Graczyk S G, McKenzie R, Kallar S, Hickok C B, Melson T, Morrill B, Hahne W F, Brown R A
Anesthesiologists of Columbia, PA, Columbia, South Carolina 29220, USA.
Anesth Analg. 1997 Feb;84(2):325-30. doi: 10.1097/00000539-199702000-00015.
The newer 5-hydroxytryptamine type 3 (5-HT3) antagonists are sometimes considered for routine prophylaxis of postoperative nausea and vomiting (PONV) in high-risk patients. This multicenter, randomized, double-blind, placebo-controlled study compared the efficacy and safety of three single intravenous (IV) doses of dolasetron mesylate salt (12.5, 25, or 50 mg) for the prevention of PONV in 635 females undergoing outpatient laparoscopic gynecologic surgery. Antiemetic efficacy was evaluated over a 24-h postoperative period by recording the number and timing of emetic episodes; effects on nausea were evaluated by a visual analog scale (VAS). The proportion of complete responders (no emetic episodes and no escape medication in 24 h) was significantly higher with each dolasetron mesylate dose (> 50% for each dose; P < or = 0.0003) than with placebo (30.6%). Fewer patients given dolasetron required or requested escape antiemetic medication compared with placebo (P < 0.0003). Dolasetron-treated patients had significantly (P < 0.0357) lower median postdose maximum nausea VAS scores compared with placebo-treated patients. Patient satisfaction with dolasetron was high and, overall, was significantly (P = 0.0131) greater than that with placebo. Dolasetron was an effective and well tolerated preventive treatment for PONV resulting from laparoscopic gynecologic surgery.
新型5-羟色胺3型（5-HT3）拮抗剂有时被考虑用于高危患者术后恶心和呕吐（PONV）的常规预防。这项多中心、随机、双盲、安慰剂对照研究比较了三种单剂量静脉注射（IV）甲磺酸多拉司琼（12.5、25或50mg）对635例接受门诊腹腔镜妇科手术的女性预防PONV的疗效和安全性。通过记录呕吐发作的次数和时间来评估术后24小时内的止吐疗效；通过视觉模拟量表（VAS）评估对恶心的影响。与安慰剂组（30.6%）相比，甲磺酸多拉司琼各剂量组的完全缓解者（24小时内无呕吐发作且未使用解救药物）比例均显著更高（各剂量组均>50%；P≤0.0003）。与安慰剂组相比，接受多拉司琼治疗的患者需要或要求使用解救性止吐药物的人数更少（P<0.0003）。与安慰剂治疗的患者相比，接受多拉司琼治疗的患者给药后最大恶心VAS评分中位数显著更低（P<0.0357）。患者对多拉司琼的满意度较高，总体而言，显著高于安慰剂组（P=0.0131）。多拉司琼是一种有效且耐受性良好的预防腹腔镜妇科手术引起的PONV的治疗方法。
