BMC Anesthesiol:加巴喷丁和雷莫司琼联合应用可更好地预防妇科腹腔镜手术后PONV的发生

2017-06-03 MedSci MedSci原创

加巴喷丁最初是作为一种抗惊厥的药物,最近证明表明加巴喷丁还可用于恶心和呕吐的治疗。本研究旨在在妇科腹腔镜手术后接受芬太尼自控镇痛的患者中对比口服加巴喷丁与雷莫司琼联合加巴喷丁的止吐效果。 研究共纳入了130名全麻下接受妇科腹腔镜手术的患者,将其随机分为三组:G组麻醉前1 h接受300毫克口服加巴喷丁,R组在手术结束时给予0.3 mg雷莫司琼,GR组麻醉前1 h接受300毫克口服加巴喷丁,术后

加巴喷丁最初是作为一种抗惊厥的药物,最近证明表明加巴喷丁还可用于恶心和呕吐的治疗。本研究旨在在妇科腹腔镜手术后接受芬太尼自控镇痛的患者中对比口服加巴喷丁与雷莫司琼联合加巴喷丁的止吐效果。

研究共纳入了130名全麻下接受妇科腹腔镜手术的患者,将其随机分为三组:G组麻醉前1 h接受300毫克口服加巴喷丁,R组在手术结束时给予0.3 mg雷莫司琼,GR组麻醉前1 h接受300毫克口服加巴喷丁,术后给予0.3 mg雷莫司琼。术后0-2、2-24、24-48小时评估患者的恶心、干呕、呕吐、止吐药物的使用、疼痛,镇痛要求和副作用。术后恶心呕吐(PONV)定义为患者出现恶心,干呕或呕吐。

结果发现,G R组完全反应的发生率(术后48 h内无PONV、无止吐药需求)(26/40, 65%)显著高于G组(16/40, 40%; P = 0.025 )和R组(18/44, 41%; P = 0.027),而G组和R组之间差异无统计学意义(P = 0.932)。各组间呕吐发生率、使用止吐药、严重呕吐、使用镇痛药或副作用无明显差异。术后疼痛评分组间相似。

总而言之,该研究发现,预防妇科腹腔镜手术后PONV,加巴喷丁和雷莫司琼联合应用优于单独用药。

原始出处:


Kyung Mi Kim, Jin Huh, et al., Combination of gabapentin and ramosetron for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a prospective randomized comparative study. BMC Anesthesiol. 2017; 17: 65. Published online 2017 May 19. doi:  10.1186/s12871-017-0357-8.

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    2017-06-30 whlxd
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1819012, encodeId=c38a18190122a, content=<a href='/topic/show?id=9c35988489d' target=_blank style='color:#2F92EE;'>#雷莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98848, encryptionId=9c35988489d, topicName=雷莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Fri Jun 30 12:09:00 CST 2017, time=2017-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050710, encodeId=3fb92050e1072, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, 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2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205995, encodeId=94be205995d6, content=好研究,非常实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 03 11:52:36 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-06 穆慕仁真

    经历过

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1819012, encodeId=c38a18190122a, content=<a href='/topic/show?id=9c35988489d' target=_blank style='color:#2F92EE;'>#雷莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98848, encryptionId=9c35988489d, topicName=雷莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Fri Jun 30 12:09:00 CST 2017, time=2017-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050710, encodeId=3fb92050e1072, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, 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style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528115, encodeId=157c1528115a2, content=<a href='/topic/show?id=638185622ae' target=_blank style='color:#2F92EE;'>#腹腔镜手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85622, encryptionId=638185622ae, topicName=腹腔镜手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dedd11898824, createdName=longqijun252, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276371, encodeId=d8b612e63717d, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206404, encodeId=08a1206404fa, content=不错的,学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Sun Jun 04 11:28:20 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205995, encodeId=94be205995d6, content=好研究,非常实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 03 11:52:36 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-04 skhzy
  7. 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2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205995, encodeId=94be205995d6, content=好研究,非常实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 03 11:52:36 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1819012, encodeId=c38a18190122a, content=<a href='/topic/show?id=9c35988489d' target=_blank style='color:#2F92EE;'>#雷莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98848, encryptionId=9c35988489d, topicName=雷莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Fri Jun 30 12:09:00 CST 2017, time=2017-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050710, encodeId=3fb92050e1072, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, 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GetPortalCommentsPageByObjectIdResponse(id=1276371, encodeId=d8b612e63717d, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206404, encodeId=08a1206404fa, content=不错的,学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Sun Jun 04 11:28:20 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205995, encodeId=94be205995d6, content=好研究,非常实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 03 11:52:36 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=1819012, encodeId=c38a18190122a, content=<a href='/topic/show?id=9c35988489d' target=_blank style='color:#2F92EE;'>#雷莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98848, encryptionId=9c35988489d, topicName=雷莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Fri Jun 30 12:09:00 CST 2017, time=2017-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050710, encodeId=3fb92050e1072, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, 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style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528115, encodeId=157c1528115a2, content=<a href='/topic/show?id=638185622ae' target=_blank style='color:#2F92EE;'>#腹腔镜手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85622, encryptionId=638185622ae, topicName=腹腔镜手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dedd11898824, createdName=longqijun252, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276371, encodeId=d8b612e63717d, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206404, encodeId=08a1206404fa, content=不错的,学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Sun Jun 04 11:28:20 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205995, encodeId=94be205995d6, content=好研究,非常实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 03 11:52:36 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-04 明天会更好!

    不错的,学习了!谢谢分享!

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1819012, encodeId=c38a18190122a, content=<a href='/topic/show?id=9c35988489d' target=_blank style='color:#2F92EE;'>#雷莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98848, encryptionId=9c35988489d, topicName=雷莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Fri Jun 30 12:09:00 CST 2017, time=2017-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050710, encodeId=3fb92050e1072, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, 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style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528115, encodeId=157c1528115a2, content=<a href='/topic/show?id=638185622ae' target=_blank style='color:#2F92EE;'>#腹腔镜手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85622, encryptionId=638185622ae, topicName=腹腔镜手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dedd11898824, createdName=longqijun252, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276371, encodeId=d8b612e63717d, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sun Jun 04 15:09:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206404, encodeId=08a1206404fa, content=不错的,学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Sun Jun 04 11:28:20 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205995, encodeId=94be205995d6, content=好研究,非常实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 03 11:52:36 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-03 1e0f8808m18(暂无匿称)

    好研究,非常实用。

    0

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腹腔镜手术虽然与优质的短期和中期临床结果有关,但其导致症状的复发是一个重大挑战。术后pH监测被认为是诊断复发性GERD的“黄金标准”,常用于常规术后随访。近期,一项发表在杂志Ann Surg上的研究旨在通过常规术后24小时pH监测来评估病理性食管酸暴露患者的症状和再次手术的需要。此项研究收集了1994年4月至2015年6月进行腹腔镜治疗患者的数据并进行分析;常规术后24小时pH监测。在病理和生理学

Br J Surg:预防SSI,抗生素使用时机研究

行腹腔镜结直肠癌手术的患者,口服预防性抗生素预防手术部位的感染(SSI),是有争议的。本研究的目的是,评估围手术期静脉输注抗生素是否不如术前联合口服和围手术期静脉注射抗生素。将一个癌症中心里择期腹腔镜结直肠癌切除术患者随机分为:联合术前口服抗生素(甲硝唑和卡那霉素)和围手术期静脉注射抗生素(头孢美唑)(联合组)或围术期静脉注射抗生素(头孢美唑)(仅静脉注射组)。主要终点是SSI发生率。次要终点为切