Comparison of prophylactic anti-emetic effects of ondansetron and dexamethasone in women undergoing day-case gynaecological laparoscopic surgery

We aimed to determine the effect of ondansetron and dexamethasone on preventing post-operative nausea and vomiting (PONV). Sixty women undergoing laparoscopic gynaecological surgery were randomized to receive ondansetron 4 mg, dexamethasone 8 mg or saline. Drugs were administered 2 min before induction of anaesthesia, and anaesthesia and post-operative analgesic regimens were standardized. The incidence of PONV in the first 24 h after the operation was 35% in the ondansetron group, 55% in dexamethasone group and 85% in the control group. A significant difference between the groups was only seen in the first 3 h post-operatively. In this period, ondansetron was significantly more effective than dexamethasone and saline, but no differences were seen between dexamethasone and saline. In all treatment groups, post-operative visual analogue scale scores, sedation scores and usage of analgesics were similar. In conclusion, ondansetron, but not dexamethasone, prevented PONV in the first 3 h after gynaecological laparoscopic surgery.     

A randomized controlled trial of two different interventions for the prevention of postoperative nausea and vomiting: total intravenous anaesthesia using propofol and remifentanil versus prophylactic palonosetron with inhalational anaesthesia using sevoflurane-nitrous oxide

Total intravenous anaesthesia (TIVA) can reduce the risk of postoperative nausea and vomiting (PONV) almost as much as a single antiemetic. This study compared TIVA (using propofol and remifentanil) with prophylactic palonosetron (a 5-hydroxytryptamine type 3 receptor antagonist) combined with inhalation anaesthesia using sevoflurane in 50% nitrous oxide, for the prevention of PONV. Patients were randomly assigned to one of two prophylactic interventions: (i) palonosetron 0.075 mg, intravenously before induction of inhalation anaesthesia (palonosetron group); and (ii) TIVA (propofol target blood concentration 2.5-6.0 μg/ml; remifentanil target blood concentration 2.5-6.0 ng/ml; TIVA group). Nausea/vomiting occurrence and severity were monitored immediately after the end of surgery for 24 h. The incidence of PONV was around 50% in both groups and the severity of nausea was similar in both groups. Prophylactic palonosetron with inhalational anaesthesia using sevoflurane in 50% nitrous oxide reduced the incidence of PONV after gynaecological laparoscopic surgery almost as much as TIVA using propofol and remifentanil.     

A randomized double blind study to evaluate efficacy of palonosetron with dexamethasone versus palonosetron alone for prevention of postoperative and postdischarge nausea and vomiting in subjects undergoing laparoscopic surgeries with high emetogenic risk

Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) are common occurrences (50%-80%) after laparoscopic surgery. Palonosetron (Pal), the newest 5-HT3 antagonist, is an effective antiemetic that has advantages in treating PDNV due to its prolonged duration of action. We hypothesized that a combination of Pal and dexamethazone (Dex) could further improve the efficacy of the treatment in comparison to Pal alone in patients at high risk for PONV. Patients scheduled to undergo laparoscopic surgeries under general anesthesia were randomized to receive 8-mg dexamethasone + 0.075-mg palonosetron (Pal + Dex) or an equivalent volume of saline + 0.075 mg palonosetron (Pal). Data was collected at defined postoperative times (2, 6, 12, 24, and 72 hours). All patients also completed an 18-question QOL-Functional Living Index-Emesis instrument at 96 hours. We enrolled 118 patients, ASA 1-2, with at least 3 PONV risk factors, who were undergoing outpatient surgery. Both groups had a low incidence of vomiting in the PACU (Pal + Dex, 1.7%; Pal, 6.8%) and at 72 hours (0.0% both groups). Complete response (no vomiting, no rescue medication) was not different between treatment groups for any time intervals. Cumulative success rates over the entire 72 hours were 60.4% (Pal + Dex) versus 60.0% (Pal). The Pal + Dex group showed a trend toward greater satisfaction on the QOL- Functional Living Index-Emesis scores with the greatest differences in the "nausea domain". The combination therapy of palonosetron + dexamethasone did not reduce the incidence of PONV or PDNV when compared with palonosetron alone. There was no change in comparative efficacy over 72 hours, most likely due to the low incidence of PDNV in both groups.     

