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剖宫产硬膜内麻醉期间使用亚催眠剂量丙泊酚预防术中恶心呕吐

[Prophylaxis of intraoperative nausea and vomiting with sub-hypnotic dose of propofol during intradural anesthesia in cesarean section].

作者信息

Caba F, Echevarría M, Bernal-Dávalos L, Pallarés-González J A, Rodríguez-Rodríguez R

机构信息

Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de Valme, Sevilla.

出版信息

Rev Esp Anestesiol Reanim. 1997 Aug-Sep;44(7):262-6.

PMID:9380919
Abstract

OBJECTIVES

To determine the preventive and therapeutic effect of 10 mg of propofol administered after delivery on the incidence of intraoperative nausea and vomiting (IONV) during intradural anesthesia for cesarean delivery.

PATIENTS AND METHOD

Controlled, randomized double blind study of 60 women (ASA I-II) receiving intradural anesthesia for elective or deferred emergency cesarean delivery. The propofol group received 10 mg i.v. immediately after fetal extraction. The control group received an equal volume of Intralipid. The presence of IONV after administration of the prophylactic bolus was treated with a second bolus, and if nausea had not subsided completely after two minutes, treatment was topped up with dehydro-benzoperidol.

RESULTS

The control group included 31 women and the propofol group 29, of whom 3 were excluded. Control variables were similar in the two groups. There were no significant differences in the incidence and severity of IONV between the two groups (22.5 versus 23%). The top-up antiemetic drug was used in the same number of patients in each group.

CONCLUSIONS

Although 10 mg propofol has been described as an effective direct antiemetic, episodes of IONV were neither prevented nor reversed by its use during intradural anesthesia for cesarean delivery.

摘要

目的

确定分娩后静脉注射10毫克丙泊酚对剖宫产硬膜内麻醉期间术中恶心呕吐(IONV)发生率的预防和治疗效果。

患者与方法

对60例接受择期或延期急诊剖宫产硬膜内麻醉的女性(ASA I-II级)进行对照、随机双盲研究。丙泊酚组在胎儿娩出后立即静脉注射10毫克丙泊酚。对照组注射等体积的脂肪乳剂。预防性推注药物后出现IONV时,给予第二次推注治疗;如果两分钟后恶心仍未完全缓解,则追加使用脱氢苯哌啶进行治疗。

结果

对照组有31名女性,丙泊酚组有29名女性,其中3名被排除。两组的对照变量相似。两组之间IONV的发生率和严重程度无显著差异(分别为22.5%和23%)。每组使用追加止吐药物的患者数量相同。

结论

尽管10毫克丙泊酚被描述为一种有效的直接止吐药,但在剖宫产硬膜内麻醉期间使用它并不能预防或逆转IONV的发作。

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