Tolksdorf W, Meisel R, Müller P, Bender H J
Anaesthesist. 1985 Dec;34(12):656-62.
Parenteral scopolamine lost its significance for premedication because of severe side effects, at least in German speaking countries. The drug is now available as a transdermal therapeutic system (TTS-Scopolamine) which provides constant low plasma concentrations for three days, high enough to act as an antiemetic but low enough to be free from severe side effects. In a double blind study against TTS-Placebo TTS-Scopolamine was investigated in 40 patients, undergoing minor gynecological surgery. The anaesthetic procedure was standardized with alfentanil, etomidate, N2O and, if needed, Ethrane, drugs which have a moderate to strong emetic action. The premedication consisted of Flurazepam (evening) and diazepam (morning). The dosages were standardized. TTS-scopolamine was statistically significantly superior to TTS-placebo with respect to the antiemetic action and the judgment by the anaesthetist. Intraoperative complications such as thoracic rigidity and bradycardia were more frequent in the placebo group. There were no severe side effects. TTS-scopolamine can be recommended as an antiemetic for premedication, especially when benzodiazepines are used for the relief of anxiety. It should be administered on the evening before and can be removed one or two days after surgery.
由于存在严重的副作用，至少在德语国家，胃肠外使用东莨菪碱已不再用于术前用药。该药物现在有透皮治疗系统（TTS - 东莨菪碱）剂型，可在三天内持续维持较低的血浆浓度，浓度高到足以起到止吐作用，但又低到不会产生严重副作用。在一项针对40例接受小型妇科手术患者的双盲研究中，对TTS - 东莨菪碱与TTS - 安慰剂进行了对比研究。麻醉过程采用阿芬太尼、依托咪酯、N₂O 进行标准化处理，如有需要还使用恩氟烷，这些药物具有中度到强烈的催吐作用。术前用药包括氟西泮（晚上）和地西泮（早上）。剂量进行了标准化。在止吐作用以及麻醉医生的判断方面，TTS - 东莨菪碱在统计学上显著优于TTS - 安慰剂。安慰剂组术中出现胸壁强直和心动过缓等并发症更为频繁。未出现严重副作用。TTS - 东莨菪碱可推荐作为术前用药的止吐药物，尤其是当使用苯二氮䓬类药物缓解焦虑时。应在手术前一晚给药，术后一两天可去除。