小剂量纳洛酮在芬太尼静脉自控镇痛中的应用

目的对比芬太尼静脉自控镇痛（PCIA）泵中分别加入小剂量纳洛酮和昂丹司琼对患者恶心呕吐发生率及镇痛效果的影响,寻找更有效防止恶心呕吐的配伍方式。方法选取60例择期于静脉复合全麻下行腹部手术的患者,随机分为3组,N组（纳洛酮组,20例）：纳洛酮＋芬太尼;O组（昂丹司琼组,20例）：昂丹司琼＋芬太尼;C组（对照组,20例）：芬太尼。评估24 h内患者恶心呕吐的发生率,以及2、6、12、24、48 h内疼痛最明显时的视觉模拟评分（VAS）。结果 3组总恶心呕吐发生率比较差异有统计学意义（P〈0.05）;N组的总恶心呕吐发生率明显低于C组和O组（P＇〈0.0125）;重度恶心呕吐发生率N组明显低于C组（P＇〈0.0125）,N组与O组及O组与C组间差异无统计学意义（P＇均〉0.0125）。VAS评分N组在6 h明显低于C组（P〈0.05）;在O组和C组间差异无统计学意义（P〉0.05）。结论与昂丹司琼比较,小剂量纳洛酮应用于芬太尼PCIA可明显降低患者恶心呕吐的发生率,同时可增强芬太尼的镇痛效果。     

Efficacy of prophylactic ondansetron in a patient-controlled analgesia environment

We conducted a prospective, randomized, double-blind, placebo-controlled trial to examine the efficacy of prophylactic ondansetron on post-operative nausea and vomiting (PONV) during opioid patient-controlled analgesia (PCA). In total, 374 patients using opioid PCA, but otherwise considered to be low risk for PONV, were randomly allocated to ondansetron (4 mg given intravenously and 16 mg added into the PCA pump) or saline (control group). PONV was evaluated in terms of nausea graded on a visual analogue scale, and the number of patients who experienced emetic episodes or needed rescue anti-emetics in the 48-h post-operative period. Patient satisfaction for PCA was scored at the end of the evaluation period. The only difference between the two groups was the higher number of headaches in the ondansetron group. In patients using opioid PCA, but with no other high risk factors for PONV, prophylactic ondansetron does not have any clinical benefit.     

Ondansetron versus dolasetron: a comparison study in the prevention of postoperative nausea and vomiting in patients undergoing gynecological procedures

The purpose of this study was to determine if 4 mg of ondansetron and 12.5 mg of dolasetron were equally effective in preventing postoperative nausea and vomiting (PONV) in patients undergoing gynecological procedures. While the overall incidence of PONV appears to be 25% to 35%, the incidence among this patient population is considerably higher. Patients were assigned to 1 of 2 antiemetic treatment groups. Patients in group 1 received 4 mg of ondansetron at the end of surgery, while patients in group 2 received 12.5 mg of dolasetron at the end of surgery. Data collection occurred perioperatively and in the 24 hours following surgery. chi 2 determined there was no statistical difference between groups related to emesis in the postanesthesia care unit (PACU), emesis in the 24 hours following surgery, and side effects. Results of this study showed there was no statistically significant difference between 4 mg of ondansetron or 12.5 mg of dolasetron when administered at the end of surgery for preventing PONV in patients undergoing gynecological procedures. Given the cost difference between these 2 antiemetics, there is a potential for significant cost savings in this high-risk patient population.     

