地塞米松联合氟哌利多对术后吗啡硬膜外镇痛恶心呕吐的影响

目的研究地塞米松静脉给药联合小剂量氟哌利多硬膜外给药对降低术后吗啡硬膜外镇痛恶心呕吐（PONV）的作用。方法随机双盲选择90例在硬膜外麻醉下行腹部手术的女性病人进行观察。所有病人在手术后均接受硬膜外吗啡联合小剂量氟哌利多镇痛。地塞米松（D）组病人在手术后静注地塞米松10mg，对照组（C）组病人则给予等量生理盐水。结果7例患者因故退出此观察。在手术后48h内D组病人手术后总的恶心呕吐发生率为19．0％，明显低于C组病人的36．6％（P〈0．05）。两组病人之间手术后皮肤瘙痒的发生率无明显差异，组间镇痛效果亦无明显差异。结论地塞米松联合氟哌利多是一种减少与硬膜外吗啡镇痛有关的恶心呕吐并发症的有效方法。

Influence of Intravenous Dexamethasone Combined with Low-dose Droperidol on Postoperative Nausea and Vomiting in Patients Undergoing Epidural Morphine

Objective To observe the effect of intravenous dexamethasone （Dex） combined with low-dose droperidol on the decrease in postoperative nausea and vomiting related-to epidural morphine. Methods Ninety female patients requiring epidural anesthesia for abdominal surgical operation were enrolled in the randomized double-blinded study. All patients received epidural mort phine combined with low-dose droperidol for analgesia after operation. At the end of operation, the patients in Dex group received Dex （ 10 mg, iv）, whereas the patients in control group received normal saline. Results Seven patients were eliminated from the investigation for some reasons. The total incidence of postoperative nausea and vomiting （PONV） was 19.0 % in the Dex group, which was significantly lower than that （ 36.6 % ） in the control group （ P 〈 0. 05 ） within 48 hours after operation. There was no significant difference in the incidence of pruritus or in the pain scoring between the two groups. Conclusion Dexamethasone combined with droperidol may be a valuable method to reduce PONV related to epidural morphine analgesia.