Larsson S, Hägerdal M, Lundberg D
Department of Anesthesiology, University Hospital, Lund, Sweden.
Acta Anaesthesiol Scand. 1988 Feb;32(2):131-4. doi: 10.1111/j.1399-6576.1988.tb02701.x.
Ninety patients scheduled for general or orthopaedic surgical procedures were randomly assigned to receive one of three i.m. premedications: dixyrazine 0.5 mg kg-1; morphine 0.15 mg kg-1 and scopolamine 0.0065 mg kg-1; or placebo. The premedication was administered and evaluated in a double-blind fashion. The patients were anaesthetized with thiopentone, fentanyl, pancuronium, and ventilated with nitrous oxide in oxygen. The three premedications had no noticeable anxiolytic effect. Although there was no difference in the frequency of observed postoperative nausea and vomiting between the three groups, premedication with dixyrazine nonetheless reduced the patients' experience of postoperative nausea as well as their need for postoperative antiemetics. Although patients in the two treatment groups were significantly more sedated immediately before induction of anaesthesia than patients receiving placebo, the degree of postoperative sedation was similar in all three groups. Morphine-scopolamine caused more postoperative dizziness than dixyrazine and placebo. Lack of recall was produced by both morphine-scopolamine and dixyrazine. It is concluded that premedication with dixyrazine is a useful alternative, especially in patients who have previously experienced postoperative nausea and vomiting.
90例计划接受普通外科或骨科手术的患者被随机分配接受三种肌肉注射术前用药之一：地西拉嗪0.5mg/kg；吗啡0.15mg/kg和东莨菪碱0.0065mg/kg；或安慰剂。术前用药采用双盲方式给药和评估。患者用硫喷妥钠、芬太尼、潘库溴铵麻醉，并用笑气-氧气通气。三种术前用药均无明显的抗焦虑作用。虽然三组之间观察到的术后恶心和呕吐频率没有差异，但地西拉嗪术前用药仍可减轻患者术后恶心的体验以及术后对止吐药的需求。虽然两个治疗组的患者在诱导麻醉前比接受安慰剂的患者明显更镇静，但所有三组的术后镇静程度相似。吗啡-东莨菪碱引起的术后头晕比地西拉嗪和安慰剂更多。吗啡-东莨菪碱和地西拉嗪均可导致记忆缺失。结论是，地西拉嗪术前用药是一种有用的选择，尤其适用于既往有术后恶心和呕吐经历的患者。