Biphasic dosing regimen of meclizine for prevention of postoperative nausea and vomiting in a high-risk population

The purpose of this study was to determine if giving 50 mg of meclizine the night before and on the day of surgery would effectively reduce postoperative nausea and vomiting (PONV) for the entire 24 hours after surgery in patients identified as being at high risk for PONV Subjects were randomly assigned to receive either 50 mg of oral meclizine (experimental group) or a placebo (control group) the night before and the day of surgery. All subjects were intravenously administered 4 mg of ondansetron before the conclusion of surgery. Seventy subjects (35 control; 35 experimental) were included in analysis. postoperaIn the placebo group we noted higher verbal numeric rating scale scores for nausea, a higher incidence oftive nausea and vomiting (PONV) continues to be a common complication after general anesthesia, with the incidence ranging from 17% to 87%.15 It has been reported that PONV increased antiemetic requirements, and lower overall anesthesia satisfaction scores at all time intervals measured, compared with the experimental group, but the differences were not statistically significant until analyzed by postoperative setting. No difference in sedation or side effects was noted between groups. Based on these results, we recommend that the administration of 50 mg of oral meclizine the night before and on the day of surgery be considered effective antiemetic prophylaxis in patients identified as having a high risk for PONV.     

Efficacy of single-dose intravenous dolasetron versus ondansetron in the prevention of postoperative nausea and vomiting.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a significant problem in surgical patients. The 5-hydroxytryptamine3-receptor antagonists ondansetron, dolasetron, and granisetron are being used to prevent PONV and avoid the adverse events associated with traditional antiemetics such as antihistaminic agents, anticholinergic agents, and dopamine antagonists. OBJECTIVE: Because practitioners have taken widely differing approaches to the selection and dosing of agents in this class, this retrospective study assessed the relative efficacy of i.v. dolasetron and ondansetron in preventing PONV when used according to their approved labeling. METHODS: The medical charts of patients who underwent total abdominal hysterectomy or laparoscopic cholecystectomy and received either dolasetron 12.5 mg or ondansetron 4 mg were reviewed. Efficacy was assessed based on the number of episodes of PONV and time to the occurrence of PONV in the 24 hours after surgery. RESULTS: Of 75 medical records reviewed, 59 met the criteria for inclusion in the efficacy analysis. There were no statistically significant between-group differences in demographic or baseline clinical characteristics. The majority of patients were obese (body mass index > or = 27 kg/m2), had no history of either PONV or motion sickness, and underwent total abdominal hysterectomy. PONV occurred in 11 of 25 (44%) patients receiving dolasetron and 18 of 34 (53%) patients receiving ondansetron. Four patients receiving dolasetron experienced PONV in the first 2 hours after surgery, compared with 7 patients receiving ondansetron. CONCLUSION: There were no significant differences in efficacy between single doses of i.v. dolasetron 12.5 mg and i.v. ondansetron 4 mg in the prevention of PONV.     

Meclizine in combination with ondansetron for prevention of postoperative nausea and vomiting in a high-risk population

Postoperative nausea and vomiting (PONV) is prevalent in surgical patients with known risk factors: general anesthesia, female, nonsmoker, motion sickness history, and PONV history. Common treatment involves ondansetron; however, the effects are short-lived, and supplemental medication may be required. Meclizine, a long-acting drug with a low side-effect profile, may be ideal in combination with ondansetron for at-risk patients. We randomized 77 subjects scheduled for general anesthesia and screened for 4 of 5 PONV risk factors for experimental or control group assignment. Severity of PONV was measured using a 0 to 10 verbal numeric rating scale (VNRS). Other measured variables included time to onset and incidence of PONV and total antiemetic requirements. No significant differences in demographics (excluding weight), surgical or anesthesia time, analgesic requirements, or nausea incidence in the postanesthesia care unit (PACU) and same-day surgery unit were noted. The meclizine group had lower VNRS scores in the PACU at 15 (P = .013) and 45 (P = .006) minutes following rescue treatment. The incidence of nausea was lower in the meclizine vs. placebo group (10% vs. 29%) following discharge (P = .038). Prophylactic meclizine resulted in lower incidence and severity of PONV in a high-risk population, especially after rescue treatment.     

