低剂量 scopolamine 和 palonosetron 在减少胃肠内镜检查后立即恶心和吐方面的有效性:一项前性,随机化,受控研究
Jianghuai Lin1, Zhiming Cai2, Yingzi Lin3
1Department of Anesthesiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
Journal of clinical pharmacology
|September 3, 2024
概括
放出后恶心和吐 (PDNV) 在纳尔布芬和埃托米达镇静后很常见. 结合 scopolamine 和 palonosetron 显著降低了 PDNV 发病率,改善了患者的康复.
科学领域:
- 麻醉学 麻醉学
- 临床药理学 临床药理学
- 患者安全 患者安全
背景情况:
- 放出后恶心和吐 (PDNV) 是镇静后的常见并发症.
- 纳尔布芬和埃托米达是常用的镇静剂,但它们与PDNV的关联需要进一步调查.
- 有效的预防策略对于改善患者在门诊手术后的结果至关重要.
研究的目的:
- 用于确定用纳尔布芬和埃托米达特镇静后PDNV的发生率.
- 评估 scopolamine,palonosetron及其组合在预防PDNV中的疗效.
- 评估这些干预措施对PDNV频率,严重程度和相关副作用的影响.
主要方法:
- 进行了两阶段的前性临床试验.
- 第1阶段:对77名患者进行观察性研究,以评估PDNV发病率.
- 第二阶段:随机比较帕洛诺塞,斯科波胺和组合疗法与对照组进行PDNV预防.
主要成果:
- 镇静后8小时内PDNV的发生率为37.66%.
- 斯科波胺和帕洛诺塞特朗 (PS组) 的组合在8小时内显著降低PDNV至2.56% (P < .001).
- 单独使用斯科波胺 (S组) 也显示PDNV显著降低 (19.64%) 与帕洛诺组 (35.71%) 和对照组 (38.39%) 相比.
结论:
- 在纳尔布芬和埃托米达特镇静后,PDNV的发病率很高.
- 与斯科波胺和palonosetron的联合治疗在预防PDNV方面非常有效.
- 这些发现支持使用组合预防来增强镇静后护理和患者康复.
更多相关视频
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
Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists
281
Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...
281
Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists
225
Serotonin, a crucial neurotransmitter synthesized by enterochromaffin cells, plays a cardinal role in regulating gastrointestinal (GI) motility. With over 90% of the body's total serotonin in the GI tract, its influence on digestive processes is profound. Serotonin is swiftly released upon various stimuli, such as food boluses or certain drugs, triggering intrinsic sensory neurons in the myenteric plexus and extrinsic vagal and spinal sensory neurons. This leads to the activation of the...
225
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


