摘要
目的 观察地塞米松联合恩丹西酮对手术后病人自控镇痛 (PCA)所致恶心呕吐的防治效果。方法 随机将 2 0 0例在连续硬膜外麻醉下行下肢手术的患者分为四组 :对照 (C)组于手术切皮前 (T1)和手术结束时 (T2 )分别静脉注射生理盐水 2ml;地塞米松 (D)组于T1、T2 时分别注射地塞米松 10mg和生理盐水 2ml;恩丹西酮 (O)组于T1、T2 时分别注射生理盐水 2ml和恩丹西酮4mg ;地塞米松 +恩丹西酮 (D +O)组于T1、T2 时分别注射地塞米松 10mg和恩丹西酮 4mg。术毕均行病人自控静脉芬太尼镇痛 (PCIFA)。观察术后 2 4h内病人镇痛效果、镇静评分和恶心呕吐发生情况。结果 5例患者因故退出此观察。组间镇痛效果、镇静评分无明显差异。C组恶心呕吐发生率为 5 2 1% ,明显高于D组 (33 3% )和O组 (32 7% ) ,P <0 0 5 ;D +O组恶心呕吐发生率为16 0 % ,与C组比较 ,P <0 0 1,与D组和O组比较 ,P <0 0 5 ;各处理组恶心程度均小于对照组 ,P <0 0 5 ;D +O组呕吐程度低于C组 ,P <0 0 5。结论 地塞米松与恩丹西酮单独应用均能有效地减少手术后PCIFA相关的恶心呕吐 ,减轻恶心程度 ;
Objective To investigate the influence of dexamethasone combined with ondansetron on postoperative nausea and vomiting (PONV)during intravenous patient controlled analgesia(PCIA) with fentanyl Methods 200 patients scheduled for lower limb surgery under continuous epidural anesthesia were double blindly and randomly divided into four groups Group control(group C) received normal saline(NS) 2ml at the beginging(T 1) and the end (T 2) of surgery respectively.Group dexamethasone(group D) received dexamethasone 10mg at T 1 and NS 2ml at T 2.Group ondansetron(group O) received NS 2ml at T 1 and ondansetron 4mg at T 2;Group dexmethasone combined with ondansetron (group D+O) received dexamethasone 10 mg at T 1 and ondansetron 4mg at T 2 All patients received PCIA with fentanyl Pain rating,sedation score,nausea and vomiting episodes were recorded for 24 h after surgery Results Five patients were eliminated from the investigation for some reasons The incidence of nausea and vomiting in group C(52 1%) was higher than that in group D(33 3%) and group O(32 7%) ( P< 0 05).The incidence of nausea and vomiting in group D+O (16 0%)was lower than that in group C( P< 0 01),group D and group O ( P< 0 05). The score of nausea in group C was higer than that in the other three groups and the score of vomiting in group C was higher than that in group D+O( P< 0 05) Conclusions Dexamethasone or ondansetron gived alone can decrease the incidence of nausea and vomiting during PCIA with fentanyl.A combination of the two antiemetics can reduce the incidence of nausea and vomiting further
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第5期273-275,共3页
Journal of Clinical Anesthesiology
