地塞米松对妇科术后患者自控吗啡镇痛的止吐作用

ANTIEMETIC EFFECT OF DEXAMETHASONE IN PATIENTS UNDERGOING CONTROL EPIDURAL ANALGESIA WITH MORPHINE AFTER GYNECOLOGICAL OPERATION

目的观察地塞米松对妇科术后患者吗啡硬膜外自控镇痛的止吐作用。方法 12 0例妇科手术患者 ,随机分为 3组 :手术后即刻静脉注射地塞米松 10mg(D1组 )、地塞米松 5mg +甲氧氯普胺 10mg(D2 组 )、生理盐水10ml(C组 )。术后 3天硬膜外自控镇痛 (吗啡 5mg +布比卡因 10 0mg +氟哌利多 5mg ,用生理盐水稀释至 10 0ml)连续应用 ,观察恶心呕吐发生率。结果恶心呕吐发生率D1组为 15 .0 % ,D2 组为 17.5 % ,C组为 4 5 .0 % ;D1、D2 组分别与C组比较 ,均有显著性差异 (P <0 .0 5 ) ,D1与D2 组比较无显著性差异 (P >0 .0 5 )。

ObjectiveTo assess the antiemetic effect of dexamethasone in patients undergoing control epidural analgesia with morphine after gynecological operation. Methods120 patients scheduled for gynecological operations under epidural anesthesia were randomly assigned to three groups. The patients received dexamethasone 10 mg(group D 1)or dexamethasone 5 mg plus metoclopramide 10 mg(group D 2),or saline 10 ml(group C)intravenously at the end of operation. Patient control epidural analgesia(morphine 5 mg plus bupivacaine 100 mg, droperidol 5 mg and saline to 100 ml)was used continuously for 3 days after operation. The incidence of postoperative nausea and vomiting(PONV) was observed in 24 hours postoperatively. ResultsThe patients in group D 1( 15.0 % )or group D 2( 17.5 % ) had a less frequent incidence of PONV than those in group C( 45.0 % ),the differences between group D 1 and group C, group D 2 and group C were significant(P< 0.05 ).There were no significant differences between group D 1 and group D 2. ConclusionBoth dexamethasone and dexamethasone plus metoclopramide significantly reduced PONV.