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帕洛诺司琼与地塞米松联用和昂丹司琼与地塞米松联用预防腹腔镜胆囊切除术后恶心呕吐的比较

Comparison of Palonosetron and Dexamethasone with Ondansetron and Dexamethasone to Prevent Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy.

作者信息

Rajnikant Kumar, Bhukal Ishwar, Kaloria Narender, Soni Shiv Lal, Kajal Kamal

机构信息

Department of Anaesthesia, Cloud Nine Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Anesth Essays Res. 2019 Apr-Jun;13(2):317-322. doi: 10.4103/aer.AER_21_19.

Abstract

BACKGROUND

Laparoscopic cholecystectomy (LC) is associated with high risk of postoperative nausea and vomiting (PONV) if no prophylactic antiemetic is used.

AIMS

The study compared prophylactic palonosetron and dexamethasone with ondansetron and dexamethasone in patients undergoing LC.

SETTING AND DESIGN

This prospective, double-blinded, randomized, controlled study was conducted at a tertiary care center.

MATERIALS AND METHODS

The study was carried out in 86 patients who underwent LC. The patients were randomly assigned to following study groups: Group 1 who received palonosetron (0.75 mg) with dexamethasone (8 mg) and Group II who received ondansetron (4 mg) with dexamethasone (8 mg). Patients were observed for nausea with visual analog scale and vomiting episode during 48 h postoperative follow-up.

STATISTICAL ANALYSIS USED

Data were analyzed as mean, standard deviation, percentage, and number. The following statistical tests were used: paired or unpaired -test, Mann-Whitney test, Chi-square test, and repeated ANOVA test.

RESULTS

There was no statistically significant difference in heart rate, mean arterial pressure, and oxygen saturation from baseline. During 48 h follow-up, the incidence of nausea, vomiting, and PONV was higher in Group II, but the difference was not statistically significant. The total dose of rescue antiemetic was 2.14 ± 4.15 mg in Group I and 5.00 ± 8.62 mg in Group II patients ( = 0.058). Headache was present in three patients in Group I and two patients of Group II.

CONCLUSION

The palonosetron with dexamethasone is comparable to ondansetron with dexamethasone in the prevention of PONV in patients undergoing LC.

摘要

背景

如果不使用预防性止吐药,腹腔镜胆囊切除术(LC)术后恶心呕吐(PONV)的风险较高。

目的

本研究比较了接受LC手术的患者使用预防性帕洛诺司琼和地塞米松与昂丹司琼和地塞米松的效果。

设置与设计

这项前瞻性、双盲、随机对照研究在一家三级护理中心进行。

材料与方法

对86例行LC手术的患者进行研究。患者被随机分为以下研究组:第1组接受帕洛诺司琼(0.75毫克)和地塞米松(8毫克),第2组接受昂丹司琼(4毫克)和地塞米松(8毫克)。在术后48小时的随访中,用视觉模拟量表观察患者恶心情况,并记录呕吐发作次数。

所用统计分析方法

数据以均值、标准差、百分比和数量进行分析。使用了以下统计检验:配对或非配对t检验、曼-惠特尼检验、卡方检验和重复方差分析检验。

结果

与基线相比,心率、平均动脉压和血氧饱和度无统计学显著差异。在48小时随访期间,第2组恶心、呕吐和PONV的发生率较高,但差异无统计学意义。第1组患者的抢救性止吐药总剂量为2.14±4.15毫克,第2组为5.00±8.62毫克(P = 0.058)。第1组有3例患者出现头痛,第2组有2例。

结论

在预防LC手术患者的PONV方面,帕洛诺司琼联合地塞米松与昂丹司琼联合地塞米松效果相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0706/6545955/2646401ad88f/AER-13-317-g001.jpg

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