地塞米松预防剖宫产患者自控镇痛不良反应的临床研究

A study of the effect of dexamethasone in preventing untoward response from cesarean women caused by using patient self-controlled epidural analgesia

目的观察地塞米松预防剖宫产患者自控镇痛致恶心、呕吐、瘙痒等不良反应疗效。方法选择同期妇产科硬膜外麻醉手术患者。Ⅰ组(实验组):剖宫产手术50例,Ⅱ组(对照组):妇科手术50例。两组于手术结束时施行患者自控硬膜外镇痛,同时Ⅰ组静脉注射地塞米松10 mg;Ⅱ组静脉注射格拉司琼4mg。观察记录患者镇痛效果(视觉模拟评分法)及恶心、呕吐、胃肠恢复、瘙痒等不良反应的发生率。结果镇痛效果确切,两组比较差异无统计学意义(P>0.05),不良反应:恶心、呕吐发生率两组差异无统计学意义(P>0.05),皮肤瘙痒发生率及胃肠恢复延长Ⅰ组低于Ⅱ组(P<0.05)。结论地塞米松能有效预防剖宫产患者自控镇痛所致恶心、呕吐、皮肤瘙痒等不良反应。

Objective To investigate the effect of dexamethasone in the the prevention of untoward responses such as vomit, nausea and itch, caused by using patient-self controlled epidural analgesia after cesarean section. Methods Post-opera-tive gynecological patients and cesarean women operated under epidural block were selected. The first group （experiment group） cesarean section 50 cases. The second group （contrast） gynecological operation 50 cases. P. C. E. A. （ patient self-controlled epidural analgfesia） was carried out in both groups. The first group was treated with dexamethasone 10 mg I. V. The second group was treated with granisetron 4mg I.V. the analgesic effect, nausea, vomit, skin-itch and the time for recovery of digestive function were closely observed and recorded. Results The analgesic effect is excellent, there is no significant difference between, these two groups（P〉0.05）. Of untoward responses such as nausea, voimit , no obvious difference is observed between these two groups （P〈0.05）. The skin-itching rate is lower in group I and the time for digestive function recovery is shorter in group I too. Conclusion Desamethasone can be effectively used to prevent these untoward responses such as nausea, vomit and skinitching from using patient self-controlled epidural analgesia by women after cesarean section.