目的 探讨氟哌利多联合昂丹司琼在预防术后舒芬太尼联合地佐辛静脉自控镇痛(PCIA)所致的恶心呕吐(PONV)的疗效.方法 将接受术后舒芬太尼联合地佐辛PCIA的外科手术患者按随机数表法分为试验组与对照组.对照组采用舒芬太尼150 μg、地佐辛20 mg、昂丹司琼8 mg制备PCIA,试验组采用舒芬太尼150μg、地佐辛20 mg、氟哌利多5 mg、昂丹司琼8 mg制备PCIA.比较2组PONV发生率、PONV严重程度分级和术后不同时间点心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO2)水平、手术相关指标、视觉模拟评分(VAS)、Ramsay评分、PCIA按压次及药物不良反应发生率.结果 试验组和对照组术后2、12、24、36 和 48 h 的 PONV 发生率分别为 1.64％、4.84％、6.56％、3.28％、0 和14.75％、18.03％、19.67％、16.39％、9.84％;试验组和对照组术后 24 h 的 HR分别为(91.42±8.75)和(98.13±9.62)beat·min-1,MAP 分别为(91.98±4.56)和(99.05±4.17)mmHg,SPO2分别为(98.13±1.65)％和(98.95±1.82)％,VAS 分别为(2.68±0.49)和(2.97±0.63)分,Ramsay 评分分别为(2.27±0.65)和(2.05±0.32)分,PCIA 按压次数分别为(2.14±0.37)和(4.36±0.78)次,试验组上述指标与对照组比较,在统计学上差异均有统计学意义(均P＜0.05).试验组与对照组术后总药物不良反应发生率分别为13.12％和8.20％,在统计学上差异无统计学意义(P＞0.05).结论 氟哌利多联合昂丹司琼可降低术后舒芬太尼联合地佐辛PCIA致PONV发生风险,确保镇痛效果,安全性好.
Objective To investigate the efficacy of flupentixol combined with ondansetron in preventing postoperative nausea and vomiting(PONV)in patients receiving sufentanil and dezocine patient-controlled intravenous analgesia(PCIA).Methods Surgical patients receiving sufentanil and dezocine PCIA were randomly divided into treatment and control groups using a random number table.The control group received sufentanil 150 μg,dezocine 20 mg,and ondansetron 8 mg for PCIA,while the treatment group received sufentanil 150 μg,dezocine 20 mg,flupentixol 5 mg,and ondansetron 8 mg for PCIA.The incidence of PONV,severity of PONV,heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SPO2)levels at different time points after surgery,surgery-related indicators,visual analogue scale(VAS)scores,Ramsay scores,PCIA pressing times,and incidence of adverse drug reactions were compared between the two groups.Results The incidence of PONV in the treatment group and the control group at 2,12,24,36 and 48 hours after surgery were 1.64％,4.84％,6.56％,3.28％,0 and 14.75％,18.03％,19.67％,16.39％,9.84％,respectively.The HR at 24 hours after surgery in the treatment group and the control group were(91.42±8.75)and(98.13±9.62)beat·min-1,respectively;the MAP were(91.98±4.56)and(99.05±4.17)mmHg;SPO2 were(98.13±1.65)％and(98.95±1.82)％;VAS scores were 2.68±0.49 and 2.97±0.63;Ramsay scores were 2.27±0.65 and 2.05±0.32;PCIA pressing times were(2.14±0.37)and(4.36±0.78)times,respectively.The differences in the above indicators between the treatment group and the control group were statistically significant(all P＜0.05).The incidence of total adverse drug reactions after surgery in the treatment group and the control group were 13.12％and 8.20％,respectively,with no statistically significant difference(P＞0.05).Conclusion Flupentixol combined with ondansetron can reduce the risk of PONV caused by sufentanil combined with dezocine PCIA after surgery,ensuring good analgesic effects and safety.
程贞永;顾尔伟;谢红;王小燕;胡波;程隆妮;杨飞
中国科学院合肥肿瘤医院麻醉科,安徽合肥 230031
药学
氟哌利多;昂丹司琼;舒芬太尼;地佐辛;静脉自控镇痛;恶心;呕吐
droperidol;ondansetron;sufentanil;dezocine;patient-controlled intravenous analgesia;nausea;vomit
《中国临床药理学杂志》 2024 (005)
649-653 / 5
10.13699/j.cnki.1001-6821.2024.05.004
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