帕洛诺司琼预防老年人机器人辅助下下腹部手术后恶心呕吐的有效性和安全性研究

Eficacy and Safety of Palonosetron to Prevent Elderly Patients’ Postoperative Nausea and Vomiting after Lower Abdominal Surgery Which Used Da Vinci Surgical System

关键词:  帕洛诺司琼  5-羟色胺3受体  达芬奇外科手术系统  术后恶心呕吐

Key words:  palonosetron  5-hyydroxytrytamine 3 recptor  da Vinci Surgical System  post operative nausea and vomiting

摘要:

目的 探讨帕洛诺司琼用于预防老年人机器人辅助下下腹部手术后恶心呕吐的有效性和安全性。方法 60例全麻下行机器人辅助下下腹部手术的老年患者(ASA分级Ⅰ~Ⅱ)随机分为2组：试验组和对照组，每组30例。于入AICU 30 min后，试验组：缓慢静脉注射帕洛诺司琼0.25 mg，对照组：缓慢静脉注射昂丹司琼4 mg和地塞米松0.1 mg·kg^-1。记录患者术后0~6 h、>6~12 h、>12~24 h和>24~48 h内发生恶心、呕吐的例数和完全缓解率(complete response rate，CRR)及相关不良反应。结果 术后0~6 h、>6~12 h和>12~24 h内恶心呕吐CRR 2组比较无统计学差异，术后24~48 h内试验组恶心呕吐CRR明显高于对照组(P＜0.05)。结论 与昂丹司琼联合地塞米松比较，帕洛诺司琼可显著地降低老年人机器人辅助下下腹部手术后48 h内恶心呕吐的发生率，在临床应用中是有效和安全的。

Abstract:

OBJECTIVE To discuss the efficacy and safety of palonosetron to prevent elderly patients’ postoperative nausea and vomiting after lower abdominal surgery which used da Vinci Surgical System. METHODS Sixty?cases of elderly patients undergoing general anesthesia for lower abdominal surgery which used da Vinci Surgical System, ASA Ⅰ-Ⅱ, were randomly divided into 2 groups: treatment group and control group. The patients of treatment group were given palonosetron 0.25 mg and control group were given ondansetron 4 mg combined with dexamethasone 0.1 mg·kg^-1 by intravenous injection after 30 min in AICU. The number of nausea, vomitting and complete response rate(CRR) of the patients during 0-6?h, >6-12 h, >12-24 h and >24-48 h after surgery in 2 groups was recorded. Other related adverse effects were also noted. RESULTS The CRR between 2 groups had no statistical difference during 0-6 h, >6-12 h, >12-24 h after surgery. Compared with control group, the CRR during >24-48 h in treatment group was significantly lower than control group(P<0.05). CONCLUSION Prophylactic therapy with palonosetron is more effective than ondansetron combined with dexamethasone for prevention of elderly patients’ postoperative nausea and vomiting after lower abdominal surgery which used da Vinci Surgical System in 48 h, which provides a safe and effective compatibility program in clinical.