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帕洛诺司琼与昂丹司琼联合地塞米松预防腹腔镜妇科手术患者术后恶心呕吐的止吐疗效比较

Antiemetic Efficacy of Palonosetron Compared with the Combination of Ondansetron and Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Gynaecological Surgery.

作者信息

Dey Samarjit, Chanu Sairem Mangolnganbi, Dev Priyanka, Borthakur Manas, Karim Habib Md Reazaul, Yunus Md

机构信息

All India Institute of Medical Sciences - Raipur, Raipur, Chhattisgarh, India.

Department of Obstetrics and Gyanecology, JIPMER, Puducherry 605006, India.

出版信息

Rom J Anaesth Intensive Care. 2022 Sep 25;28(1):19-24. doi: 10.2478/rjaic-2021-0003. eCollection 2021 Jul.

Abstract

BACKGROUND AND AIMS

For the prevention of PONV, we evaluated the efficacy of palonosetron compared with ondansetron along with dexamethasone in patients undergoing laparoscopic gynaecological surgery.

METHODS

A total of 84 adults, posted for elective laparoscopic surgeries under general anaesthesia were included in the study. The patients were randomly allocated to two groups (n = 42 each). Immediately after induction, patients in the first group (group I) received 4 mg ondansetron with 8 mg dexamethasone, and patients in the second group (group II) received 0.075 mg palonosetron. Any incidences of nausea and/or vomiting, the requirement of rescue antiemetic, and side effects were recorded.

RESULTS

In group I, 66.67% of the patients had an Apfel score of 2, and 33.33% of the patients had a score of 3. In group II, 85.71% of patients had an Apfel score of 2, and 14.29% of the patients had a score of 3. At 1, 4, and 8 hours, the incidence of PONV was comparable in both groups. At 24 hours there was a significant difference in the incidence of PONV in the group treated with ondansetron with dexamethasone combination (4/42) when compared to the palonosetron group (0/42). The overall incidence of PONV was significantly higher in group I (23.81%: ondansetron and dexamethasone combination) than in group II (7.14%: palonosetron). The need for rescue medication in group I was significantly high. Conclusion: Palonosetron was more efficacious compared to the combination of ondansetron and dexamethasone for preventing PONV for laparoscopic gynaecological surgery.

摘要

背景与目的

为预防术后恶心呕吐(PONV),我们评估了帕洛诺司琼与昂丹司琼联合地塞米松在接受腹腔镜妇科手术患者中的疗效。

方法

本研究纳入了84例计划在全身麻醉下进行择期腹腔镜手术的成年人。患者被随机分为两组(每组n = 42)。诱导后立即给药,第一组(I组)患者接受4 mg昂丹司琼与8 mg地塞米松,第二组(II组)患者接受0.075 mg帕洛诺司琼。记录恶心和/或呕吐的发生率、抢救性止吐药的使用需求及副作用。

结果

I组中,66.67%的患者Apfel评分为2分,33.33%的患者评分为3分。II组中,85.71%的患者Apfel评分为2分,14.29%的患者评分为3分。在1小时、4小时和8小时时,两组的PONV发生率相当。在24小时时,与帕洛诺司琼组(0/42)相比,昂丹司琼联合地塞米松治疗组(4/42)的PONV发生率存在显著差异。I组的PONV总发生率(23.81%:昂丹司琼与地塞米松联合)显著高于II组(7.14%:帕洛诺司琼)。I组对抢救药物的需求显著更高。结论:在预防腹腔镜妇科手术的PONV方面,帕洛诺司琼比昂丹司琼与地塞米松的联合用药更有效。

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