摘要
目的 观察与评价注射用福沙匹坦双葡甲胺联合帕洛诺司琼预防治疗妇科腹腔镜手术术后恶心呕吐(PONV)的可行性与安全性.方法 选取妇科腹腔镜手术患者180例,按随机数字表法分为3组(每组60例):帕洛诺司琼组(A组),福沙匹坦双葡甲胺组(B组),福沙匹坦双葡甲胺联合帕洛诺司琼组(C组).A组用药帕洛诺司琼0.075 mg,B组用药福沙匹坦双葡甲胺150 mg,C组用药福沙匹坦双葡甲胺150 mg加帕洛诺司琼0.075 mg.观察患者术后2 h、术后第1天和术后第2天PONV发生情况,术后第1天和术后第2天视觉模拟评分法(VAS)疼痛评分、镇痛满意度评分,术后2d内因呕吐不耐受需追加紧急补救止吐药物(甲氧氯普胺/地塞米松)(PONV补救)的例数和镇痛补救的例数.记录患者手术时间、瑞芬太尼用量、出血量、输液量以及药物相关不良反应事件的发生情况.结果 术后2 h,与A组比较,C组PONV0级患者例数增加,PONV1、2、3级患者例数降低(均P＜0.05).术后第1天和第2天,与A组和B组比较,C组患者PONV0级患者例数增加,PONV 1、2、3级患者例数降低(均P＜0.05);与A组和B组比较,C组术后镇痛满意度评分增加(均P＜0.05).3组患者术后各时间点VAS疼痛评分差异无统计学意义(均P＞0.05),3组患者手术时间、瑞芬太尼用量、出血量、输液量、PONV补救例数、镇痛补救例数差异无统计学意义(均P＞0.05).3组患者术后药物相关不良反应事件未见发生.结论 福沙匹坦双葡甲胺联合帕洛诺司琼能够有效、安全用于预防腹腔镜妇科手术患者.
Abstract
Objective To evaluate the feasibility and safety of fosaprepitant dimeglumine combined with palonosetron for the prevention and treatment of postoperative nausea and vomiting(PONV)after gynecologic laparoscopy.Metheods A total of 180 pa-tients undergoing gynecological laparoscopic surgery were selected.According to the random number table method,they were divided into three groups(n=60):a palonosetron group(group A),a fosaprepitant dimeglumine group(group B),and a fosaprepitant dimeglu-mine combined with palonosetron group(group C).Group A received 0.075 mg palonosetron,group B was treated with 150 mg fosaprep-itant dimeglumine,and group C received fosaprepitant dimeglumine 150 mg plus palonosetron 0.075 mg.Their PONV incidence at postoperative 2 h,on postoperative days 1 and 2,Visual Analogue Scale(VAS)scores on postoperative days 1 and 2,analgesia satisfac-tion scores,the number of PONV rescue cases(additional use of antiemetic agent metoclopramide/dexamethasone due to intolerance to vomiting)and the number of rescue analgesia cases within 2 d after surgery.The duration of operation,remifentanil dosage,the volume of blood loss,fluid intake,and the incidence of drug-related adverse reactions were recorded.Results At postoperative 2 h,com-pared with group A,group C showed increases in the number of patients with grade 0 PONV,and decreases in the number of patients with grades 1,2,and 3 PONV(all P＜0.05).On postoperative days 1 and 2,compared with groups A and B,group C presented increases in the number of patients with grade 0 PONV,and decreases in the number of patients with grades 1,2,and 3 PONV(all P＜0.05).Com-pared with groups A and B,the satisfaction towards postoperative analgesia increased in group C(all P＜0.05).There was no statistical difference in postoperative VAS scores among the three groups(all P＞0.05).Furthermore,no statistical difference was found in the du-ration of operation,remifentanil dosage,the volume of blood loss,fluid intake,the number of PONV rescue cases and the number of res-cue analgesia cases among the three groups(all P＞0.05).No drug-related adverse reactions occurred in the three groups.Conclu-sion The combined use of fosaprepitant dimeglumine and palonosetron is effective and safe to prevent PONV in patients undergoing laparoscopic gynecological surgery.
基金项目
河南省医学教育研究项目(Wjlx2022032)
河南省医学教育研究项目(Wjlx2021343)
河南省医学科技攻关计划(LHGJ20200184)
NETL
NSTL
万方数据