亚催眠剂量的丙泊酚不能治疗儿童腺样体扁桃体切除术后的呕吐。

Subhypnotic propofol does not treat postoperative vomiting in children after adenotonsillectomy.

作者信息

Zestos M M, Carr A S, McAuliffe G, Smith H S, Sikich N, Lerman J

机构信息

Department of Anaesthesia, Hospital for Sick Children, University of Toronto, Ontario, Canada.

出版信息

Can J Anaesth. 1997 Apr;44(4):401-4. doi: 10.1007/BF03014461.

DOI:10.1007/BF03014461

PMID:9104523

Abstract

PURPOSE

To investigate the efficacy of a subhypnotic dose of propofol to treat vomiting in children after adenotonsillectomy.

METHODS

Two hundred and fifty-two children, aged 2-12 yr, underwent a standardized anaesthetic opioid administration, and postoperative care after adenotonsillectomy, adenoidectomy or tonsillectomy. A prospective, double-blinded, placebo-controlled study was performed in 70 of the patients who retched or vomited after surgery and who had intravenous access. Patients were assigned randomly to receive either 0.2 mg.kg-1) propofol (n = 35), or placebo (intralipid 10%, n = 35).

RESULTS

The overall incidence of vomiting during the first 18-24 hr was 50%. Of those who had received propofol after the first episode of vomiting, 63% relapsed requiring a rescue antiemetic compared with 57% of those who had received intralipid (P = NS). Of the children who received propofol, 54% experienced pain on injection and 46% were mildly sedated compared with 3% and 11%, respectively, in the placebo group (P < 0.003).

CONCLUSION

We conclude that an intravenous bolus of 0.2 mg.kg-1 propofolis not effective in the treatment of postoperative vomiting in children after adenotonsillectomy when a standardized anaesthetic with thiopentone, halothane, nitrous oxide, and 1.5 mg.kg-1 codeine phosphate is used, but it does cause sedation and pain on injection.

摘要

目的

探讨亚催眠剂量丙泊酚治疗儿童腺样体扁桃体切除术后呕吐的疗效。

方法

252例2至12岁儿童接受了标准化麻醉阿片类药物给药，并在腺样体扁桃体切除术、腺样体切除术或扁桃体切除术后接受了术后护理。对70例术后出现干呕或呕吐且有静脉通路的患者进行了一项前瞻性、双盲、安慰剂对照研究。患者被随机分配接受0.2mg·kg⁻¹丙泊酚（n = 35）或安慰剂（10%脂肪乳剂，n = 35）。

结果

术后18至24小时内呕吐的总体发生率为50%。首次呕吐发作后接受丙泊酚治疗的患者中，63%复发需要抢救性使用止吐药，而接受脂肪乳剂治疗的患者中这一比例为57%（P = 无显著性差异）。接受丙泊酚治疗的儿童中，54%注射时感到疼痛，46%出现轻度镇静，而安慰剂组分别为3%和11%（P < 0.003）。