小剂量氟哌利多复合地塞米松对小儿腹腔镜手术后恶心呕吐的预防作用

Effect of small dose of droperidol combined with dexamethasone in preventing PONV after pediatric laparoscopic operation

目的观察小剂量氟哌利多复合地塞米松对小儿腹腔镜手术PONV的预防作用和不良反应的发生情况。方法择期1~4岁小儿,ASAⅠ或Ⅱ级,拟在全麻下行腹腔镜下内环结扎术、隐睾下降内固定术200例,随机均分为氟哌利多组（A组）、地塞米松组（B组）、氟哌利多复合地塞米松（C组）和对照组（D组）。麻醉诱导用丙泊酚2 mg/kg、芬太尼3μg/kg、顺式阿曲库铵0.12 mg/kg,麻醉维持采用静吸复合麻醉。手术开始时A组静脉给予氟哌利多25μg/Kg,B组地塞米松0.1 mg/kg,C组氟哌利多25μg/kg复合地塞米松0.1 mg/kg,D组不给予任何药物。术后镇痛采用芬太尼以0.01μg/kg/min速度经静脉泵入镇痛。观察并记录术后6、12、24 h患者PONV和不良反应的发生情况。结果 D组患儿术后6、12、24 h PONV发生率明显高于A、B、C组（P〈0.05）,而C组PONV明显低于A、B组（P〈0.05）,A、B组差异无统计学意义。结论小剂量氟哌利多复合地塞米松对小儿腹腔镜手术后恶心呕吐有良好的预防作用。

Objective To observe the effect of small dose of droperidol combined with dexamethasone in preventing PONV after pediatric laparoscopic operation and the occurrence of complications .Methods 200 pediatric patients scheduled for laparoscopic surgeries of hernia and cryptorchidism decline fixation （1-4 years old, ASA status I-II） ,were randomly assigned into four groups （ A：droperidol group , B：dexamethasone group , C：droperidol combined with dexamethasone group , D：control group）.Anesthesia induced by propofol 2mg/kg, fentanyl 3ug/kg, cisatracurium 0.12mg/kg, and maintained with intravenous inhalational anesthesia .At the beginning of surgeries, droperidol （25ug/Kg） was administrated in group A, dexamethasone （0.1mg/kg） in group B, and droperidol （25ug/Kg） combined with dexamethasone （0.1mg/kg） in group C.Postoperative analgesia was performed with fentanyl （0.01ug/kg/min）.PONV and other complications were observed and documented .Results Incidence of PONV in group D was significantly higher comparing with other groups （ P〈0.05）.Incidence of PONV in group C was significantly lower comparing with group A and B （P〈0.05）, there was no statistically differences between group A and B .Conclusions Small dose of droperidol combined with dexamethasone can significantly prevent occurrence of PONV after pediatric laparoscopic operation .