帕洛诺司琼与托烷司琼对预防单节段腰椎减压植骨融合内固定手术后恶心呕吐的效果比较

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Abstract Objective To investigate the effect of single injection of Palonosetron and Tropisetron in the prevention of nausea and vomiting(PONV)after single-segment lumbar decompression,bone graft fusion and internal fixation.Methods A total of 70 patients of 117thHospital of PLA from February to July in 2017 underwent single segment posterior lumbar interbody fusion surgery,ASA score ofⅠorⅡgrade,Apfel score more than 3 points,and the patients who unwent elective lumbar posterior decompression and internal fixation surgery were selected as the research object.According to the random single blind,70 patients were divided into the palonosetron group(group P)and the tropisetron group(group T),35 cases in each group.Anesthesia with intravenous inhalational anesthesia,skin suture,group P was given intravenous Palonosetron 0.25 mg,group T was given Tropisetron or 5 mg,and were treated with Sufentanil 50 μg+Dezocine 20 mg analgesia (PCIA),the follow-up of 72 h.The incidence of nausea and vomiting after operation in the two groups was compared and the total effective rate(CR)was calculated.Results The incidence of nausea in group P at 0-24 h and＞24-48 h after operation was 25.7%(9/35),8.6%(3/35),which was significantly lower than that of group T of 48.6%(17/35),28.6%(10/35);the incidence of vomiting in group P was 14.3%(5/35),5.7%(2/35),which was significantly lower than that of group T of 45.7%(16/35),25.7%(9/35),the differences were statistically significant(P＜0.05).The incidence of nausea and vomiting in the two groups at＞48-72 h after operation was no significant difference (P＞0.05).After 0-24 h,＞24-48 h and 0-72 h,the CR standard rates of group P were 85.7%,94.3%and 80.0%,which were significantly higher than those in group T(54.3%,77.1%and 54.0%),the differences were statistically significant(P＜0.05).The CR standard rates of 48-72 h in group P and group T were 100.0%and 97.1%,and the difference was not statistically significant(P＞0.05).Conclusion In the prevention of nausea and vomiting during the postoperative analgesia of the lumbar surgery,the effect of single-dose intravenous injection of Palonosetron of 0.25 mg at the end of the operation is superior to that of the single intravenous injection of Tropisetron 5 mg.

Key words： Palonosetron Tropisetron Lumbar vertebra Patient controlled intravenous analgesia Nausea and vomiting

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	LIANG Jun-li
	LYU Wen-yan

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LIANG Jun-li,LYU Wen-yan. Comparison of the effect of Palonosetron and Tropisetron in the prevention of nausea and vomiting after single segment lumbar decompression,bone graft fusion and internal fixation[J]. 中国当代医药, 2018, 25(10): 16-18转22.

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