联合用药预防自控镇痛患者恶心呕吐的临床研究

Clinical Studies of Combinations of Antiemetics on Prevention Nausea and Vomiting During Postoperative Patient Controlled Analgesia

目的:探讨地塞米松与氟派利多或昂丹司琼联合应用对术后自控镇痛患者恶心呕吐的影响。方法:160例全麻术后行自控镇痛(patient controlled analgesia,PCA)的女性患者随机分为4组,组1:单纯舒芬太尼;组2:舒芬太尼+地塞米松;组3:舒芬太尼+地塞米松+氟哌利多;组4:舒芬太尼+地塞米松+昂丹司琼。记录患者术后恶心呕吐(post operative nausea and vomiting,PONV)的发生,疼痛及镇静评分,PCA持续时间,并观察术后不良事件。结果:恶心呕吐发生程度均为组1>组2>组3>组4,其中组1的恶心呕吐程度较组2、组3、组4的高,且差异显著(P<0.05),组2的恶心呕吐程度较组3、组4的高,且差异显著(P<0.05)。4组患者疼痛及镇静评分差异无统计学意义。结论:地塞米松与氟哌利多或昂丹司琼联合应用可以显著减少术后自控镇痛患者恶心呕吐的发生。

Objective：To evaluate the efficacy of different combinations of antiemetics on nausea and vomiting in postoperative patient controlled analgesia（PCA）.Methods：Totally 160 patients underwent patient controlled intravenous analgesia（PCIA） were randomly divided into four groups（n=40）.Group 1 with sufentanyl;group 2 with sufentanyl and dexamethasone,group 3 with sufentanyl,dexamethasone and dorperidlo;group 4 with sufentanyl,dexamethasone and ondansetron.Nausea,vomiting,VAS,sedation score,the duration of PCIA and adverse events were recorded.Results： The scores of nausea and vomiting were group 1group 2group 3group 4,in which the scores of nausea and vomiting in group 1 was significantly higher than group 2,group 3 and group 4（P0.05）,group 2 was significantly higher than group 3 and group 4（P0.05）.The VAS and sedation scores had no difference among four groups.Conclusion：Dexamethasone combined with droperidol or ondansetron for PCIA can significantly reduce the incidence of nausea and vomiting.