Watts S A
Palmerston North Hospital, New Zealand.
Anaesth Intensive Care. 1996 Oct;24(5):546-51. doi: 10.1177/0310057X9602400506.
This study determined the overall incidence of postoperative nausea and vomiting (PONV) in 38 patients undergoing laparoscopic gynaecological procedures who received a standardized propofol/isoflurane anaesthetic but no preoperative antiemetic. A further 166 patients similarly anaesthetized were then randomly allocated to receive either metoclopramide 10 mg. ondansetron 4 mg, or cyclizine 50 mg as an intravenous antiemetic immediately preinduction. Overall incidence of PONV was determined for all groups and the relative efficacy of the three antiemetic agents assessed. Fifty per cent of patients in the initial group (no antiemetic) reported significant nausea and/or vomiting up to 24 hours postoperatively. The incidence of PONV in the metoclopramide group was 24%, in the ondansetron group 20%, and in the cyclizine group 51%. There was no detectable difference in relative efficacy between ondansetron 4 mg and metoclopramide 10 mg. The incidence of PONV in the group who received cyclizine was similar to that found in the pilot group who received no PONV prophylaxis. Both metoclopramide and ondansetron may potentially decrease the incidence of PONV following gynaecologic laparoscopy by up to 50% when administered intravenously prior to a propofol/isoflurane anaesthetic.
本研究确定了38例行腹腔镜妇科手术患者术后恶心呕吐（PONV）的总体发生率，这些患者接受了标准化的丙泊酚/异氟烷麻醉，但未使用术前止吐药。随后，将另外166例接受类似麻醉的患者随机分配，在诱导前即刻静脉注射10毫克胃复安、4毫克昂丹司琼或50毫克赛克利嗪作为止吐药。确定了所有组的PONV总体发生率，并评估了三种止吐药的相对疗效。初始组（未使用止吐药）中有50%的患者在术后24小时内报告有明显的恶心和/或呕吐。胃复安组的PONV发生率为24%，昂丹司琼组为20%，赛克利嗪组为51%。4毫克昂丹司琼和10毫克胃复安在相对疗效上没有可检测到的差异。接受赛克利嗪组的PONV发生率与未进行PONV预防的试验组相似。在丙泊酚/异氟烷麻醉前静脉注射时，胃复安和昂丹司琼都有可能使妇科腹腔镜检查后PONV的发生率降低多达50%。
