地塞米松强化欧必亭、恩丹西酮抗术后恶心、呕吐作用的研究

Dexamethasone enhances the effect of tropisetron and ondansetron against nausea and vomiting after patient -controlled analgesia

目的研究病人自控镇痛术条件下地塞米松是否具有强化欧必亭、恩丹西酮抗术后恶心、呕吐(PONV)之作用及其对伤口愈合之影响。方法120名择期手术患者随机分为4组:对照组A给予恩丹西酮8mg;对照组B给予欧必亭3 mg;观察组C给予恩丹西酮8mg+地塞米松10mg;观察组D给予欧必亭3mg+地塞米松10mg。记录术后4、8、12、24 h及2、3d时患者恶心、呕吐情况及伤口愈合等级、时间。结果A组与B组恶心、呕吐差异非常显著(P<0.01);C、D组较A、B组恶心、呕吐显著降低(CvsA,P<0.01;DvsB,P<0.05);观察组与对照组术后伤口愈合等级、时间无显著差异(P>0.05)。结论病人自控镇痛术条件下地塞米松10mg具有明显强化欧必亭、恩丹西酮抗恶心、呕吐作用,该剂量地塞米松对伤口愈合时间及等级无影响。

Objective To studytheenhancementby dexamethasoneof theeffectof ondansetronand tropiesetronagainst postoperativenauseaandvomiting(PONV)in patientsreceivingpatient-controlledanalgesia(PCA)andobservetheeffectof dexamethasoneon woundhealing.Methods OnehundredandtwentyelectivesurgicalpatientsreceivingPCAweredivided into4groups,including2controlgroupswiththeprescriptionof ondansetron(8mg)andtropiesetron(3mg)respectively(control A andB)and2observationgroupsin whichthepatientsweregivenondansetron(8mg)plusdexamethasone(10mg)and tropiesetron(3mg)plusdexamethasone(10mg)respectively(observationgroupsC andD).The incidenceandseverityof PONVwas observedat4,8,2,24h and2,3d postoperatively,andthetimeandgradeof healingof thewoundevaluated.Results SignificantdifferenceinPONVbetweengroupA andgroupB wasobserved(P<0.01),andintheobservationgroups,PONVwas markedlyreducedcomparedwiththecontrolgroups(C vs A,P<0.01;D vs B,P<0.05).In lightof thetimeand gradeof woundhealing,theobservationgroupsdifferedlittlefromthecontrolgroups.Conclusion Dexamethasone(10mg)cangreatlyenhancetheeffectof ondansetronandtropiesetronagainstPONVinpatientsrecevingPCAwithoutinterferingthe healingof thewound.