【摘要】 目的:比较昂丹司琼对不同方式全身麻醉下术后恶心呕吐(postoperative nausea and vomiting,PONV)的防治效果。方法:择期妇科腹腔镜手术患者240例,根据全身麻醉维持方式,随机分为七氟烷麻醉组(A1组)、七氟烷麻醉加昂丹司琼组(A2组)、丙泊酚麻醉组(B1组)、丙泊酚麻醉加昂丹司琼组(B2组)、丙泊酚-七氟烷静吸复合麻醉组(C1组)、丙泊酚-七氟烷静吸复合麻醉加昂丹司琼组(C2组),各组40例;昂丹司琼使用方法为在手术结束前5 min静脉注射8 mg。观察气管导管拔除后不同时间段内(0~4 h、4~8 h、8~12 h、12~16 h、16~24 h)恶心、呕吐发生情况。结果:①与A1组相比,术后24 h内B1、C1组恶心发生率明显较低(P<0.05);分别与A1、B1和C1组相比,A2、B2、C2组在术后0～12 h内恶心发生率明显降低(P<0.05),术后12-24 h内恶心发生率降低不明显。②与A1相比,术后24 h内B1、C1组呕吐发生率明显较低(P<0.05);分别与A1、B1和C1组相比,A2、B2、C2组在术后24h内呕吐发生率明显降低(P<0.05)。结论:七氟烷麻醉比丙泊酚麻醉或七氟烷-丙泊酚联合麻醉更易发生PONV;昂丹司琼对不同麻醉方式下PONV的疗效不一样,对术后24 h内呕吐的治疗效果优于恶心的治疗效果,且对七氟烷麻醉所引起的PONV治疗效果更好。更多还原

【Abstract】 Objective: To compare the efficacy of ondansetron on the prevention of postoperative nausea and vomiting(PONV) under different general anesthesia methods.Methods:Two hundreds and forty patients undergoing gynecologic laparoscopy with different maintain methods of general anesthesia were randomly divided into six groups:sevoflurane group(group A1),sevoflurane with ondansetron group(group A2),propofol group(group B1),propofol with ondansetron group(group B2),propofol combined sevoflurane group(group C1),and propofol combined sevoflurane with ondansetron group(group C2),40 patients in each group.Ondansetron of 8mg was given intravenous at 5 min before the end of surgery.Observed the nausea and vomiting situation after tracheal extubation in different periods(0~4h,4~8h,8~12h,12~16h,16~24h).Results:① In group B1 and group C1,the incidences of nausea reduced significantly compared with those in group A1 in 24 h(P < 0.05).In group A2,B2 and C2 compared with those in group A1,B1 and C1 respectively,the incidence of nausea was significantly lower in 0-12 h(P < 0.05),while within 12-24 h the incidence of nausea did not reduced obviously.② In group B1 and group C1,the incidences of vomiting reduced significantly compared with those in group A1 in 24 h(P < 0.05).Compared with those in group A1,B1 and C1 respectively,the incidence of vomiting in group A2,B2 and C2 was significantly lower in 24 h(P < 0.05).Conclusion:Compared with the anesthesia methods of propofol or propofol combined sevoflurane,the sevoflurane anesthesia method has a more susceptible to PONV in patients.Ondansetron doesn’t have the same efficacy in PONV under different general anesthesia methods,and the treatment of nausea was better than vomiting within 24h after surgery.What’s more,ondansetron has better treatment of PONV caused by sevoflurane anesthesia method.更多还原