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德克萨米他和恶心和吐的风险以及在儿童桃体切除术后的术后出血:一项随机试验
Christoph Czarnetzki1, Nadia Elia, Christopher Lysakowski
1Division of Anesthesiology, University Hospitals of Geneva, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland.
JAMA
|December 11, 2008
概括
德克萨米他可降低儿科桃体切除术患者的术后恶心和吐 (PONV),取决于剂量. 然而,更高的剂量增加了严重的术后出血的风险,导致早期终止试验.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 药理学 药理学是指药理学的学科.
- 外科手术的结果
背景情况:
- 德克萨米他是一种常见的预防药物,用于儿科桃体切除术中的术后恶心和吐 (PONV).
- 预防PONV并最大限度地降低风险的最佳剂量仍在研究中.
研究的目的:
- 为了确定德克萨米他是否减少PONV的风险在桃体切除术后24小时以剂量依赖的方式.
- 评估德克萨米他剂量与不良事件发生率之间的关联,特别是术后出血.
主要方法:
- 一个随机的,安慰剂对照试验,涉及215名接受选择性桃体切除术的儿童.
- 参与者接受了静脉注射德克萨米他 (0.05,0.15,或0.5毫克/公斤) 或安慰剂后麻醉诱导.
- 主要终点:24小时后的PONV;次要终点:止痛药的使用和不良反应.
主要成果:
- 德克萨米他显著降低了PONV以剂量依赖的方式 (P<.001).
- 剂量为0.5mg/kg与术后出血风险显著增加有关 (调整后的相对风险6.80,P=.003).
- 由于出血,八名儿童需要紧急重新手术,他们都接受了德克萨米他.
结论:
- 德克萨米他有效地降低了儿科桃体切除术后的PONV风险,以剂量依赖的方式.
- 最高剂量 (0.5 mg/kg) 显著增加了术后出血的风险,需要谨慎使用.
- 该研究因安全担忧而提前停止,因为高剂量的德甲会增加出血风险.
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