Walder A D, Aitkenhead A R
University Department of Anaesthesia, Queens Medical Centre, Nottingham.
Anaesthesia. 1994 Sep;49(9):804-6. doi: 10.1111/j.1365-2044.1994.tb04458.x.
A double-blind, randomised, controlled trial was performed to assess the antiemetic efficacy of metoclopramide when included in a morphine patient-controlled analgesia regimen. Fifty ASA grade 1 or 2 patients scheduled for elective intermediate or major gynaecological surgery were allocated into one of two groups. All patients received a standardised anaesthetic and metoclopramide 5 mg was given intravenously 10 min before the end of the procedure. Group 1 received a patient-controlled analgesia regimen using morphine 1 mg.ml-1 solution. Group 2 received a patient-controlled analgesia regimen using morphine 1mg.ml-1 with metoclopramide 0.5 mg.ml-1 solution. Postoperative antiemetic treatment was with metoclopramide 10 mg intramuscularly or cyclizine 50 mg intramuscularly if this was ineffective. Pain scores, sedation scores, and morphine requirement were not significantly different between the groups. There was no difference in nausea scores between the groups, but more patients suffered moderate or severe nausea in group 1 (10 patients) than group 2 (three patients, p < 0.026). We conclude that metoclopramide, when included in a patient-controlled analgesia regimen, reduces the incidence of moderate to severe nausea, but not the overall incidence of nausea.
进行了一项双盲、随机、对照试验，以评估甲氧氯普胺纳入吗啡患者自控镇痛方案时的止吐效果。50例计划进行择期中型或大型妇科手术的ASA 1或2级患者被分为两组。所有患者均接受标准化麻醉，并在手术结束前10分钟静脉注射5毫克甲氧氯普胺。第1组采用1毫克/毫升吗啡溶液的患者自控镇痛方案。第2组采用含0.5毫克/毫升甲氧氯普胺的1毫克/毫升吗啡溶液的患者自控镇痛方案。术后若甲氧氯普胺10毫克肌肉注射无效，则用赛克利嗪50毫克肌肉注射进行止吐治疗。两组之间的疼痛评分、镇静评分和吗啡需求量无显著差异。两组之间的恶心评分无差异，但第1组（10例患者）中出现中度或重度恶心的患者比第2组（3例患者，p<0.026）更多。我们得出结论，甲氧氯普胺纳入患者自控镇痛方案时，可降低中度至重度恶心的发生率，但不能降低恶心的总体发生率。
