摘要
目的 探讨和比较甲氧氯普胺、氟哌利多、地塞米松等药物对术后硬膜外自控镇痛 (PCEA)所产生恶心、呕吐不良反应的影响。方法 将 80例在硬膜外麻醉下择期妇科手术的患者随机分成 4组。所有患者均用吗啡作为镇痛药物 ,但各组所使用的抗呕吐药不同。手术结束后使用PCEA ,并分别记录术后 2 4h和 48h的视觉模拟评分 (VAS)、恶心呕吐的发生率、皮肤瘙痒及呼吸频率等。结果 术后 2 4h内 ,地塞米松组抗呕吐的作用明显高于其他 3组 ,抗恶心作用与氟哌利多组相似 ,均明显高于甲氧氯普胺组和对照组。各组间VAS和手术后皮肤瘙痒的发生率差异无显著性。结论 椎管内单次应用地塞米松可显著减少术后硬膜外吗啡镇痛引起的恶心、呕吐 ,未见明显不良反应 。
Objective In order to select a more effective prophylactic antiemetic for minimizing vomiting during epidural analgesia after gynecologic operation, three prophylactics antiemetic were investigated. Methods Eighty operated gynecologic patients under epidural anesthesia were assigned to four groups at random and morphine was used as analgesia in all patients postoperatively. Different prophylactic antiemetic was used in each group, metoclopramide (group A), droperidol (group B), dexamethasone (group C) and normal saline (group D), and the PCEA was used after the operation. Results Prevention of vomiting in group C was better than that in the other three groups and prevention of nausea was better than that in group A and D, and no significant difference was observed in group B within 24 hours postoperatively. Conclusion Single dosage of dexamethasone used epidurally can decrease the incidence of vomiting and nausea caused by morpine during epidural analgesia in gynecologic operations, and is better than droperidol and metoclopramide.
出处
《上海医学》
CAS
CSCD
北大核心
2002年第7期417-419,共3页
Shanghai Medical Journal
