Efficacy of palonosetron and ramosetron on postoperative nausea and vomiting related to intravenous patient-controlled analgesia with opioids after gynecological laparoscopic surgery (double-blinded prospective randomized controlled trial)
Efficacy of palonosetron and ramosetron on postoperative nausea and vomiting related to intravenous patient-controlled analgesia with opioids after gynecological laparoscopic surgery (double-blinded prospective randomized controlled trial)
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DOI：
10.1007/s00540-015-1981-4
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发表时间：
2015-08-01
影响因子：
2.8
通讯作者：
Lee, Sun Joo
中科院分区：
文献类型：
--
作者：
Kim, Seong-Hyop;Oh, Chung-Sik;Lee, Sun Joo
观察帕洛诺司琼和雷莫司琼预防妇科腹腔镜术后阿片类药物静脉自控镇痛(PCA)后恶心呕吐(PONV)的效果。C组注入生理盐水50ml，P组注入帕洛诺司琼75 mg加入生理盐水50ml，R0.3和R-PCA组注入雷莫司琼0.3 mg加入生理盐水50ml。所有组均连接含有芬太尼的PCA泵，而R-PCA组在PCA方案中加入雷莫司琼0.6 mg。R-PCA组出院后24~72 h PONV发生率、评分和Rhodes指数均显著低于其他两组。P组和R0.3组PONV发生率、严重程度、Rhodes指数均低于C组，无统计学意义。妇科腹腔镜手术患者单剂量应用帕洛诺司琼75 mg或雷莫司琼0.3 mg均不能预防与静脉阿片类药物PCa相关的PONV。与单剂帕洛诺司琼75 mg或雷莫司琼0.3 mg相比，单剂雷莫司琼0.3 mg，然后雷莫司琼0.6 mg与PCA混合使用可显著降低PONV。
The study was designed to assess the efficacy of palonosetron and ramosetron in preventing postoperative nausea and vomiting (PONV) related to intravenous (IV) patient-controlled analgesia (PCA) with opioids after gynecological laparoscopic surgery.Patients were randomly allocated to 4 groups-C, P, R0.3 and R-PCA. At the end of surgery, group C received an infusion of 50 ml normal saline, group P received palonosetron 75 mu g mixed in 50 ml normal saline, and groups R0.3 and R-PCA received ramosetron 0.3 mg mixed in 50 ml normal saline. A PCA pump containing fentanyl was connected for all groups; however, ramosetron 0.6 mg was mixed with the PCA regimen for the R-PCA group. PONV and postoperative pain were assessed.PONV incidence and scale, and Rhodes index in R-PCA group between 24 and 72 h after discharge from the post-anesthetic care unit (PACU) showed significantly lower values, compared with the other groups. PONV incidence and scale, and Rhodes index in P group and R0.3 group were lower than the corresponding values in C group at all times, without statistical significance.A single dose of palonosetron 75 mu g or ramosetron 0.3 mg was unable to prevent PONV related to IV PCA with opioids in patients undergoing gynecological laparoscopic surgery. The combination of a single dose of ramosetron 0.3 mg, followed by ramosetron 0.6 mg mixed with PCA, significantly decreased PONV compared with a single dose of palonosetron 75 mu g or ramosetron 0.3 mg.