The effect of metoclopramide combined with early enteral nutritional on patients with mechanical ventilation after craniocerebral operation

Abstract

Objective To observe the effect of metoclopramide combined with early enteral nutritional on patients with mechanical ventilation after craniocerebral operation. Methods A prospective randomized control study was conducted.56 patients with mechanical ventilation after craniocerebral operation were randomly divided into metoclopramide combined with early enteral nutritional group(observation group)and parenteraI nutrition group(control group),28 in each group. The patients in the observation group received early enteral nutrition(24-48 h after operation), and intramuscular injection of metoclopramide(10mg Q8 H)for 7 days. The patients in the control group received parenteraI nutrition. The nutritional parameters, mechanical ventilation(MV)time, success rate of the ventilator weaning and the occurrence rate of pneumonia associated with ventilation(VAP)in one week, the incidence of adverse reaction were compared between the two groups. Results After 1 week therapy,the nutritional parameters of the two groups showed no statistical significance(P>0.05);the observation group compared with the control group,3、7days of blood glucose(P1、P2)decreased significantly[(8.9±1.6)mmol/L vs(11.4±3.2)mmol/L,(8.2±1.3)mmol/L vs(10.6±2.1)mmol/L](P1=0.002,P2=0.011),Mechanical ventilation(MV)time(P3)and the occurrence rate of VAP(P4)in one week also declined[(6.5±2.3)d vs(8.9±3.1)d,21.4%vs 46.4%](P3=0.022,P4=0.048), but within a week of success rate of the ventilator weaning improved(67.9%vs 39.3%,P5=0.032). Return rate(P6), gastrointestinal bleeding(P7)was significantly lower than those of the control group(17.9%vs 42.9%,14.3%vs 42.9%,P6= 0.042,P7=0.038), but abdominal distention, diarrhea were no significant contrast(P>0.05). Conclusion Metoclopramide combined with early enteral nutritional may obviously improve the nutrition parameters, shorten the MV time, decrease the occurrence rate of VAP,not increase in side effects. Key words: Metoclopramide; Enteral nutritional; After craniocerebral operation; Mechanical ventilation