摘要
目的观察甘露醇复合多模式镇吐措施预防甲状腺术后头晕头痛及术后恶心呕吐(PONV)的临床效果。方法择期行甲状腺切除术患者100例,男39例,女61例,ASAⅠ或Ⅱ级,按照随机数字表随机均分为两组:对照组(C组)和甘露醇复合多模式镇吐组(M组)。两组患者均采用丙泊酚和瑞芬太尼全凭静脉麻醉(TIVA)方法。麻醉诱导后静脉注射地塞米松10 mg,手术结束前30min给予盐酸帕洛诺司琼注射液0.25 mg。M组在手术结束前30 min快速静注甘露醇2ml/kg,C组给予等量的生理盐水。观察术后24h内两组患者头晕头痛及PONV的发生率。结果M组术后24h内头晕头痛发生率为5例(10%),PONV发生率5例(10%),明显低于C组的15例(30%)和12例(24%)(P<0.05),术后24h内额外使用止吐药M组为2例(4%),明显少于C组的9例(18%)(P<0.05)。结论术前给予地塞米松、术毕前30min给予强效止吐剂帕洛诺司琼并复合脱水药甘露醇进行多模式镇吐可显著降低甲状腺术后头晕头痛及PONV的发生率。
Objective To evaluate the efficacy of multimodal-antiemetic therapy on postoperative dizziness,headache,nausea and vomiting （PONV） in patients undergoing thyroidectomy.Methods One hundred patients （39 males and 61 females,ASA physical status Ⅰ or Ⅱ） scheduled for thyroidectomy were randomly divided into two groups according to random number table： control group （group C） and multimodal-antiemetic therapy group （group M）.Two groups received total intravenous anesthesia （TIVA） with propofol and remifentanil.Prophylactic dexamethasone 10 mg were given after anesthesia induction and palonosetron hydrochloride 0.25 mg was used 30 min before the end of surgery in both groups.Mannitol 2 ml/kg in group M and the same amount of normal saline in group C were given 30 min before the end of surgery.The incidence of dizziness,headache and PONV were observed for 24 h in two groups.Results The incidence of headache was 5 cases （10%）and PONV was 5 cases （10%） in group M,which were respectively significantly lower than that of group C of 15 cases （30%） and 12 cases （24%） in 24 h after surgery （P〈0.05）.The additional antiemetic therapy for 24 h after surgery in group M of 2 cases （4%） was significantly lower than that of group C of 9 cases （18%） （P〈0.05）.Conclusion The multimodal-antiemetic therapy： prophylactic dexamethasone,palonosetron hydrochloride and mannitol were used 30 min before the end of surgery could significantly reduce the incidence of dizziness,headache and PONV after thyroidectomy.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2017年第4期353-355,共3页
Journal of Clinical Anesthesiology
关键词
甲状腺术
甘露醇
多模式镇吐
Thyroidectomy
Mannitol
Multimodal-antiemetic therapy
