不同时机联合应用阿扎司琼、氟哌利多和地塞米松对腹腔镜下子宫切除术后恶心、呕吐的预防作用

Prophylactic effects of a combination azasetron of droperidol and dexamethasone in different time on nausea and vomiting after laparoscopic hysterectomy

目的:观察阿扎司琼、氟哌利多、地塞米松不同时机联合应用预防腹腔镜下子宫切除术后恶心、呕吐(PONV)的效果。方法:选取腹腔镜下行子宫切除术的320例女性患者,将患者随机分为4组(n=80)。A组(空白对照组):诱导前10min静脉注射生理盐水5ml;B组(阿扎司琼组):诱导前10min静脉注射阿扎司琼10mg;C组:诱导前10min静脉注射阿扎司琼10mg+氟哌利多1.25mg+地塞米松10mg;D组:诱导前10min静脉注射阿扎司琼10mg+地塞米松10mg,手术结束前30min静注氟哌利多1.25mg。观察4组患者术后48h内的PONV发生率。结果:4组患者的PONV发生率差异显著(P<0.01),其中A组发生率最高,其他依次为B组、C组、D组。结论:诱导前10min应用阿扎司琼10mg+地塞米松10mg,手术结束前30min应用氟哌利多1.25mg,能显著降低腹腔镜下子宫切除术后PONV发生率。

Objective： To observe the effect of combination of azasetron dexamethasene and droperidol in different time to prevent post-operative nausea and vomiting. Methods：320 female patients who underwent laparoscopic hysterectomy were randomly divided into 4 groups, with 80 cases in each group. Group A received intravenous injection of normal saline 5ml lOmin before anesthesia induction. Group B received intravenous injection of azasetron 10rag 10min before anesthesia induction. Group C received intravenous injection of azasetron lOmg plus dropefidol 1.25rag plus dexamethasone lOmg 10rain before anesthesia induction. Group D re- ceived intravenous injection of azasetron lOmg plus dexamethasone 10mg 10 rain before anes- thesia induction and droperidol 1.25rag 30min before completion of operation. The incidence of post-operative nausea and vomiting（PONV） in the 4 groups was observed within 48hours after operation. Results：There was statistical difference among 4 groups in the incidence of PONV. The incidence was the highest in group A, followed by group B, C and D. Conclusions：Intrave- nous injection of azasetron 10rag plus dexamethasone 10rag 10rain before anesthesia induction and droperidol 1.25rag 30rain before completion of operation can effectively reduce the inci- dence of nausea and vomiting in advance after laparoscopic hysterectomy.