Fujii Y, Tanaka H, Toyooka H
Department of Anaesthesiology, Toride Kyodo General Hospital, Ibaraki, Japan.
Can J Anaesth. 1997 Apr;44(4):396-400. doi: 10.1007/BF03014460.
Postoperative nausea and vomiting (PONV) are commonly observed undesirable consequences of laparoscopic cholecystectomy. This study was undertaken to compare granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, with droperidol for reducing the incidence and severity of PONV after laparoscopic cholecystectomy.
Eighty patients, aged 25-65 yr, scheduled for elective laparoscopic cholecystectomy were enrolled in a randomized, double-blinded investigation and assigned to one of three treatment regimens: placebo (saline), 1.25 mg droperidol (approximately 25 micrograms.kg-1) or 3 mg granisetron (approximately 60 micrograms.kg-1). The study drugs were administered iv immediately before the induction of anaesthesia. A standard general anaesthetic technique was employed throughout. Nausea, vomiting and safety assessments were performed continuously during the first 24 hr after anaesthesia.
The incidence of PONV was 46% with placebo, 41% with droperidol and 15% with granisetron (P < 0.05; overall chi 2 test). Four patients who had received placebo and two who had received droperidol required another rescue antiemetic, compared with none who had received granisetron (P < 0.05). Adverse events postoperatively were not different among the groups.
Granisetron is more effective than droperidol and placebo for reducing the incidence and severity of PONV after laparoscopic cholecystectomy.
术后恶心呕吐(PONV)是腹腔镜胆囊切除术后常见的不良后果。本研究旨在比较选择性5-羟色胺3型受体拮抗剂格拉司琼与氟哌利多在降低腹腔镜胆囊切除术后PONV发生率和严重程度方面的效果。
80例年龄在25至65岁之间、计划行择期腹腔镜胆囊切除术的患者被纳入一项随机双盲研究,并被分配至三种治疗方案之一:安慰剂(生理盐水)、1.25mg氟哌利多(约25μg·kg-1)或3mg格拉司琼(约60μg·kg-1)。研究药物在麻醉诱导前即刻静脉注射。全程采用标准的全身麻醉技术。在麻醉后的头24小时内持续进行恶心、呕吐及安全性评估。
安慰剂组PONV发生率为46%,氟哌利多组为41%,格拉司琼组为15%(P<0.05;总体χ2检验)。接受安慰剂的4例患者和接受氟哌利多的2例患者需要再次使用抢救性止吐药,而接受格拉司琼的患者无人需要(P<0.05)。各组术后不良事件无差异。
在降低腹腔镜胆囊切除术后PONV的发生率和严重程度方面,格拉司琼比氟哌利多和安慰剂更有效。