静脉应用地塞米松可缓解面神经微血管减压术后疼痛

Intravenous dexamethasone relieving postoperative pain of microvascular decompression

目的探讨静脉应用地塞米松对面神经微血管减压术后疼痛的影响。方法 80例择期面神经减压手术患者,随机分成地塞米松组和对照组,诱导前给予地塞米松10 mg或生理盐水。所有患者均接受静脉全麻,术毕给予芬太尼PCIA镇痛,观察术后2、4、6、12、24 h VAS评分及不良反应。结果术后各时间点,地塞米松组VAS评分均低于对照组(P<0.05);对照组24 h内追加镇痛药次数及芬太尼用量均高于地塞米松组(P<0.05);对照组恶心、呕吐发生率高于地塞米松组(P<0.05)。结论地塞米松具有良好的术后镇痛协同作用,且不良反应小。

Objective To evaluate the effect of intravenous dexamethasone on postoperative pain of microvascular decompression.Methods Totally 80 patients receiving elective microvascular decompression were randomized into two groups,with placebo or dexamethasone（10 mg,iv） given before the induction of anesthesia.The patients were generally anesthetized and the postoperative pain was managed with iv fentanyl using patient-controlled analgesia.The visual analog scale scores were recorded for pain at 2,4,6,12 and 24 h after surgery and the side effects were also observed.Results The visual analog scale scores in the dexamethasone group were significantly lower than those in the placebo group at all time points（P〈0.05）.The total dose of fentanyl（0-24 h after surgery） and the frequency of analgesic use in the dexamethasone group were significantly lower than those in the placebo group（P〈0.05）.The incidence of nausea and vomiting in the dexamethasone group was lower than that in the placebo group（P〈0.05）.Conclusion Dexamethasone（iv） before anesthesia induction can intensify the analgesic effect of fentanyl,with less side effects.