Department of Anaesthesia, Lausanne University Hospital, Lausanne, Switzerland.
Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
Anaesthesia. 2017 Jul;72(7):859-863. doi: 10.1111/anae.13907. Epub 2017 Apr 27.
We tested whether prophylactic droperidol and ondansetron, in combination with a moderate dose of dexamethasone, were equally effective in reducing nausea and vomiting after tonsillectomy in children and that both were superior to saline with dexamethasone. We randomly allocated 300 children to intravenous saline, droperidol 10 μg.kg or ondansetron 150 μg.kg , after induction of anaesthesia and the administration of intravenous dexamethasone 250 μg.kg . The rates (95%CI) of nausea or vomiting within 24 postoperative hours were: 42/91 after saline, 46% (36%-57%); 43/87 after droperidol, 49% (39%-60%); reduced to 18/84 by ondansetron, 21% (13%-32%), p < 0.001. There were no differences in the rates of side-effects between groups. We conclude that ondansetron is more effective than saline in preventing nausea or vomiting after paediatric tonsillectomy when given with a moderate dose of dexamethasone, whereas droperidol was not.
我们测试了在小儿扁桃体切除术后，联合中等剂量地塞米松使用预防性氟哌利多和昂丹司琼，是否与使用生理盐水加地塞米松同样有效来减少恶心和呕吐，并且观察这两种方案是否优于生理盐水加地塞米松。我们将 300 名儿童随机分配至静脉注射生理盐水、氟哌利多 10μg/kg 或昂丹司琼 150μg/kg，在麻醉诱导和静脉注射地塞米松 250μg/kg 后。在术后 24 小时内出现恶心或呕吐的比例（95%CI）为：生理盐水组 91 例中有 42 例，42%（36%-57%）；氟哌利多组 87 例中有 43 例，49%（39%-60%）；昂丹司琼组 84 例中有 18 例，18%（13%-32%），p<0.001。各组之间不良反应的发生率没有差异。我们得出结论，当与中等剂量地塞米松联合使用时，昂丹司琼比生理盐水更能有效预防小儿扁桃体切除术后的恶心或呕吐，而氟哌利多则不然。
