Morimoto Y, Nakamura M, Tamura T, Kunii T, Shimizu K, Miyauchi Y
Department of Anesthesiology and Critical Care, Tokuyama Central Hospital.
Masui. 1996 Sep;45(9):1096-9.
The antiemetic effect of ondansetron (a 5-HT3 antagonist) was evaluated in patients treated with intraperitoneally administered anti-neoplastic agents (cisplatin and mitomycin-C) during surgery for ovarian cancer. Anesthesia was induced with intravenous thiopental 5 mg x kg-1 and maintained with nitrous oxide 66% in oxygen and isoflurane. After surgery, 6 patients received a single intravenous dose of ondansetron 4 mg (group O), 6 others did not receive ondansetron (group C). Both groups received an intravenous dose of methyl-prednisolone 500 mg. An intravenous dose of metoclopramide 10 mg was provided in case of continued vomiting or at the patient's request as a rescue antiemetic. The incidence of vomiting was 13% in group O and 87% in group C (P < 0.05). Nausea scores (range 1-4) were significantly lower in group O as compared with group C at 4 h and 8 h after surgery. Total dose of metoclopramide was 20 +/- 13 mg (mean +/- SD) in group C and 2 +/- 4 mg in group O. Administration of anti-neoplastic agents during surgery caused severe nausea and vomiting after surgery and ondansetron prevented the occurrence of nausea and vomiting almost completely. We conclude that ondansetron is an effective antiemetic for preventing postoperative nausea and vomiting in patients administered anti-neoplastic agents.
在卵巢癌手术期间接受腹腔内注射抗肿瘤药物(顺铂和丝裂霉素 - C)治疗的患者中,评估了昂丹司琼(一种5 - HT3拮抗剂)的止吐效果。麻醉诱导采用静脉注射硫喷妥钠5mg·kg-1,并用66%氧化亚氮和异氟烷维持。术后,6例患者接受单次静脉注射昂丹司琼4mg(O组),另外6例未接受昂丹司琼(C组)。两组均接受静脉注射甲泼尼龙500mg。若持续呕吐或患者要求,可静脉注射甲氧氯普胺10mg作为急救止吐药。O组呕吐发生率为13%,C组为87%(P < 0.05)。术后4小时和8小时,O组恶心评分(范围1 - 4)显著低于C组。C组甲氧氯普胺总剂量为20±13mg(均值±标准差),O组为2±4mg。手术期间给予抗肿瘤药物会导致术后严重恶心和呕吐,而昂丹司琼几乎完全预防了恶心和呕吐的发生。我们得出结论,昂丹司琼是预防接受抗肿瘤药物治疗患者术后恶心和呕吐的有效止吐药。