托烷司琼复合地塞米松对妇科腹腔镜术后恶心呕吐的影响

Influence of tropisetron combined with dexamethasone on postoperative nausea and vomiting after gynecologic laparoscopic surgery

目的探讨托烷司琼复合地塞米松对妇科腹腔镜手术患者术后恶心呕吐(PONV)的影响。方法90例择期行妇科腹腔镜手术患者随机分为3组,每组30例。麻醉诱导前10min静注托烷司琼4mg(T组)、托烷司琼4mg加地塞米松5mg(TD组)或生理盐水5ml(C组)。观察术后6h内、6h～24h PONV情况以及拔管时、拔管后1h、4h醒觉程度评分(OAAS)。结果与C组相比,T组及TD组术后24h内PONV发生率和程度降低(P<0.05或P<0.01);与T组相比,TD组术后24h内恶心程度下降,呕吐发生率降低(P<0.05)。结论托烷司琼复合地塞米松对妇科腹腔镜术患者可减少PONV的发生,比单独应用托烷司琼更好。

Objective To asudy the effects of tropisetron combined with dexamethasone on postoperative nausea and vomiting（PONV） after gynecologic laparoscopic surgery. Methods Ninety gynecologic patients undergoing laparoscopic surgery .were randomly divided into three groups with 30 cases each. The patients in group T were given tropisetron 4 rag, those in group TD tropisetron 4 mg and dexamethasone 5 mg,and those in group C normal saline 5 ml as the controls at 10 minutes before induction of general anesthesia. PONV within 24 hours was recorded and OAAS sedation scores were evaluated. Results Compared with group C, the incidence and intensity of postoperative 24-h PONV were significantly lower in groups of T and TD （P〈0. 05 and P〈0. 01）. The intensity of nausea, incidence and intensity of vomiting in 24 h after operation were lower in group TD than those in group T （P〈0. 05）. Conclusion Tropisetron combined with dexamethasone is better than tropisetron alone in reducing PONV after gynecologic laparoscopie surgery.