A comparative analysis of isopropyl alcohol and ondansetron in the treatment of postoperative nausea and vomiting from the hospital setting to the home

We compared the efficacy of inhaled isopropyl alcohol (IPA) with ondansetron for the control of postoperative nausea and vomiting (PONV) during a 24-hour period in 100 ASA class I-III women undergoing laparoscopic surgery. Nausea was measured postoperatively using a 0 to 10 verbal numeric rating scale (VNRS). The control group received ondansetron, 4 mg intravenously, and the experimental group inhaled IPA vapors. Breakthrough PONV was treated with 25-mg promethazine suppositories. Demographic and anesthesia characteristics were similar between groups. There was a significant difference between groups in mean +/- SD time to alleviation of PONV symptoms: for a 50% reduction in VNRS scores, 15.00 +/- 10.6 vs. 33.88 +/- 23.2 minutes was required in the experimental vs. the control group (P = .001). A total of 21 subjects (10 control; 11 experimental) reported PONV symptoms following discharge to home. The IPA treatment was successful in alleviating PONV symptoms in the home in 91% of the experimental group. We determined that using IPA after discharge from the postanesthesia care unit is a valuable method to control PONV in the hospital and at home. The results of this study suggest that IPA is much faster than ondansetron for 50% relief of nausea.     

地塞米松对术后硬膜外吗啡引起恶心呕吐的预防作用

目的:评价地塞米松对硬膜外吗啡引起恶心呕吐的预防效果。方法:妇科肿瘤择期手术病人120例,随机双盲分为地塞米松(A)组、恩丹西酮(B)组、生理盐水(C)组三组,每组40人。当手术开始时,随机给予地塞米松10 mg或者恩丹西酮8 mg或者生理盐水2 mL。所有病人在手术结束前1 h均接受硬膜外吗啡2 mg,然后以0.125％布比卡因100 mL和吗啡0.12mg/kg维持硬膜外术后止痛48 h,评价镇痛效果、恶心呕吐。结果:A组和B组早期和晚期恶心呕吐发生率低于C组(P<0.05),而A组和B组无差别(P>0.05)。结论:地塞米松和恩丹西酮均能降低硬膜外吗啡引起的恶心呕吐,地塞米松对术后硬膜外吗啡引起的恶心呕吐有预防作用。     

恩丹西酮合用地塞米松预防腹腔镜胆囊切除术后恶心呕吐的临床研究

目的 :探讨预防性应用高选择 5 -HT3 受体拮抗剂恩丹西酮合用地塞米松预防腹腔镜胆囊切除术后恶心呕吐 (Postoperativenauseaandvomiting ,PONV)的效果。方法 :择期行腹腔镜胆囊切除术病人 10 5例随机分为三组 ,每组 35例。对照组 (C组 )在胆囊取出时静脉注射 0 .9%生理盐水 5ml作为对照 ;恩丹西酮组 (O组 ) :在胆囊取出时静脉给予恩丹西酮 8mg ;恩丹西酮合用地塞米松 (O Dex组 ) ,在胆囊取出时静脉给予恩丹西酮8mg ,地塞米松 10mg。观察手术后 2 4h内恶心、呕吐发生率。结果 :术后 2 4h恶心、呕吐发生率恩丹西酮组显著低于对照组 (P <0 .0 1) ,术后 2 4h恶心、呕吐发生率恩丹西酮组高于恩丹西酮合用地塞米松组 (P <0 .0 1)。结论 :恩丹西酮合用地塞米松和恩丹西酮均能有效预防腹腔镜胆囊切除术PONV的发生 ,恩丹西酮合用地塞米松优于恩丹西酮     

The search for cost-effective prevention of postoperative nausea and vomiting in the child undergoing reconstructive burn surgery: ondansetron versus dimenhydrinate.

