低剂量丹塞特龙与德克萨梅他用于腹腔镜胆囊切除术后术后恶心和吐的预防 - 一项随机双盲研究
Geetanjali T Chilkoti1, Janaki Nandanan1, Ashok Kumar Saxena1
1Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
Journal of anaesthesiology, clinical pharmacology
|March 3, 2025
概括
与标准剂量 (100μg/kg) 相比,在腹腔镜胆囊切除术后使用较低剂量的丹塞 (50μg/kg) 与德克萨米增加了术后恶心. 在两剂Ondansetron剂量之间,吐率相似.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 手术护理 手术护理
背景情况:
- 手术后恶心和吐 (PONV) 是手术后的一个常见并发症.
- 丹塞和德克萨米他的组合有效用于PONV预防.
- 丹与较多的副作用和较高的成本有关,而不是德克萨米他.
研究的目的:
- 为了评估标准剂量 (100微克/千克) 与低剂量 (50微克/千克) 的疗效,在PONV预防中将丹塞与德克萨结合使用.
- 为了在腹腔镜胆囊切除术期间比较两组丹塞剂量组之间的PONV发病率和严重程度.
主要方法:
- 随机,双盲,干预性研究,包括110名接受腹腔镜胆囊切除术的患者.
- 患者接受了100微克/千克或50微克/千克的丹塞和8毫克的德克萨米他.
- 收集的数据包括PONV发病率,PONV得分,救援抗emetic使用,以及在手术后的前6小时内血液动力学参数.
主要成果:
- 在1-2小时间隔的低剂量丹塞组 (50微克/千克) 中,PONV的发病率显著更高 (P<0.05).
- 在低剂量组中,更高比例的患者需要救援抗药,尽管这在统计学上没有显著意义.
- 两组之间没有观察到术后吐发生率的显著差异.
结论:
- 与100μg/kg剂量相比,50μg/kg的翁丹塞特龙与德克萨米的组合与手术后立即后期的术后恶心发病率较高有关.
- 在腹腔镜胆囊切除术患者的PONV预防中,标准剂量为100μg/kg的丹塞与德克萨似乎更有效.
更多相关视频
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
171
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,...
171
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
147
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...
147
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
209
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...
209
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
39
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...
39
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
199
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
199
Depolarizing Blockers: Pharmocokinetics
300
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
300


