Jellish W S, Leonetti J P, Fluder E, Thalji Z
Department of Anesthesiology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Otolaryngol Head Neck Surg. 1998 Jun;118(6):785-9. doi: 10.1016/S0194-5998(98)70269-4.
This study compares the preoperative administration of ondansetron with that of droperidol or saline solution for the prevention of nausea and vomiting in otologic surgery patients. A total of 120 otherwise healthy individuals were randomly assigned to receive either saline solution, ondansetron (4 mg intravenously), or droperidol (25 microg/kg intravenously) before anesthetic induction. Intraoperative and postanesthesia care unit times were recorded along with incidence of nausea, vomiting, pain, nausea and recovery scores, and the administration of rescue antiemetics. Similar assessments were made during the next 24 hours. Demographics were similar, but more males received ondansetron. Anesthetic recovery scores were lower after administration of droperidol than after ondansetron. Incidence of nausea was similar between groups, but severity was greater with placebo and droperidol than with ondansetron. More vomiting occurred with placebo than with ondansetron or droperidol. No intergroup differences in rescue antiemetic administration were noted, however. Twenty-four hours later, more patients receiving placebo had nausea or vomited than patients receiving droperidol or ondansetron. Fewer women in the ondansetron group vomited than in the other two groups. Ondansetron 4 mg intravenously is as effective as droperidol and better than saline solution in preventing nausea and vomiting in patients undergoing otologic surgery. No cost advantage as determined by lower use of rescue antiemetics or shorter postanesthesia care unit times was noted after ondansetron therapy.
本研究比较了昂丹司琼与氟哌利多或生理盐水术前给药对耳科手术患者恶心和呕吐的预防作用。总共120名其他方面健康的个体在麻醉诱导前被随机分配接受生理盐水、昂丹司琼（静脉注射4毫克）或氟哌利多（静脉注射25微克/千克）。记录术中及麻醉后监护病房时间以及恶心、呕吐、疼痛、恶心和恢复评分，以及急救止吐药的使用情况。在接下来的24小时内进行类似评估。人口统计学特征相似，但接受昂丹司琼的男性更多。氟哌利多给药后的麻醉恢复评分低于昂丹司琼给药后。各组之间恶心发生率相似，但安慰剂组和氟哌利多组的严重程度高于昂丹司琼组。安慰剂组的呕吐发生率高于昂丹司琼组或氟哌利多组。然而，在急救止吐药使用方面未观察到组间差异。24小时后，接受安慰剂的患者出现恶心或呕吐的人数多于接受氟哌利多或昂丹司琼的患者。昂丹司琼组呕吐的女性少于其他两组。静脉注射4毫克昂丹司琼在预防耳科手术患者恶心和呕吐方面与氟哌利多效果相同且优于生理盐水。昂丹司琼治疗后，未观察到因急救止吐药使用减少或麻醉后监护病房时间缩短而带来的成本优势。
