托烷司琼联合地塞米松对椎管内吗啡镇痛恶心呕吐的预防作用

The Clinical Research on Tropisetron Combined with Dexamethasonein Preventing the Adverse Effects of Epidural Morphine

目的对比观察托烷司琼联合地塞米松预防椎管内吗啡术后镇痛不良反应恶心呕吐的临床效果。方法选择60例拟行子宫全切除术的病人,随机分成托烷司琼组(T组)和对照组(C组),每组30例。C组关腹前硬膜外腔内注射吗啡2mg+0.25%布比卡因5ml。T组在开腹时经静脉注射托烷司琼5mg+地塞米松10mg,术后24h观察镇痛效果及恶心呕吐并发症。结果两组病人24h内镇痛效果良好,T组恶心发生率为26.7%,呕吐发生率10%,均比对照组低,组间比较差异有显著性(P<0.05)。结论静脉注射托烷司琼5mg+地塞米松10mg,能安全有效地预防或减轻术后恶心呕吐的发生。

Objective To observe the clinical effects of Tropisetron combined with Dexamethasone on the aausea and vomiting prevention of morphine postoperative analgesia. Methods Sixty cases of women undergoing hysterectomy were randomly assigned to two groups ： the Tropisetron （group T） and the control（ group C） group with 30 cases each, Morphine 5mg in 0.25% bupivacaiue 5ml was injected into the epidural space at the onset of abdominal closure, Intravenous Tropisetron 5mg and Dexamethasone 10mg, was administered in group T while opening the abdoment, the complications such as nausea, vomiting were recorded at 24h pnstoperatively. Results The analgesia was excellent with in 24h in both groups with no significant difference .The occumence of nausea, vomiting and was 26.7%, 10% respectively and it was lower compared with the contrail group. There was significant difference with in the groups（ P 〈 0.05）, Conclusion Intravennus injection of 5mg Tropisetron and 10mg Dexamethasone ran decrease the rate of nausea and vomiting with morphine postoperative analgesia.