Postoperative nausea and vomiting (PONV) is a common and unpleasant problem for children with burns who are undergoing reconstructive burn surgery. Ondansetron and dimenhydrinate have been found to be effective for the prevention of PONV in other patient populations, but they have not been directly compared in the pediatric population. A prospective, randomized, double-blind, placebo-controlled comparison of ondansetron and dimenhydrinate was performed. One hundred patients with a mean age of 11.8 years who were undergoing reconstructive burn surgery with general anesthesia were randomly assigned to receive either a placebo, 0.1 mg/kg of ondansetron, or 0.5 mg/kg of dimenhydrinate. The 3 groups were well matched for all demographic and procedural variables. The study drugs were given twice, first at the end of surgery and again 4 hours later, to ensure adequate blood levels during the 8-hour study period. Postoperatively, on the basis of the presence and amount of PONV experienced, all patients were assigned a PONV score by a blinded investigator. Statistically significant reductions in the incidence of PONV in the patients who received ondansetron or dimenhydrinate were found, as compared with the results of patients who received placebo. Postoperative vomiting was reduced from 61% in the placebo group to 29% and 40% in the ondansetron and dimenhydrinate groups, respectively, and PONV was similarly reduced from 69% to 47% and 40%, respectively. The differences between ondansetron and dimenhydrinate were not significant. The average cost to our pharmacy for the prescribed dose of ondansetron was $19.34; the cost for dimenhydrinate was $0.90. In this patient population, dimenhydrinate was as effective as ondansetron for the prevention of PONV and postoperative vomiting, and it was much less expensive.     

布托啡诺联合恩丹西酮在直肠癌根治术后硬膜外吗啡镇痛中的抗瘙痒以及抗恶心呕吐作用

目的：考察术前联合应用恩丹西酮和布托啡诺,对接受硬膜外吗啡镇痛患者术后瘙痒及恶心呕吐的预防作用是否优于单药应用。方法：选择限期直肠癌根治手术的患者120例,随机分为4组。依据分组,手术消毒时,组1患者硬膜外注入吗啡2mg＋0.9%氯化钠液（共5mL）,组2硬膜外注入吗啡2mg＋布托啡诺1mg＋0.9%氯化钠液（共5mL）,组3硬膜外注入吗啡2mg＋0.9%氯化钠液（共5mL）,同时静脉给予恩丹西酮8mg,组4硬膜外注入吗啡2mg＋布托啡诺1mg＋0.9%氯化钠液（共5mL）,同时静脉给予恩丹西酮8mg。术后予患者自控硬膜卡镇痛（PCEA）持续镇痛,评定患者术后48h内的视觉模拟疼痛（VAS评分）、舒适度（BCS评分）、镇静（Ramesay评分）以及瘙痒、恶心呕吐的发生情况。结果：4组患者之间VAS、BCS及Ramesay评分均无显著差异（P〉0.05）,但组2,组3,组4出现需要治疗的瘙痒及恶心呕吐的发生率显著低于组1（P〈0.05）;另外,组4患者恶心呕吐的发生率显著低于组2（P〈0.05）,而且组4患者瘙痒的发生率显著低于组3（P〈0.05）。结论：布托啡诺联合恩丹西酮在不影响吗啡镇痛效果的同时,可以显著减少直肠癌患者根治术后恶心呕吐以及瘙痒的发生率,其效果明显优于单独用布托啡诺或者恩丹西酮,从而提高患者的满意度。     

Preventing Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy: A Prospective, Randomized, Double-Blind Study

Background

Postoperative nausea and vomiting (PONV) are potential complications in patients after laparoscopic cholecystectomy (LC). Combination antiemetic therapy often is effective for preventing PONV in patients undergoing LC, and combinations of antiemetics targeting different sites of activity may be more effective than monotherapy.

