Bai Bing, Pei Li-Jian, Zhang Yue-Lun, Sang Nuo-Er, Zhang Xiu-Hua, Huang Yu-Guang
Department of Anesthesiology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Central Research Laboratory,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018 Jun 28;40(3):373-377. doi: 10.3881/j.issn.1000-503X.2018.03.013.
Objective To evaluate the application of adding ondansetron in morphine intravenous analgesia pump for prevention of postoperative nausea and vomiting(PONV)in women. Methods Data of surgical female inpatients who received general anesthesia and postoperative intravenous analgesia with morphine in our center from January 1st,2013 to December 31st,2014 were retrospectively analyzed. Based on whether ondansetron was added,patients were divided into the observation group(n=834) and the control group(n=856). Outcome variables including morphine consumption,visual analogue scale(VAS) score,nausea score,and total times of vomiting within 48 hours after surgery were collected and compared. Results Age(t=0.432,P=0.665),morphine consumption during the first post-operative day(t=0.599,P=0.548) and during the second post-operative day(t=0.236,P=0.813),maximum VAS score of postoperative pain during movement during the first post-operative day [3(2,4) vs. 3(2,5);Z=1.850,P=0.064] and at rest during the second post-operative day [0(0,1) vs. 0(0,1);Z=1.511,P=0.131] were not significantly different between two groups. While the maximum VAS score of postoperative pain at rest during the first post-operative day [0(0,2) vs.0(0,2);Z=2.435,P=0.015] and during movement during the second post-operative day [3(1,3)vs.3(2,4);Z=3.445,P=0.001] were significantly different between two groups. The maximum score of postoperative nausea(χ=9.810,P=0.020) and cumulative frequency of postoperative vomiting(Z=3.726,P=0.002)in the observation group were significantly lower than those in the control group during the first post-operative day;however,there was no significant difference during the second post-operative day(χ=5.017,P=0.170;Z=0.000,P=1.000). Logistic regression analysis showed that adding ondansetron in morphine intravenous analgesia pump was an independent influencing factor of reduced postoperative nausea. The probability of nausea during the first post-operative day was 0.781 time(P=0.015)of that in the control group and 0.736 time(P=0.030)during the second post-operative day. Conclusion Adding ondansetron in morphine intravenous analgesia pump may reduce PONV in women.
目的 评估在吗啡静脉镇痛泵中添加昂丹司琼预防女性患者术后恶心呕吐（PONV）的应用效果。方法 回顾性分析本中心2013年1月1日至2014年12月31日期间接受全身麻醉并术后使用吗啡静脉镇痛的外科女性住院患者资料。根据是否添加昂丹司琼，将患者分为观察组（n = 834）和对照组（n = 856）。收集并比较包括吗啡用量、视觉模拟评分（VAS）、恶心评分以及术后48小时内呕吐总次数等结局变量。结果 两组患者的年龄（t = 0.432，P = 0.665）、术后第1天吗啡用量（t = 0.599，P = 0.548）和术后第2天吗啡用量（t = 0.236，P = 0.813）、术后第1天活动时术后疼痛的最大VAS评分[3(2,4) vs. 3(2,5); Z = 1.850，P = 0.064]以及术后第2天静息时术后疼痛的最大VAS评分[0(0,1) vs. 0(0,1); Z = 1.511，P = 0.131]差异均无统计学意义。而术后第1天静息时术后疼痛的最大VAS评分[0(0,2) vs. 0(0,2); Z = 2.435，P = 0.015]以及术后第2天活动时术后疼痛的最大VAS评分[3(1,3) vs. 3(2,4); Z = 3.445，P = 从0.001]两组间差异有统计学意义。术后第1天观察组术后恶心的最大评分（χ = 9.810，P = 0.020）和术后呕吐的累积频率（Z = 3.726，P = 0.002）均显著低于对照组；然而，术后第2天差异无统计学意义（χ = 5.017，P = 0.170；Z = 0.000，P = 1.000）。Logistic回归分析显示，在吗啡静脉镇痛泵中添加昂丹司琼是降低术后恶心的独立影响因素。术后第1天恶心的概率是对照组的0.781倍（P = 0.015），术后第2天是对照组的0.736倍（P = 0.030）。结论 在吗啡静脉镇痛泵中添加昂丹司琼可能降低女性患者的PONV。
