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剖宫产脊髓麻醉期间预防性使用昂丹司琼预防术中寒战、恶心和呕吐:一项随机对照试验

Prophylactic ondansetron for preventing intraoperative shivering, nausea and vomiting during spinal anesthesia for cesarean section: a randomized controlled trial.

作者信息

Zhang Yuan, Xia Fen, Zhang Wangping, Lv Anqing

机构信息

Department of Anesthesiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China.

Department of anesthesiology, Jiaxing Women and Children's Hospital, Jiaxing, China.

出版信息

Front Pharmacol. 2024 Dec 10;15:1500642. doi: 10.3389/fphar.2024.1500642. eCollection 2024.

Abstract

BACKGROUND

Shivering, nausea and vomiting are common complications in cesarean section during neuraxial anesthesia. The aim of this study was to investigate the effects of prophylactic use of ondansetron on intraoperative shivering, nausea and vomiting in women undergoing cesarean section.

METHODS

A total of 80 full-term parturients were randomly divided into the ondansetron group and the control group. The ondansetron group received 0.075 mg/kg of ondansetron 15 min before anesthesia, the control group were given the same volume of saline solution. The incidence of shivering, nausea and vomiting was noted. The occurrence and severity of shivering and other outcomes, such as hypotension, bradycardia and dizziness were recorded during the surgery. Umbilical arterial blood was analyzed, and the neonatal Apgar scores were assessed.

RESULTS

The incidence of grade ≥1 shivering was lower in ondansetron group. The incidence of shivering, nausea and vomiting was significantly lower in ondansetron group than the control group (2.5% vs. 22.3%, = 0.007, 2.5% vs. 40%, = 0.001, respectively). No significant differences were observed in the incidence of hypotension, bradycardia, headache and dizziness between the 2 groups ( > 0.05). The umbilical artery pH and neonatal Apgar score were similar between the 2 groups ( > 0.05).

CONCLUSION

Prophylactic use of ondansetron could prevent intra-operative shivering and reduce the incidence of nausea and vomiting in cesarean section under spinal anesthesia without increasing the incidence of maternal and infant adverse events.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn, identifier ChiCTR2100042453.

摘要

背景

寒战、恶心和呕吐是剖宫产腰麻期间常见的并发症。本研究旨在探讨预防性使用昂丹司琼对剖宫产术中寒战、恶心和呕吐的影响。

方法

80例足月产妇随机分为昂丹司琼组和对照组。昂丹司琼组在麻醉前15分钟静脉注射0.075mg/kg昂丹司琼,对照组给予等体积生理盐水。记录寒战、恶心和呕吐的发生率。术中记录寒战的发生情况及严重程度,以及低血压、心动过缓和头晕等其他结果。分析脐动脉血,并评估新生儿Apgar评分。

结果

昂丹司琼组≥1级寒战的发生率较低。昂丹司琼组寒战、恶心和呕吐的发生率显著低于对照组(分别为2.5% vs. 22.3%,P = 0.007;2.5% vs. 40%,P = 0.001)。两组低血压、心动过缓、头痛和头晕的发生率差异无统计学意义(P > 0.05)。两组脐动脉pH值和新生儿Apgar评分相似(P > 0.05)。

结论

预防性使用昂丹司琼可预防剖宫产脊髓麻醉下术中寒战,降低恶心和呕吐的发生率,且不增加母婴不良事件的发生率。

临床试验注册

https://www.chictr.org.cn,标识符ChiCTR2100042453。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24e8/11666353/08d390ad3cb1/fphar-15-1500642-g001.jpg

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