Safety of reducing nausea and vomiting by intravenous infusion of tropisetron hydrochloride after internal fixation with proximal femoral nail antirotation

doi:10.3969/j.issn.2095-4344.3774

Abstract

Abstract: BACKGROUND: Tropisetron hydrochloride has been shown to effectively reduce postoperative nausea and vomiting in patients undergoing proximal femoral nail antirotation fixation, and it is safe and effective. At present, the use of tropisetron in this operation is mainly added to patient controlled intravenous analgesia or intravenous drip after the operation. However, the comparison of two administration methods of tropisetron is rarely reported.
OBJECTIVE: To investigate the effectiveness and safety of different administration methods of tropisetron hydrochloride for reduction of postoperative nausea and vomiting in proximal femoral nail antirotation.
METHODS: Ninety patients with intertrochanteric fracture of femur who underwent proximal femoral nail antirotation admitted in Shantou Hospital of Traditional Chinese Medicine from July 2018 to March 2020 were randomly divided into two groups (n=45). Patients in the group A (intravenous drip administration group) were given tropisetron hydrochloride 5 mg + normal saline 100 mL by intravenous drip immediately after the operation, and the patient controlled intravenous analgesia pump (tropisetron hydrochloride was not added into the pump) was used. Patients in the group B (patient controlled intravenous analgesia pump group) were given 100 mL normal saline by intravenous drip immediately after the operation, and the patient controlled intravenous analgesia pump (5 mg tropisetron hydrochloride was added into the pump) was used. The pain score, sedative score, postoperative nausea and vomiting score and postoperative nausea and vomiting incidence at 1, 6, 12, 24, and 48 hours after the operation of two groups were counted and compared.
RESULTS AND CONCLUSION: (1) The pain score and sedative score of the two groups were not statistically significant (P > 0.05) at various time points. (2) The postoperative nausea and vomiting score and postoperative nausea and vomiting incidence of group A were significantly less than those in the group B at 1 and 6 hours after the operation (P < 0.05). The differences in postoperative nausea and vomiting score and postoperative nausea and vomiting incidence of the two groups were not statistically significant at 12, 24, and 48 hours after the operation (P > 0.05). (3) There was no significant difference in incidence of adverse reactions between the two groups (P > 0.05). (4) Compared with added tropisetron hydrochloride to patient controlled intravenous analgesia pump, postoperative intravenous drip administration of tropisetron hydrochloride can quickly reduce the occurrence of nausea and vomiting after proximal femoral nail antirotation fixation.

Key words: bone, femur, intertrochanteric fracture, tropisetron, proximal femoral nail antirotation, internal fixation, postoperative nausea and vomiting, pain, sedation

CLC Number:

Chen Sheng, Zheng Zhihui, Guan Keli, Li Xiaowu, Cai Peibiao, Chen Haibo, Zheng Xun, Zeng Qingqiang. Safety of reducing nausea and vomiting by intravenous infusion of tropisetron hydrochloride after internal fixation with proximal femoral nail antirotation[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(12): 1869-1873.

