Objective:To compare the safety and efficacy of dexmedetomidine and dexamethasone for the prevention of postoperative nausea and vomiting(PONV)in patients scheduled for laparoscopic surgery.Methods:A total of 86 femal...Objective:To compare the safety and efficacy of dexmedetomidine and dexamethasone for the prevention of postoperative nausea and vomiting(PONV)in patients scheduled for laparoscopic surgery.Methods:A total of 86 female patients were prospectively administered dexmedetomidine 1μg/kg i.v.(the group A,n=43),and dexamethasone 8 mg i.v.(the group B,n=43).The two groups were compared in treatment response,hemodynamic changes,and Numerical Analog Scale(NAS).Besides,the relation of PONV with patient baseline characteristics in the perioperative period was determined as well.Results:Patients in group A had lower PONV scores(t=3.1,P<0.002),less needs for rescue anti-emetics(χ2=0.47,P<0.001),and decreased intraoperative heart rate(t=9.72,P<0.001)and mean arterial pressure(t=7.58,P<0.001)compared to that of group B.Group A reported lower NAS than group B(t=2.66,P<0.001).In addition,we found no relationship between PONV score and rescue anti-emetic requirement,age,or body mass index(P=0.96,P=0.60,P=0.28,respectively).Conclusion:Dexmedetomidine could be used as an effective antiemetic in laparoscopic surgeries,with better efficacy than dexamethasone.Dexmedetomidine not only can reduce PONV but also is effective in postoperative analgesia.展开更多
Rationale:Cardiac pulmonary arrest is the most challenging and dreaded complication of neuraxial blockade.Patient’s concern:A 21-year-old patient at 37 weeks of gestation,with previous lower segment Caesarean section...Rationale:Cardiac pulmonary arrest is the most challenging and dreaded complication of neuraxial blockade.Patient’s concern:A 21-year-old patient at 37 weeks of gestation,with previous lower segment Caesarean section pregnancy presented for elective Caesarean section.Diagnosis:Cardiac arrest after performing a subarachnoid block.Intervention:Maternal resuscitation.Outcome:Return of spontaneous circulation was achieved within 4-5 min of cardiopulmonary resuscitation.A single live healthy male baby was delivered.Lesson:A careful preoperative evaluation,adequate preload,constant vigilant monitoring to recognize vasovagal response at the earliest,and immediate initiation of resuscitative measures play the most important role in saving the precious lives in case of pregnant patients undergoing Caesarean section under subarachnoid block.展开更多
文摘Objective:To compare the safety and efficacy of dexmedetomidine and dexamethasone for the prevention of postoperative nausea and vomiting(PONV)in patients scheduled for laparoscopic surgery.Methods:A total of 86 female patients were prospectively administered dexmedetomidine 1μg/kg i.v.(the group A,n=43),and dexamethasone 8 mg i.v.(the group B,n=43).The two groups were compared in treatment response,hemodynamic changes,and Numerical Analog Scale(NAS).Besides,the relation of PONV with patient baseline characteristics in the perioperative period was determined as well.Results:Patients in group A had lower PONV scores(t=3.1,P<0.002),less needs for rescue anti-emetics(χ2=0.47,P<0.001),and decreased intraoperative heart rate(t=9.72,P<0.001)and mean arterial pressure(t=7.58,P<0.001)compared to that of group B.Group A reported lower NAS than group B(t=2.66,P<0.001).In addition,we found no relationship between PONV score and rescue anti-emetic requirement,age,or body mass index(P=0.96,P=0.60,P=0.28,respectively).Conclusion:Dexmedetomidine could be used as an effective antiemetic in laparoscopic surgeries,with better efficacy than dexamethasone.Dexmedetomidine not only can reduce PONV but also is effective in postoperative analgesia.
文摘Rationale:Cardiac pulmonary arrest is the most challenging and dreaded complication of neuraxial blockade.Patient’s concern:A 21-year-old patient at 37 weeks of gestation,with previous lower segment Caesarean section pregnancy presented for elective Caesarean section.Diagnosis:Cardiac arrest after performing a subarachnoid block.Intervention:Maternal resuscitation.Outcome:Return of spontaneous circulation was achieved within 4-5 min of cardiopulmonary resuscitation.A single live healthy male baby was delivered.Lesson:A careful preoperative evaluation,adequate preload,constant vigilant monitoring to recognize vasovagal response at the earliest,and immediate initiation of resuscitative measures play the most important role in saving the precious lives in case of pregnant patients undergoing Caesarean section under subarachnoid block.
