内关穴注射预防妇科腹腔镜手术后恶心呕吐

Preventive effect of acupoint injection at Neiguan(PC 6) on postoperative nausea and vomiting after laparoscopic gynecologic surgery

目的:探寻预防妇科腹腔镜手术后恶心呕吐的方法。方法:选择美国麻醉医师协会(ASA)病情估计分级Ⅰ-Ⅱ级拟行妇科腹腔镜手术患者120例随机分为3组,每组40例。Ⅰ组患者于术前20 min行氟哌利多2.5 mg(1 mL)加0.9%氯化钠注射液1 mL行双侧内关穴注射;Ⅱ组患者于术前20 min静脉注射氟哌利多1 mL;Ⅲ组患者不给予任何镇吐药物和措施。观察各组患者术后24 h恶心呕吐的发生次数与程度,并按评定标准予以评分。结果:恶心发生率:Ⅰ组10.0%(4/40),Ⅱ组57.5%(23/40),与Ⅲ组80.0%(32/40)比较,差异有统计学意义(P<0.01,P<0.05)。Ⅰ组与Ⅱ组比较,P<0.01。呕吐发生率:Ⅰ组7.5%(3/40)、Ⅱ组52.5%(21/40),与Ⅲ组75.0%(30/40)比较,差异有统计学意义(P<0.01,P<0.05);Ⅰ组与Ⅱ组比较,P<0.01。3组患者均未发现明显嗜睡、焦虑及锥体外系反应等并发症。结论:内关穴注射小剂量氟哌利多预防妇科腹腔镜手术后恶心呕吐临床效果确切,无其他不良反应。

Objective To investigate the method for preventing the postoperative nausea and vomiting （PONV） after laparoscopic gynecologic surgery. Methods One hundred and twenty patients being for laparoscopic gyneco- logic surgery at I-Ⅱ grade as American Society of anesthesiologists （ASA） were randomly divided into three groups, 40 cases in each group. Twenty minutes before the operation, the mixture of 2.5 mg Droperidol （1 mL） and 1 mL 0. 9% sodium chloride solution was injected into the bilateral Neiguan （PC 6） in group I , and an intrave- nous injection with 1 mL Droperidol was used in group Ⅱ , while there was no treatment carried out in group Ⅲ. Twenty four hours after the operation, the frequency and degree of nausea and vomiting were observed and scored according to the criteria standard. Results The incidence rate of nausea was 10.0% （4/40） in group I , 57.5% （23/40） in group Ⅱ , which was significantly different from 80. 0% （32/40） in group Ⅲ[ （P〈0.01, P〈0. 05, re- spectively）, while it was lower in group I than in group Ⅱ （P〈0.01）. The incidence rate of vomiting was 7.5o.% （3/40） in group I , 52. 5% （21/40） in group Ⅱ , which was significantly different from 75.0% （30/40） in group Ⅲ （P〈0. 01, P〈0.05 respectively）, while it was lower in group I than in group Ⅱ （P〈0.01）. No complica- tion, such as obvious drowsiness, anxiety and extracortieospinal tract reaction, was observed among the three groups. Conclusion Acupoint injection at Neiguan （PC 6） with a small dose of Droperidol can effectively prevent the PONV after laparoscopic gynecologic surgery without other adverse effects.