帕洛诺司琼联合地塞米松对妇科腹腔镜手术术后恶心呕吐的预防效果

Effect of palonosetron plus dexamethasone on the prevention of postoperative nausea and vomiting after gynecological laparoscopic operation

目的 观察帕洛诺司琼联合地塞米松对妇科腹腔镜手术术后恶心呕吐（PONV）的预防效果。方法 选取2015年5月至2016年2月于首都医科大学附属北京佑安医院择期行妇科腹腔镜手术患者80例为研究对象，采用随机数字表法分为帕洛诺司琼组（P组）和帕洛诺司琼联合地塞米松组（PD组），各40例。2组均在全身麻醉诱导前即刻给药，P组静脉单次给予帕洛诺司琼0.075 mg，PD组静脉单次给予帕洛诺司琼0.075 mg＋地塞米松8 mg，2组所给药物均为4 ml。记录术后0-6 h、〉6-24 h、〉24-48 h时患者恶心呕吐的发生率及发生强度［采用视觉模拟评分量表（VAS）］、恶心呕吐及疼痛补救用药情况；记录术后不良反应发生情况。结果 PD组术后〉6-24 h恶心、呕吐发生率明显低于P组，差异有统计学意义［15.0%（6/40）比30.0%（12/40）、7.5%（3/40）比22.5%（9/40）］（P〈0.05）。2组术后0-48 h补救用药比例及恶心、呕吐发生强度比较，差异均无统计学意义（P〉0.05）。2组术后不良反应发生率比较差异无统计学意义（P〉0.05）。结论 预防妇科全身麻醉腹腔镜手术PONV时，诱导前静脉单次给予0.075 mg帕洛诺司琼＋地塞米松8 mg作用明显强于单次给予0.075 mg帕洛诺司琼，且不增加不良反应发生率。

Objective To observe the effect of palonosetron plus dexamethasone on the prevention of postoperative nausea and vomiting（PONV） after gynecological laparoscopic operation. Methods Totally 80 patients scheduled gynecological laparoscopic operation from May 2015 to February 2016 in Beijing YouAn Hospital, Capital Medical University were randomly divided into palonosetron group and palonosetron plus dexamethasone group, with 40 cases in each group. The palonosetron group was administered palonosetron 0.075 mg（4 ml） and the palonosetron plus dexamethasone group was administered palonosetron 0.075 mg（4 ml） and dexamethasone 8 mg（4 ml） before anesthesia induction. Nausea and vomiting incidence and severity, compensational drug use rate and adverse reaction rate were recorded at 0-6 h, 〉6-24 h, 〉24-48 h after operation. Results Incidences of nausea and vomiting in palonosetron plus dexamethasone group at 〉6-24 h after operation were significantly lower than those in palonosetron group[15.0%（6/40） vs 30.0%（12/40）, 7.5%（3/40） vs 22.5%（9/40）]（P〈0.05）. Nausea and vomiting severity, compensational drug use rate and adverse reaction rate had no significant differences between groups（P〉0.05）. Conclusions Palonosetron 0.075 mg plus dexamethasone 8 mg is more effective in the prevention of PONV after gynecological laparoscopic operation compared to palonosetron 0.075 mg alone, without increasing side effects.