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首页> 外文期刊>Current therapeutic research, clinical and experimental. >Antiemetic Effects of Midazolam Added to Fentanyl-Ropivacaine Patient-Controlled Epidural Analgesia After Subtotal Gastrectomy: A Prospective, Randomized, Double-Blind, Controlled Trial
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Antiemetic Effects of Midazolam Added to Fentanyl-Ropivacaine Patient-Controlled Epidural Analgesia After Subtotal Gastrectomy: A Prospective, Randomized, Double-Blind, Controlled Trial

机译：咪达唑仑在胃大部切除术后加芬太尼罗哌卡因患者自控硬膜外镇痛的止吐作用：前瞻性，随机，双盲，对照试验

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BACKGROUND: Nausea and vomiting are frequent adverse effects of patient-controlled epidural analgesia (PCEA) with opioids. OBJECTIVE: This study was designed to assess the antiemetic effect of midazolam added to fentanyl-ropivacaine PCEA. METHODS: In a prospective, randomized, double-blind, controlled trial, smoking patients with gastric cancer undergoing elective subtotal gastrectomy were evenly allocated to 1 of 2 treatment groups to manage postoperative pain: 0.2% ropivacaine mixed with fentanyl 4 mug/mL and midazolam 0.2 mg/mL (test group) or 0.2% ropivacaine mixed with fentanyl 4 mug/mL (control group). The PCEA infusion was set to deliver 4 mL/h of the study solution, with a bolus of 2 mL per demand and a 15-minute lockout time. The incidence of postoperative nausea and vomiting (PONV), pain intensity, sedation score, usage of rescue analgesia and rescue antiemetic, respiratory depression, urinary retention, and pruritus were recorded at 2, 6, 12, 24, 48, and 72 hours after surgery. Total infused volume of PCEA at 72 hours after surgery was measured. RESULTS: A total of 60 patients were approached and randomized to treatment. No patients were excluded by exclusion criteria and all enrolled patients completed this study. Incidence of nausea (7% vs 33%; P = 0.02) in the test group was significantly lower than in the control group. The overall frequency of PONV in the test group was significantly less than that of the control group (7% vs 40%; P = 0.006). In addition, the mean (SD) infused volume of PCEA in the test group was significantly lower than that in the control group (392.3 [68.9] vs 351.2 [49.8] mL; P = 0.01). However, there were no significant differences in pain intensity, usage of rescue antiemetics and rescue analgesics, and mild pruritus between groups. No patient reported moderate or severe sedation, respiratory depression, or hypoxemia. In addition, there were no severe adverse events. CONCLUSIONS: Midazolam added to fentanyl-ropivacaine PCEA ...
机译：背景：恶心和呕吐是阿片类药物患者自控硬膜外镇痛（PCEA）的常见不良反应。目的：本研究旨在评估将咪达唑仑添加到芬太尼-罗哌卡因PCEA中的止吐作用。方法：在一项前瞻性，随机，双盲，对照试验中，将接受择期次全胃切除术的吸烟胃癌患者平均分配至2个治疗组中的1个以处理术后疼痛：0.2％罗哌卡因与芬太尼4杯/毫升和咪达唑仑混合0.2 mg / mL（测试组）或0.2％罗哌卡因与芬太尼4杯/ mL混合（对照组）。 PCEA输注设置为以每小时4 mL / h的速度注入研究溶液，每次需求量推注2 mL，锁定时间为15分钟。术后2、6、12、24、48和72小时记录了术后恶心和呕吐（PONV）的发生率，疼痛强度，镇静评分，急救镇痛和急救止吐药的使用，呼吸抑制，尿retention留和瘙痒的发生率。手术。测量术后72小时的PCEA总输注量。结果：共有60例患者被接受并随机分组治疗。没有患者被排除标准排除，所有入组患者均完成了这项研究。测试组的恶心发生率（7％vs 33％; P = 0.02）显着低于对照组。测试组中PONV的总体频率显着低于对照组（7％对40％; P = 0.006）。此外，测试组PCEA的平均（SD）输注量显着低于对照组（392.3 [68.9] vs 351.2 [49.8] mL; P = 0.01）。但是，两组之间的疼痛强度，急救止吐药和急救镇痛药的使用以及轻度瘙痒之间无显着差异。没有患者报告中度或重度镇静，呼吸抑制或低氧血症。此外，没有严重的不良事件。结论：将咪达唑仑添加到芬太尼罗哌卡因PCEA中...

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