general anesthesia. The placebo group (control group) was compared with the metoclopramide and dimenhydrinate groups.

RESULTS

Demographic data including maternal age, height, weight, body mass index, gravidity, parity, miscarriage, induced abortion, the number of offspring, and the medical history did not show significant differences among the three groups. Postoperative nausea, vomiting, and the use of rescue medication ratios were significantly lower in metoclopramide and dimenhydrinate groups compared with the placebo group (p < 0.05); however, the difference between the metoclopramide and dimenhydrinate groups was not significant (p > 0.05).

CONCLUSION

Dimenhydrinate and metoclopramide significantly decrease postoperative nausea, vomiting, and the need for rescue antiemetic medication. Both agents have similar efficacy and may be used as an alternative to each other.

摘要

背景

本研究旨在评估择期剖宫产术前预防性使用甲氧氯普胺和茶苯海明的疗效及结果。

方法

计划进行择期剖宫产的参与者(n = 84)被平均随机分为安慰剂组(10毫升0.9%氯化钠溶液)、10毫克甲氧氯普胺组或50毫克茶苯海明组。手术前8小时禁止经口进食;然而,患者可在手术前4小时前继续饮水。在预计手术前1小时,用5毫升注射器给予安慰剂和止吐药。在甲氧氯普胺和茶苯海明组,通过加入0.9%氯化钠溶液将一剂药物配制成5毫升。在对照组使用5毫升0.9%氯化钠溶液。所有预防性药物均通过肌肉注射给药。所有患者均接受全身麻醉。将安慰剂组(对照组)与甲氧氯普胺组和茶苯海明组进行比较。

结果

包括产妇年龄、身高、体重、体重指数、妊娠次数、产次、流产、人工流产、子女数和病史在内的人口统计学数据在三组之间未显示出显著差异。与安慰剂组相比,甲氧氯普胺组和茶苯海明组术后恶心、呕吐及使用急救药物的比例显著降低(p < 0.05);然而,甲氧氯普胺组和茶苯海明组之间的差异不显著(p > 0.05)。

结论

茶苯海明和甲氧氯普胺可显著降低术后恶心、呕吐及急救止吐药物的需求。两种药物疗效相似,可相互替代使用。

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