盐酸帕诺洛司琼预防腹腔镜直肠癌术后恶心呕吐的临床研究

摘要

Objective To investigate the preventive effect ofpalonosetron against nausea and vomiting (PONV) after laparoscopic proctocolectomy for rectal cancer.Methods 100 ASA 1-2,47-77 kg,45-74 years old patients were randomly divided into group Ⅰ and group Ⅱ,50 for each group.Group Ⅰ were intravenously given 0.25 mg palonosetron before anesthesia induction and group Ⅱ 5 mg tropisetron.Anesthesia was induced with propofol,sufentanyl,and atracurium and maintained with sevoflurane inhalation and remifentanil and atracurium contiuous pumping.The patients received patient controlled intravenous analgesia (PCIA) with sufentanil 2 ug/kg diluted to 100 ml with normal saline.Metoclopramide was used as rescue antiemetic.The incidence and intensity of PONV were observed 48 h after the surgery.Results Within 24 h after thesurgery,there were no statistical differences in the incidence and scale of PONV between these two groups (44％ vs.52％).24-48 h after the surgery,the incidence of PONV was significantly lower in group Ⅰ than in group Ⅱ (6％ vs.20％).No severe adverse reaction occurred in both groups.Conclusions Palonosetron in the prevention of delayed PONV after laparoscopic proctocolectomy for rectal cancer is effective and safe.%目的 评价帕诺洛司琼预防腹腔镜直肠癌术后恶心呕吐(PONV)的效果.方法 择期腹腔镜下行直肠癌根治术患者100例,ASA Ⅰ～Ⅱ级,随机分为帕诺洛司琼组(Ⅰ组)和托烷司琼组(Ⅱ组),各50例.采用常规麻醉诱导和维持.Ⅰ组麻醉诱导前静脉注射帕洛诺司琼0.25 mg,Ⅱ组给予托烷司琼5 mg.所有患者均使用舒芬太尼2μg/kg,生理盐水稀释至100 ml的术后镇痛泵.观察术后48 h恶心呕吐的发生率、严重程度及头痛、头晕等不良反应.结果 术后24 h内,Ⅰ组PONV的发生率(44％)与Ⅱ组(52％)差异无统计学意义(P＞ 0.05).术后24 ～ 48h内,Ⅰ组PONV的发生率(6％)显著低于Ⅱ组(20％)(P＜0.05),两组均未发现严重不良反应.结论 帕诺洛司琼可安全有效的用于预防迟发性PONV.