氟哌利多复合地塞米松对曲马多镇痛致恶心呕吐的防治作用

Prophylaxis and treatment effect of droperidol combined with Dexamethasone on nausea and vomiting during patient-controlled analgesia with Tramadol

目的观察氟哌利多复合地塞米松对曲马多镇痛所致恶心呕吐的防治作用。方法80例硬膜外麻醉下剖腹产病人,随机分为4组,每组20例;术后行曲马多病人自控硬膜外镇痛(PCEA)。对照组(A)给予曲马多500毫克;氟哌利多组(B)给予曲马多500毫克+氟哌利多5毫克;地塞米松组(C)给予曲马多500毫克+地塞米松20毫克;氟哌利多复合地塞米松组(D)给予曲马多500毫克+氟哌利多5毫克+地塞米松20毫克。观察24小时镇痛情况(VAS评分)及恶心呕吐发生情况。结果组间镇痛效果(VAS)无明显差异;A组恶心呕吐发生率为35%,明显高于B组(15%)和C组(15%),P<0.05;D组恶心呕吐发生率为5%,与A组比较P<0.01,与B组和C组比较P<0.05。结论氟哌利多与地塞米松单独应用均能有效减少曲马多镇痛所致恶心呕吐反应,两药联合应用防治恶心呕吐作用进一步增强。

Objective To investigate the prophylaxis and treatment effect of droperidol combined with Dexamethasone on nausea and vomiting during patient-controlled analgesia with Tramadol. Methods 80 patients of caesarean birth under epidural anesthesia were randomly divided into four groups with 20 cases each. All patients were given postoperative patientcontrolled epidural analgesia（PCEA） with Tramadol. Group control （group A） received Tramadol 500 mg; group droperidal （group B） received Tramadoal 500 mg ＋Droperidal 5 mg; Group dexamethasone （group C） received Tramadol 500 mg ＋Dexamethasone 20mg; group D droperidal combined with Dexamethasone （ group D ） received Tramadol 500 mg＋Droperidal 5 mg ＋Dexamethasone 20mg. Pain rating （VAS） , nausea and womiting episodes within 24 hours were observed and recorded. Results VAS showed no difference between four groups. The incidence of nausea and vomiting in group A （35%） was higher than that in group B （ 15% ） and group C （ 15% ） （P〈0.05） ;The incidence of nausea and vomiting in group D （5%） was lower than that in group A （P〈 0.01 ）, group B and group C （P〈0.05）. Conclusions Droperidal or Dexamethasone gived alone can decrease the incidence of nausea and vomiting during PCEA with Tramadol. And combination of two antiemetics can reduce the incidence of nausea and vomiting further.