氟哌利多与地塞米松联用对甲状腺术后恶心呕吐发生率的影响

DROPERIDOL-DEXAMETHASONE COMBINATION FOR POSTOPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING THYROIDECTOMY

1目的 比较氟哌利多和地塞米松联用与二者单独应用对甲状腺手术后恶心呕吐 (PONV)发生率的影响。 2方法 选择 ASA体格状况分类 ～ 级 ,择期连续硬膜外或颈丛阻滞麻醉下行甲状腺手术病人 90例 ,术毕随机分为 3组 ,每组 30例 ,分别静注氟哌利多 1.2 5 m g(D组 ) ,地塞米松 10 .0 0 mg(M组 ) ,氟哌利多 1.2 5 m g与地塞米松 10 .0 0 m g混合液 (DM组 )。观察记录术后 2 4h内恶心、干呕、呕吐以及嗜睡和锥体外系不良反应发生情况。 3结果 3组间恶心、干呕、呕吐单项发生率差异无显著性 ,但总 PONV发生率 DM组明显低于 D组和 M组 ,差异有显著性 (χ2 =4.32 ,6 .6 7,P<0 .0 5 ,0 .0 1)。 4结论 氟哌利多和地塞米松联用可预防

Objective\ To compare the efficacy of droperidol in combination with dexamethasone and each drug alone in the reduction of postoperative nausea, retching and vomiting (PONV) after thyroidectomy.\ Methods\ Ninety ASA physical status Ⅰ or Ⅱ adult patients undergoing selective thyroidectomy under epidural or cervical plexus block were randomly divided into three groups after the operation, in group D( n =30) droperidol 1.25mg iv, in group M( n =30) dexamethasone 10.00mg iv, in group DM( n =30) droperidol 1.25mg with dexamethasone 10.00mg iv. The incidence of PONV and side effects were recorded in each group during the first 24h after operation.\ Results\ There were no significant difference among groups in the incidence in terms of nausea, retching and vomiting, but the total incidence of PONV in group DM was significantly lower than those in groups D and M ( χ 2=4.32,6.67,P <0.05,0.01). No drowsiness and extrapyramidal side effects were seen during the time of observation. Conclusion \ Prophylactic use of combined droperidol and dexamethsone was more effective than each antiemetic alone in the prevention of PONV after thyroidectomy.