Bustos-Molina F, García-Cruz J J, Cid-Calzada J, Soro-Domingo M, Bejarano-López C, Cortés-Uribe A
Servicio de Anestesiología y Reanimación, Unidad de Cirugía Mayor Ambulatoria, Complejo Hospitalario de Toledo.
Rev Esp Anestesiol Reanim. 1996 Apr;43(4):138-41.
To evaluate the efficacy of antiemetic prophylaxis with ondansetron administered before major ambulatory surgery.
We retrospectively analyzed 1,881 patients (566 women, 31%) who underwent ambulatory surgery for various conditions between January and December 1993; 84% were ASA I, 15% ASA II and 1% ASA III: Mean age was 35.82 +/- 21.66 years; mean weight was 61.26 +/- 21.77 kg, and mean height was 155.13 +/- 19.27 cm. The techniques employed were total intravenous anesthesia in 64.8%, epidural in 22%, regional intravenous in 5.8%, local in 3.8%, peripheral blockade in 2.6% and intradural in 1%. One thousand thirty-three patients were premedicated with 4 mg ondansetron 30 minutes before the start of surgery; the remaining 848 received no antiemetic drug. We determined the incidences of nausea and vomiting during the 24 hours after surgery and the data were subjected to analysis of variance, covariance adjustment for quantitative variables, chi 2 test with continuity correction for nausea and vomiting.
The incidences of nausea and vomiting were significantly lower in the patients premedicated with ondansetron. Only 36 (3.48%) of the premedicated patients experienced nausea, in comparison with 63 (7.4%) patients with no antiemetic premedication. Vomiting was experienced by 68 (6.58%) patients who received ondansetron, as compared to 112 (13.2%) patients who did not receive the drug.
In our experience, administering 4 mg of ondansetron before major ambulatory surgery significantly reduces the incidence of nausea and vomiting in the immediate postoperative period.
评估在大型非住院手术前使用昂丹司琼进行预防性止吐的疗效。
我们回顾性分析了1993年1月至12月期间因各种疾病接受非住院手术的1881例患者（566例女性，占31%）；84%为ASA I级，15%为ASA II级，1%为ASA III级：平均年龄为35.82±21.66岁；平均体重为61.26±21.77 kg，平均身高为155.13±19.27 cm。所采用的技术包括：全静脉麻醉占64.8%，硬膜外麻醉占22%，区域静脉麻醉占5.8%，局部麻醉占3.8%，外周阻滞占2.6%，硬膜内麻醉占1%。1033例患者在手术开始前30分钟预先使用4 mg昂丹司琼；其余848例未接受止吐药物。我们确定了术后24小时内恶心和呕吐的发生率，并对数据进行方差分析、对定量变量进行协方差调整、对恶心和呕吐进行连续性校正的卡方检验。
预先使用昂丹司琼的患者恶心和呕吐的发生率显著较低。预先用药的患者中只有36例（3.48%）出现恶心，而未进行止吐预处理的患者有63例（7.4%）出现恶心。接受昂丹司琼的患者中有68例（6.58%）出现呕吐，而未接受该药物的患者有112例（13.2%）出现呕吐。
根据我们的经验，在大型非住院手术前给予4 mg昂丹司琼可显著降低术后即刻恶心和呕吐的发生率。
