【摘要】 目的 观察小剂量纳洛酮复合恩丹西酮对曲马多静脉术后镇痛恶心呕吐的影响。方法 120例联合阻滞麻醉下行骨科下肢手术的患者，术后行48h静脉镇痛，随机分成3组(每组40例)：Ⅰ组：曲马多0.35mg/(kg·h)加生理盐水稀释至100ml；Ⅱ组：在Ⅰ组基础上加恩丹西酮4mg；Ⅲ组：在Ⅱ组基础上加纳洛酮0.01μg/(kg·h)。三组负荷量均给0.1ml/kg的复合镇痛液，维持量2ml/h。观察48h的疼痛视觉评分、镇静评分、恶心呕吐评级。结果 3组镇痛镇静评分无统计学差异。Ⅰ组恶心呕吐发生率高于Ⅱ组，但无统计学差异。Ⅲ组恶心呕吐明显低于I组(P<0.01)，也低于Ⅱ组。结论 小剂量纳洛酮复合恩丹西酮可以明显降低曲马多静脉术后镇痛引起的恶心呕吐。

    【关键词】 小剂量纳洛酮；术后恶心呕吐；曲马多；恩丹西酮

    Influence of low dose naloxone combined with ondansetron on postoperative nausea and vomiting during intravenous analgesia with tramadol

    CHEN Qing，WANG Qi，XIANG Fei.Department of Anesthesiology，Jiangning Hospital，Nanjing 211100，China

    【Abstract】 Objective To observe the influence of low dose naloxone combined with ondansetron on postoperative nausea and vomiting(PONV)during intravenous analgesia with tramadol.Methods 120 patients scheduled for lower limb surgery were enrolled in the study.All patients received 48 houres tramadol in intravenous analgesia.They wre divided randomly into three groups(n=40 for each group).Group Ⅰ： tramadol 35μg/(kg·h) were added in 100ml 0.9%saline.Group Ⅱ： ondansetron 4mg was added in group Ⅰ.Group Ⅲ： ondansetron 4mg and naloxone 0.01μg/(kg·h) were added in group Ⅰ.0.1ml/kg analgesic mixture was given as loading dose and 2ml/h analgesic mixture was given as maintaining dose.Postoperative nausea and vomiting(PONV)episodes ......