小剂量托烷司琼、氟哌利多、甲氧氯普胺及甲泼尼龙联合用药预防术后静脉镇痛恶心呕吐的临床效果

Clinical effect of low-dose combination of tropisetron,droperidol,metoclopramide and methylprednisolone in preventing nausea and vomiting after postoperative intravenous analgesia

目的研究小剂量托烷司琼、氟哌利多、甲氧氯普胺及甲泼尼龙联合用药预防术后静脉镇痛恶心呕吐的临床效果。方法选取2020年4月至2021年3月收治的62例肱骨骨折行切开复位钢板内固定患者,按照随机双盲法将其分为对照组和观察组,每组31例。对照组采用托烷司琼治疗方案,观察组采用小剂量托烷司琼、氟哌利多、甲氧氯普胺及甲泼尼龙联合治疗方案。比较两组患者术毕的生命体征,术后48 h内恶心呕吐、不良反应发生情况,术后48 h的VAS、Ramsay评分及术后首次进食时间。结果两组患者的MAP、HR、SpO2、T比较,差异无统计学意义(P>0.05)。观察组的恶心呕吐总发生率低于对照组,差异具有统计学意义(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。两组患者的VAS、Ramsay评分比较,差异无统计学意义(P>0.05)。观察组的术后首次进食时间显著短于对照组,差异具有统计学意义(P<0.05)。结论小剂量托烷司琼、氟哌利多、甲氧氯普胺及甲泼尼龙联合用药预防术后静脉镇痛恶心呕吐的效果显著,可缩短术后首次进食时间,且未明显增加不良反应。

Objective To study the clinical effect of low-dose combination of tropisetron,droperidol,metoclopramide and methylprednisolone in preventing nausea and vomiting after postoperative intravenous analgesia.Methods A total of 62 patients undergoing open reduction and plate internal fixation for humeral fractures admitted from April 2020 to March 2021 were selected and divided into control group and observation group according to a randomized double-blind method,with 31 cases in each group.The control group was treated with tropisetron,and the observation group was treated with low-dose combination of tropisetron,droperidol,metoclopramide and methylprednisolone.The vital signs after surgery,nausea,vomiting and adverse reactions within 48 h after surgery,VAS and Ramsay scores at 48 h after surgery and time of first feeding after surgery were compared between the two groups.Results There were no significant differences in MAP,HR,SpO2 and T between the two groups(P>0.05).The total incidence of nausea and vomiting in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).There were no significant differences in VAS and Ramsay scores between the two groups(P>0.05).The time of first feeding after surgery of the observation group was significantly shorter than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The low-dose combination of tropisetron,droperidol,metoclopramide and methylprednisolone has a significant effect on the prevention of nausea and vomiting after postoperative intravenous analgesia,which can shorten the time of first feeding after surgery,without significantly increasing the adverse reactions.