倍他米松预先给药对腹腔镜子宫肌瘤切除术患者术后恶心呕吐及疼痛的影响

Effects of Betamethasone Pre-administration on Postoperative Nausea and Vomiting and Pain in Patients Undergoing Laparoscopic Myomectomy

目的探讨倍他米松预先给药对腹腔镜子宫肌瘤切除术患者术后恶心呕吐及疼痛的影响。方法选取2019年7月—2020年6月择期行腹腔镜下子宫肌瘤切除术者160例为研究对象,根据预先给药不同分为A组和B组,每组80例。麻醉诱导前,A组给予托烷司琼联合地塞米松,B组给予托烷司琼联合倍他米松,余麻醉诱导方法、药物及其他干预措施相同。观察并记录两组手术相关指标、术后不同时间段恶心、呕吐发生率,以及术后不同时间点疼痛视觉模拟评分法(VAS)评分。结果两组手术时间、麻醉时间、芬太尼用量、瑞芬太尼用量及术中出血量比较差异均无统计学意义(P>0.05);术后0、12、24、48 h,两组间VAS评分比较差异均无统计学意义(P>0.05)。术后0~6 h和24~48 h,两组恶心、呕吐发生率比较差异无统计学意义(P>0.05)。术后6~12 h,A组恶心发生率均高于B组(P<0.05)。术后12~24 h,A组恶心、呕吐发生率高于B组(P<0.05)。结论麻醉诱导前预先给予倍他米松能够有效预防并降低腹腔镜子宫肌瘤切除术患者术后恶心呕吐的发生率。

Objective To investigate effects of Betamethasone pre-administration on postoperative nausea and vomiting,and pain in patients undergoing laparoscopic myomectomy.Methods A total of 160 patients who had undergone elective laparoscopic myomectomy between July 2019 and June 2020 were selected and divided into group A(n=80)and group B(n=80)according to different drugs for pre-administration.Before induction of anesthesia,group A was treated with Tropisetron combined with Dexamethasone,while group B was treated with Tropisetron combined with Betamethasone.The additional method of anesthesia induction,drugs,and interventions were identical in both groups.The surgical-related indexes,incidence rates of nausea and vomiting at different postoperative periods,and visual analog scale(VAS)pain scores at different postoperative times were observed and recorded in both groups.Results There were no statistically significant differences in terms of durations of surgery and anesthesia,dosages of Fentanyl or Remifentanil and intraoperative bleeding volume between two groups(P>0.05).There were no statistically significant differences in VAS scores after surgery for 0,12,24 and 48 h between two groups(P>0.05).The differences in incidence rates of nausea and vomiting were not statistically significant after surgery for 0-6 h and 24-48 h between two groups(P>0.05).Incidence rate of nausea after surgery for 6-12 h in group A was higher than that in group B(P<0.05).Incidence rate of nausea and vomiting after surgery for 12-24 h in group A was higher than that in group B(P<0.05).Conclusion Pre-administration of Betamethasone before anesthesia induction may effectively prevent and reduce incidence rate of postoperative nausea and vomiting in patients undergoing laparoscopic myomectomy.