在接受全身麻醉的患者手术后恶心和吐上预防性热西特朗的作用:系统性审查和元分析与试验序列分析
In Jung Kim1,2, Geun Joo Choi1,2, Hyeon Joung Hwang2
1Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea.
Journal of personalized medicine
|August 29, 2024
概括
热热有效地预防手术后恶心和吐 (PONV) 在接受全身麻醉的患者. 这种预防性使用减少了救援抗药的需要,并增加了完全反应率,证明了卓越的疗效.
科学领域:
- 麻醉学和外科手术期间的医学.
- 药理学和治疗学 药理学和治疗学
- 临床试验方法论 临床试验方法论
背景情况:
- 手术后恶心和吐 (PONV) 是全身麻醉后的一个常见并发症.
- 有效的预防性抗emetic策略对于改善患者的结果和满意度至关重要.
- 作为5-HT3受体对抗剂的托皮塞特朗用于PONV预防.
研究的目的:
- 系统地审查和对随机对照试验 (RCT) 进行元分析,评估PONV预防的预防性热血素.
- 为了比较热热与安慰剂,其他抗emetics,或组合疗法的疗效.
- 评估热对救援抗使用和完全响应率的影响.
主要方法:
- 从Ovid-MEDLINE,EMBASE,Cochrane图书馆和谷歌学者中获取的RCT的系统审查和元分析.
- 包括与对照组 (安慰剂,其他抗emetics,或组合) 进行比较的试验.
- 应用试验序列分析 (TSA) 来确认研究结果的可靠性.
主要成果:
- 热热显著降低了手术后恶心 (PON),手术后吐 (POV) 和PONV的发生率 (RR 0.622,95% CI 0.552-0.700).
- 在热热组中,救援抗药的使用频率较低 (RR 0.718,95% CI 0.652-0.790).
- 通过使用热素观察到更高的完整反应发生率 (RR 1.517,95% CI 1.222-1.885).
- 美国运输安全局证实了热素在PONV预防方面的优越性.
结论:
- 在全身麻醉下治疗的患者中,预防PONV的治疗方法Tropisetron显示出更高的疗效.
- 热带减少了对救援抗药的需要,并提高了完整反应率.
- 这些发现支持用于PONV预防的常规使用热素.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
181
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
181
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
154
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
154
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
238
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
238
General Anesthesia: Overview
198
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
198
Stages of General Anesthesia
391
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
391
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
63
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
63


