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

Droperidol combined with Dexamethasone for Nausea and Vomiting Induced by Tramadol for Analgesia

目的观察氟派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500mg+生理盐水至100ml;氟哌利多组(B)给予曲马多500mg+氟哌利多5mg+生理盐水至100ml;地塞米松组(C)给予曲马多500mg+地塞米松20mg+生理盐水至100ml;氟哌利多复合地塞米松组(D)给予曲马多500mg+氟哌利多5mg+地塞米松20mg+生理盐水至100ml。观察24h镇痛情况(VAS评分)及恶心呕吐发生情况。结果组间镇痛效果视觉模拟评分法(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%);D组恶心呕吐发生率为5%,与A组比较,P<0.05。结论氟哌利多与地塞米松单独使用均能有效减少曲马多镇痛所致恶心呕吐反应,两药联合使用防治恶心呕吐作用进一步增强。

[Objectives]To investigate the prevention and treatment effect of droperidol combined with dexamethasone on nausea and vomiting induced by tramadol for analgesia.[Methods]80 cases of caesarean under epidural anesthesia were randomly divided into four groups of 20 cases in each group. All patients were given postoperative Patient-Controlled Epidural Analgesia （PCEA） with tramadol. The control group （group A） received tramadol 500 mg dilute to 100 ml with normal saline （NS）, the droperidol group （group B） received tramadoal 500 mg ＋ droperidal 5 mg dilute to 100 ml with NS, the dexamethasone group （group C） received tramadol 500 mg ＋ dexamethasone 20 mg dilute to 100 ml with NS, the droperidol combined with dexamethasone group （group D） received tramadol 500 mg ＋ droperidal 5 mg ＋dexamethasone 20 mg dilute to 100 ml with NS. The analgesia effect （VAS scores）, the incidence of nausea and vomiting within 24 hours were observed and recorded.[Results]There was no significant difference in VAS scores among four groups. The incidence of nausea and vomiting in group A （35%） was higher than that in group B （15%） and group C （15%）. The incidence of nausea and vomiting in group D （5%） was lower than that in group A （P0.01）.[Conclusion]The single use of droperidol or dexamethasone can both decrease the incidence of nausea and vomiting induced by tramadol for analgesia, and the combination of two drugs can enhance the effect further.