鞘内芬太尼和静脉恩丹西酮抑制剖宫产术中恶心呕吐的比较

Comparing inhibiting effect of intrathecal fentanyl and intravenous ondansetron on intraoperative nausea and vomiting during cesarean under epidural anesthesia

  • 摘要: 目的: 比较鞘内注射芬太尼和静注恩丹西酮对剖宫产术中恶心、呕吐的抑制作用。方法: 将硬膜外麻醉下行剖宫产者45例(ASA分级Ⅰ级)随机均分为对照组、芬太尼组和恩丹西酮组,比较三组产妇术中出现恶心、呕吐的情况,并对娩出婴儿进行Apgar评分。结果: 对照组、芬太尼组、恩丹西酮组的恶心发生率分别为5例(33.3%)、1例(6.7%)、2例(13.3%),三组统计比较无明显差异;对照组的呕吐或干呕的发生率4例(26.7%)则高于芬太尼组0例(0%)和恩丹西酮组0例(0%,P<0.05),而芬太尼组和恩丹西酮组呕吐或干呕的发生率无显著差异。三组娩出婴儿的Apgar评分无显著差异(P>0.05)。结论: 鞘内注射芬太尼可减少硬膜外麻醉下产妇术中呕吐的发生率,其效果与静注恩丹西酮类似。

     

    Abstract: Objective: To compare the inhibiting effect of intrathecal(IT) fentanyl and intravenous (IV) ondansetron on intraoperative nausea and vomiting during cesarean delivery under epidural anesthesia. Methods: 45 healthy parturients(ASA grade to) were randomly assigned in equal numbers into controlled,fentanyl and ondansetron groups(n=15each,seperatly,parturients in the controlled group treated with IT saline 3ml,parturients in the fentanyl group treated with IT fentanyl 15μg.3ml-1,parturients in the ondansetron group treated with IV ondansetron 4mg).The incidence of nausea and vomiting during cesarean delivery under epidural anesthesia among the 3 groups were compared and the neonate’ Apgar scorces were assessed after delivery.(Results: )Introperative nausea and vomiting/retching were reduced in the fentanyl group and ondansetron group as compared with the controlled group(6.7% vs 13.3% vs 33.3%,P>0.05;0% vs 0% vs 26.7%,P<0.05). The neonate’ Apgar scorces were not significantly different among the 3 groups(P>0.05).Conclusion: IT fentanyl and IV ondansetron can decrease introperative vomiting during cesarean delivery performed under epidural anesthesia.The effect of both are not different.

     

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