Alexander R, Lovell A T, Seingry D, Jones R M
Department of Anaesthetics, Royal National Orthopaedic Hospital, Stanmore, Middlesex.
Anaesthesia. 1995 Dec;50(12):1086-8. doi: 10.1111/j.1365-2044.1995.tb05958.x.
In a randomised, placebo-controlled trial we have compared the efficacy of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia after orthopaedic surgery. One hundred and forty five patients, ASA 1 and 2, undergoing major orthopaedic surgery were anaesthetised using a standardised technique. They were randomly allocated to receive patient-controlled analgesia as morphine 1 mg.ml-1 alone; morphine as before plus a single dose of 1.25 mg droperidol together with 0.083 mg.ml-1 in the infusion syringe; or morphine as before plus 4 mg ondansetron and 0.13 mg.ml-1 in the syringe. The patient-controlled analgesia bolus dose was set at 1 ml with a 5 min lockout and a 4 h maximum dose of 30 mg morphine. There was no background infusion. The occurrence of nausea, vomiting and sedation was assessed every 4 h. The incidence of vomiting decreased from 59% in the morphine-only group to 35% and 14% in the droperidol (p < 0.05) and ondansetron groups (p < 0.001) respectively. The number of patients suffering from nausea alone was not significantly different between the three groups, although those in the ondansetron group experienced less severe nausea (p < 0.05) when using a two point scale. The droperidol group had significantly higher sedation scores than the other two groups (p < 0.005). We conclude that ondansetron is superior to droperidol when used with patient-controlled analgesia and causes less sedation.
在一项随机、安慰剂对照试验中，我们比较了昂丹司琼和氟哌利多在减少骨科手术后与自控镇痛相关的术后恶心和呕吐方面的疗效。145例ASA 1级和2级接受大型骨科手术的患者采用标准化技术进行麻醉。他们被随机分配接受以下治疗：仅使用1mg.ml-1吗啡的自控镇痛；如前所述的吗啡加单剂量1.25mg氟哌利多以及输液注射器中0.083mg.ml-1的药物；或如前所述的吗啡加4mg昂丹司琼以及注射器中0.13mg.ml-1的药物。自控镇痛的推注剂量设定为1ml，锁定时间为5分钟，最大剂量为4小时内30mg吗啡。没有背景输注。每4小时评估恶心、呕吐和镇静的发生情况。呕吐发生率从仅使用吗啡组的59%分别降至氟哌利多组的35%（p<0.05）和昂丹司琼组的14%（p<0.001）。三组中仅出现恶心的患者数量无显著差异，尽管使用两点量表时，昂丹司琼组患者的恶心程度较轻（p<0.05）。氟哌利多组的镇静评分显著高于其他两组（p<0.005）。我们得出结论，与自控镇痛联合使用时，昂丹司琼优于氟哌利多，且引起的镇静作用较小。
