Fujii Y, Toyooka H, Tanaka H
Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
Can J Anaesth. 1997 Aug;44(8):820-4. doi: 10.1007/BF03013157.
Motion sickness is one of the patient-related factors associated with postoperative nausea and vomiting (PONV). This study was undertaken to assess the efficacy of granisetron, droperidol and metoclopramide for preventing PONV in female patients with a history of motion sickness undergoing major gynaecological surgery.
In a prospective, randomized, placebo-controlled, double-blind study, 120 patients received either 1.25 mg droperidol, 10 mg metoclopramide, 40 micrograms.kg-1 granisetron or placebo (saline) iv immediately before induction of anaesthesia. A standardized anaesthetic technique and postoperative analgesia were used in all patients. During the first 24 hr after anaesthesia, the incidence of PONV and adverse events were recorded by nursing-staff.
The treatment groups were similar for patient demographics, types of surgery, anaesthetics administered and opioid given. The incidence of PONV was 70%, 50%, 57% and 23% in the placebo, droperidol, metoclopramide and granisetron groups, respectively (P < 0.05; overall chi 2 test). No difference in the incidence of adverse events was observed in either group.
Granisetron is a better prophylactic antiemetic than droperidol or metoclopramide in female patients with a history of motion sickness undergoing major gynaecological surgery.
晕动病是与术后恶心呕吐（PONV）相关的患者因素之一。本研究旨在评估格拉司琼、氟哌利多和甲氧氯普胺对接受大型妇科手术且有晕动病史的女性患者预防PONV的疗效。
在一项前瞻性、随机、安慰剂对照、双盲研究中，120例患者在麻醉诱导前即刻静脉注射1.25mg氟哌利多、10mg甲氧氯普胺、40μg·kg-1格拉司琼或安慰剂（生理盐水）。所有患者均采用标准化麻醉技术和术后镇痛。麻醉后的前24小时内，护理人员记录PONV和不良事件的发生率。
各治疗组在患者人口统计学、手术类型、所用麻醉剂和给予的阿片类药物方面相似。安慰剂组、氟哌利多组、甲氧氯普胺组和格拉司琼组的PONV发生率分别为70%、50%、57%和23%（P<0.05；总体卡方检验）。两组不良事件发生率均无差异。
对于接受大型妇科手术且有晕动病史的女性患者，格拉司琼在预防恶心呕吐方面比氟哌利多或甲氧氯普胺更有效。
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