Figures/Tables 6

References

[1] CAO X, WHITE PF, MA H. An update on the management of postoperative nausea and vomiting. J Anesth. 2017;31(4):617-626.
[2] SINCLAIR DR, CHUNG F, MEZEI G. Can postoperative nausea and vomiting be predicted? Anaesthesia. 1999;(91):109-118.
[3] GAN TJ, DIEMUNSCH P, HABIB AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting.Anesth Analg. 2014;118(1):85-113.
[4] 田海涛,王远贺,田少奇,等.膝关节置换应用甲基泼尼松龙对术后恶心呕吐和疼痛的影响及安全性评估[J].中国组织工程研究,2017,21(3):335-339.
[5] GERALEMOU S, GAN TJ. Assessing the value of risk indices of postoperative nausea and vomiting in ambulatory surgical patients. Curr Opin Anaesthesiol. 2016;29(6):668-673.
[6] TATEOSIAN VS, CHAMPAGNE K, GAN TJ. What is new in the battle against postoperative nausea and vomiting?.Best Pract Res Clin Anaesthesiol. 2018;32(2):137-148.
[7] SAHIN EK, IMERCI A, KINIK H, et al. Comparison of proximal femoral nail antirotation(PFNA) with AO dynamic condylar screws(DCS) for the treatment for unstable peritrochanteric femoral fractures. Eur J Orthop Surg Traumatol. 2014; 24(3):347-352.
[8] 曹国红.丙泊酚或七氟烷全身麻醉术后疼痛及术后镇痛药需求量的比较[J].世界最新医学信息文摘,2016,16(84):140.
[9] HOOPER VD. PONV/PDNV: Why Is It Still the “Big Little Problem?”. J Perianesth Nurs. 2015;30(5):375-376.
[10] MYKLEJORD DJ, YAO L, LIANG H, et al. Consensus guideline adoption for managing postoperative nausea and vomiting.WMJ. 2012;111(5):207-213,214.
[11] KIM HJ, CHOI SH, EUM D, et al. Is perioperative colloid infusion more effective than crystalloid in preventing postoperative nausea and vomiting?: A systematic review and meta-analysis. Medicine (Baltimore). 2019;98(7):e14339.
[12] MCLEOD RS, AARTS MA, CHUNG F, et al. Development of an enhanced recovery after surgery guideline and implementation strategy based on the knowledge-to-action cycle. Ann Surg. 2015;262(6):1016-1025.
[13] CAPONE A, BIENATT F, TORCHIA S, et al. Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger:a 3- to 10-year follow-up study. J Bone Joint Surg. 2017;18(1):301.
[14] 孙旭,李庭,杨明辉,等.加速康复外科的发展与在骨科的应用[J].骨科临床与研究杂志,2017,2(2):114-116.
[15] ZHU S, QIAN W, JIANG C, et al. Enhanced recovery after surgery for hip and knee arthroplasty:a systematic review and meta-analysis. Postgrad Med J. 2017; 93(1106):736-742.
[16] 曾聃,陈丹,任玉香,等.快速康复外科理念的实施在关节置换术围术期应用效果的Meta分析[J].全科护理,2017,15(33):4145-4148.
[17] ALI M, WINTER DC, HANLY AM, et al. Prospective,randomized,controlled trial of thoracic epidural or patient-controlled opiate analgesia on perioperative quality of life. Br J Anaesth. 2010;104(3):292-297.
[18] 王巧萍,李景,王晓辉.术后恶心呕吐的危险因素与防治的研究进展[J].麻醉安全与质控,2019,3(4):240-244.
[19] ANDREWS PLR, KOCH KL, STERN RM. Nausea:mechanisms and management. New York:Oxford University Press, 2011:462.
[20] NAVARI RM, AAPRO M. Antiemetic prophylaxis for chemotherapy-induced nausea and vomiting. N Engl J Med. 2016;374(14):1356-1367.
[21] 焦烨,许军.地塞米松联合托烷司琼预防剖宫产术后恶心呕吐的临床研究[J].临床和实验医学杂志,2017,16(24):2466-2468.
[22] 聂洋洋,史志国,陈玢,等.托烷司琼与昂丹司琼预防全身麻醉术后恶心呕吐效果的比较:系统评价和Meta分析[J].首都医科大学学报,2016,37(3):391-399.
[23] 项以柱.托烷司琼防治腰硬联合麻醉围术期恶心呕吐的临床研究[J].中国药业,2013,22(10):37-38.
[24] 杨自力.探讨不同止吐药预防全麻术后舒芬太尼静脉自控镇痛恶心呕吐的疗效[J].智慧健康,2019,5(24):77-78.
[25] KHALIL SN, FARAG A, HANNA E, et al. Regional anesthesia combined with avoidance of narcotics may reduce the incidence of postoperative vomiting in children. Middle East J Anesthesiol. 2005;18:123-132.
[26] WANG HW, LI LL, LI ZS, et al. Effects of patient-controlled intravenous analgesia using hydromorphone supplement with dexmedetomidine on patients undergoing transcatheter arterial chemoembolization. Zhonghua Zhong Liu Za Zhi. 2018;40(8):626-630.
[27] 郑婷婷,刘莹,李锦,等.托烷司琼与昂丹司琼预防单髋关节置换患者术后恶心呕吐的比较[J].中国医院药学杂志,2018,38(7):746-749.
[28] 林奕,吴华敏,叶峰.盐酸托烷司琼不同给药方式对腹腔镜胆囊切除术后镇痛恶心呕吐的预防研究[J].基层医学论坛,2018,22(4):440-441.
[29] 王玉红,肖维萍.托烷司琼不同给药方式对术后恶心呕吐的影响[J].中外医疗,2014,33(3):87-88.
[30] 朱玛,陈宝妫.两种托烷司琼给药方式预防腹腔镜子宫切除术后恶心呕吐的疗效观察[J].上海医药,2018,39(21):26-28.