地塞米松和格拉斯琼预防性镇吐和止痒效果

The Effects of Dexamethasone and Granisetron for the Prevention of PONV and Pruritus

目的:探讨地塞米松和格拉斯琼对妇科手术使用0．5％布比卡因和吗啡蛛网膜下腔注射镇痛预防术后恶心呕吐 (PONV)和瘙痒的作用。方法:130例择期行妇科手术的病人,被随机分成3组,Ⅰ组静注地塞米松10 mg;Ⅱ组静注格拉斯琼8 mg;Ⅲ组静注地塞米松10 mg加格拉斯琼4 mg。结果:在Ⅰ组,预防术后24 h内PONV的失败率较高(40例中有29例, 72．5％),而Ⅱ组(47例中有23例,49％)(P=0．02)和Ⅲ组(43例中有19例,44％)(P=0．01)失败率较低。3组间预防术后 24 h内瘙痒的失败率无差别(Ⅰ组、Ⅱ组和Ⅲ组分别为70％、72％和70％)(P>0．1)。结论:地塞米松10 mg加格拉斯琼4 mg预防PONV和瘙痒与单用格拉斯琼8 mg比较无统计学差异,但与地塞米松10 mg比较有统计学差异。

Objective： To investigate the effects of dexamethasone and granisetron for the prevention nausea, vomiting（ PONV）, and pruritus in patients undergoing postoperative analgesic operation with subarachnoid injection of 0.5% bupivacaine and morphine in gynecological surgery. Method： 130 patients who would have gynecological operation were divided to three groups randomly. Group Ⅰ was given dexamethasone 10 mg intravenously, group Ⅱ was given granisetron 8 mg, intravenously and group Ⅲ was given dexamethasone 10 mg plus granisetron 4 mg. Result： In group Ⅰ, failure of PONV prophylaxis in the 24 h postoperative period occurred more frequently （29 cases of 40 ; 72.5% ） compared with group Ⅱ （23 cases of 47 ; 49% ） （ P = 0.02） and group Ⅲ（ 19 of 43 ;44% ） （ P = 0.01 ）. There was no difference in the incidence of failure of prophylaxis of pruritus （70%, 72% and 70% in group Ⅰ, Ⅱ and Ⅲ, respectively） （P 〉0.1 ） in the 24h postoperative period. Conclusion： There is no difference of the effect of dexamethasone 10 mg combined with granisetron 4 mg and the effect of granisetron 8mg alone in the prophylaxis of PONV and pruritus.