比较格拉司琼与昂丹司琼在蛛网膜下腔阻滞下行下段剖宫产术时控制恶心和呕吐的效果。
To Compare the Effectiveness of Granisetron Versus Ondansetron to Control Nausea and Vomiting During Lower Segment Cesarean Section Under Subarachnoid Block.
作者信息
Mehta Milan Vijaykant, Chudasama Palak Anilkumar, Baria Tushar
机构信息
Department of Anesthesia, Banas Medical College and Research Institute, Palanpur, Gujarat, India.
Department of Anesthesia, GMERS Medical College and Hospital, Sabarkantha, Gujarat, India.
出版信息
Anesth Essays Res. 2022 Jul-Sep;16(3):378-380. doi: 10.4103/aer.aer_86_22. Epub 2022 Dec 9.
BACKGROUND
Nausea and vomiting (NV) seen during and after lower segment cesarean section (LSCS) are due to increased intragastric pressure, hypotension, stretching the peritoneum (exteriorization of the uterus), excessive surgical manipulation and visceral stimulation, using opioids, using uterotonic agents, and the patient's mental status. Ondansetron and granisetron intravenous (i.v.) are useful for avoiding bradycardia and hypotension.
OBJECTIVES
The objective of this study is to study the effectiveness of granisetron versus ondansetron to control NV during LSCS under subarachnoid block.
MATERIALS AND METHODS
Eighty patients undergoing elective cesarean section under spinal anesthesia by intrathecal bupivacaine were randomly divided into two groups (40 pregnant females of the American Society of Anesthesiologists physical status Classes I and II in each Group). Group 1 received granisetron 40 mg.kg i.v. stat after clamping the cord and Group 2 given i.v. ondansetron 8 mg stat after clamping the cord. NV were observed at the "early postoperative period (0-3 h)" and "late postoperative period (4-24 h)."
STATISTICAL ANALYSIS USED
Student's -test and Chi-square test were used to find out the statistical significance, < 0.05 was considered statistically significant.
RESULTS
The mean age was 29.3 years with 4.15 standard deviation (SD) and 28.3 years with 4.41 SD in Groups 1 and 2, respectively. The mean duration of surgery was 53.1 min with 6.67 min SD and 57.7 min with 10.26 SD in Groups 1 and 2, respectively. In the "early postoperative period," NV observed in 7.5% and 10.0% participants in Groups 1 and 2, respectively ( > 0.05), and in "late postoperative period," NV observed in 0.0% and 22.5% participants in Groups 1 and 2, respectively ( < 0.05).
CONCLUSION
Granisetron reduces the severity of spinal-induced hypotension, need for rescue vasopressor, and incidence of nausea.
背景
下段剖宫产术（LSCS）期间及术后出现的恶心呕吐（NV）是由于胃内压升高、低血压、腹膜牵拉（子宫外置）、过度手术操作和内脏刺激、使用阿片类药物、使用宫缩剂以及患者的精神状态所致。静脉注射昂丹司琼和格拉司琼有助于避免心动过缓和低血压。
目的
本研究的目的是探讨格拉司琼与昂丹司琼在蛛网膜下腔阻滞下控制LSCS期间NV的有效性。
材料与方法
80例接受鞘内布比卡因脊麻下行择期剖宫产术的患者随机分为两组（每组40例美国麻醉医师协会身体状况分级为I级和II级的孕妇）。第1组在脐带结扎后静脉注射格拉司琼40mg.kg，第2组在脐带结扎后静脉注射昂丹司琼8mg。在“术后早期（0 - 3小时）”和“术后晚期（4 - 24小时）”观察NV情况。
使用的统计分析方法
采用学生t检验和卡方检验来确定统计学意义，P < 0.05被认为具有统计学意义。
结果
第1组和第2组的平均年龄分别为29.3岁，标准差为4.15，以及28.3岁，标准差为4.41。第1组和第2组的平均手术时间分别为53.1分钟，标准差为6.67分钟，以及57.7分钟，标准差为10.26分钟。在“术后早期”，第1组和第2组分别有7.5%和10.0%的参与者出现NV（P > 0.05），在“术后晚期”，第1组和第2组分别有0.0%和22.5 %的参与者出现NV（P < 0.05）。
结论
格拉司琼可降低脊髓诱导的低血压严重程度、急救血管升压药的需求以及恶心的发生率。
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