Borgeat A, Wilder-Smith O, Forni M, Suter P M
Department of Anesthesiology, University Hospital of Geneva, Switzerland.
Can J Anaesth. 1994 Nov;41(11):1117-9. doi: 10.1007/BF03015664.
We investigated the prophylactic antiemetic effect of added low-dose infusion of propofol in patients exhibiting nausea and vomiting refractory to dexamethasone and serotonin antagonist during non-cisplatin chemotherapy for breast cancer. In a prospective open longitudinal study, 117 patients who had more than five episodes of nausea and vomiting in their first chemotherapy cycle during the first 24 hr completed the study. They received in addition to the usual prophylactic antiemetic regimen a continuous intravenous infusion of 1 mg.kg-1.hr-1 propofol started four hours before chemotherapy and continued up to 24 hr for the two subsequent cycles. The number of vomiting/nausea episodes, level of sedation, patient activity, appetite and preference for future chemotherapy cycles were assessed. In the propofol supplemented cycles 90 and 80% of patients, during the 1st and 2nd propofol-assisted cycle respectively, were free of nausea and vomiting during the first 24 hr after chemotherapy. Patients were more frequently active and had more appetite during the propofol-assisted cycles. No propofol-associated side effects were observed. We conclude that the addition of a subhypnotic infusion of propofol enables better control of nausea and vomiting caused by non-cisplatin chemotherapy in the first 24 hr post-treatment.
我们研究了在乳腺癌非顺铂化疗期间，对接受地塞米松和5-羟色胺拮抗剂治疗后仍出现难治性恶心和呕吐的患者，添加小剂量丙泊酚输注的预防性止吐效果。在一项前瞻性开放纵向研究中，117例在首个化疗周期的头24小时内出现超过5次恶心和呕吐发作的患者完成了该研究。除常规预防性止吐方案外，他们在化疗前4小时开始接受1mg·kg-1·hr-1的丙泊酚持续静脉输注，并在随后的两个周期中持续至24小时。评估呕吐/恶心发作次数、镇静程度、患者活动情况、食欲以及对未来化疗周期的偏好。在补充丙泊酚的周期中，分别在第1次和第2次丙泊酚辅助周期中，90%和80%的患者在化疗后的头24小时内无恶心和呕吐。在丙泊酚辅助周期中，患者活动更频繁，食欲更佳。未观察到与丙泊酚相关的副作用。我们得出结论，添加亚催眠剂量的丙泊酚输注能够更好地控制治疗后首24小时内非顺铂化疗引起的恶心和呕吐。
