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目的：观察5-H T3受体拮抗剂盐酸帕洛诺司琼与托烷司琼预防神经外科开颅术患者术后恶心呕吐（PONV）的有效性和安全性。方法：选择择期行神经外科手术治疗患者60例ASAI～II级，按随机数字表法分为帕洛诺司琼组（A组）和托烷司琼组（B组），每组30例。各组于缝合至硬膜时分别静脉缓慢注射帕洛诺司琼0.25m g，托烷司琼5m g。术后观察并记录一下指标：1、术后24h、48h的视觉模拟评分法（VAS），2、镇静评分（OAA/S）3、恶心发生率，4、呕吐发生率，5、其他不良反应如腹胀、头痛等。结果：两组术后24h及48h的VAS评分及OAA/S差异无统计学意义（均P＞0.05）。A组术后24h的恶心及呕吐发生率为8.0%和4%，B组分别为10%和12%，两组比较差异无统计学意义（均P＞0.05）；A组患者术后48h的恶心及呕吐的发生率为4%和6%，B组为12%和16%，A组恶心、呕吐的发生率明显低于B组（P＜0.05）。A组有2例(6.6%)轻微头痛，B组有3例（10%）轻微头痛，2组不良反应发生率比较差异无统计学意义（P＞0.05）。结论：帕洛诺司琼预防神经外科手术术后恶心、呕吐的发生率，24h与托烷司琼相当，但术后48h预防恶心呕吐的效果明显优于托烷司琼，是值得推荐的防治PONV药物。“,”Objective To observe and evaluate the efficacy and safety of palonosetron hydrochloride in the prevention of nausea and vomiting aftter neurosurgery.MethodsSixty patients with neurosurgery were divided by random digits table method into two groups;experimental group (group A, n=30) treated with 0.25mg palonosetron hydrochloride ;control group(group B, n=30) treated with 5 mg tropisetron when suture epidural.The effective control rates of nausea and vomiting were calculated.Results There were no significant differences in VAS and OAA/S score between the two groups 24 and 48 hours after operation (P>0.05) .A group of postoperative nausea and vomiting 48h occurrence rate of 4% and 6%,group B were 10% and 12%. Group A of nausea and vomiting was significantly lower than the incidence of group B(P0.05).Conclusion The preventive effect of palonosetron hydrochloride on nausea and vomiting is equal to that of tropisetron within 24h after operation .However , palonosetron hydrochloride is superior to tropisetron for preventing nausea and vomiting 48h after operation. Palonosetron is the PONV prevention recommended drugs.