Objective

The aim of this study was to compare the administration of a subhypnotic dose of propofol combined with dexamethasone with one of propofol combined with metoclopramide to prevent PONV after LC.

Methods

Sixty adult patients scheduled for LC were randomly assigned to 1 of 2 treatment groups. The patients in group 1 received 0.5 mg/kg propofol plus 8 mg dexamethasone, and those in group 2 received 0.5 mg/kg propofol plus 0.2 mg/kg metoclopramide. The number of patients experiencing nausea and vomiting at 0 to 4, 4 to 12, and 12 to 24 hours postoperatively and as well as additional use of rescue antiemetics were recorded.

Results

The total PONV rates up to 24 hours postanesthesia were 23.3% and 50% for group 1 and group 2, respectively. Comparisons of the data revealed that at 0 to 4 hours, the number of patients experiencing vomiting was 6 (20%) in group 1 and14 (46.7%) in group 2 (P = 0.028). The frequency of vomiting in group 1 was significantly lower than that for group 2 (P = 0.028), and the rate of rescue antiemetic use in group 2 was higher than that in group 1 (20% vs 46.7%; P = 0.028). In the evaluation of PONV based on the nausea and vomiting scale scores, the mean PONV score was 0.4 (0.2) in group 1 compared with 1.0 (0.2) in group 2 (P = 0.017). There were no significant differences between the values at 4 to 12 hours and at 12 to 24 hours. The frequency of adverse reactions (respiratory depression: 1.3%, 1.3%; laryngospasm: 1.3%, 0%; cough: 1.3%, 0%; hiccup: 1.3%, 0%;) was not significantly different in the 2 groups.

Conclusions

Administration of a subhypnotic dose of 0.5 mg/kg propofol plus 8 mg dexamethasone at the end of surgery was more effective than administration of 0.5 mg/kg propofol plus metoclopramide in preventing PONV in the early postoperative period in adult patients undergoing LC.     

托烷司琼预防术后静脉自控镇痛致恶心呕吐疗效观察

目的观察托烷司琼抑制患者术后静脉自控镇痛（patient controlled intrarenous analgesia,PCIA）所致恶心呕吐的效果。方法选择择期手术需行全身麻醉ASAI-Ⅱ级患者120例,所有患者术前均无明显胃肠道功能异常和恶心呕吐症状,无心、肺、肝、肾功能不全;术前24h未给任何止吐药。术毕将120例患者随机分为3组：①Ⅰ组（生理盐水组,n=40）,术毕静脉注射生理盐水2mL,患者PCIA配方为芬太尼0.6～0.8mg,用生理盐水稀释至100mL。②Ⅱ组（托烷司琼组,n=40）,术毕静脉注射托烷司琼2mg;在Ⅰ组PCIA配方中加托烷司琼4mg。③Ⅲ组（氟哌利多组,n=40）术毕静脉注射氟哌利多2.5mg,在Ⅰ组PCIA配方中加氟哌利多2.5mg。术后连续观察48h,记录术后0、4、8、16、24、32、48h视觉模拟评分（VAS）、舒适评分（BCS）及恶心呕吐等不良反应。结果所有患者术后镇痛及舒适评分均达基本满意水平,各组相比,差异无统计学意义（P〉0.05）。防治恶心、呕吐效果,Ⅱ组效果最好,Ⅱ组、Ⅲ组与Ⅰ组相比差异均有显著性（均P〈0.05）;Ⅱ组与Ⅲ组相比差异无显著性（P〉0.05）。Ⅲ组出现了3例锥体外系症状及5例嗜睡症状,Ⅱ组有3例出现一过性轻微头痛。结论托烷司琼及氟哌利多均能抑制PCIA所致恶心、呕吐,但托烷司琼不良反应少且轻微。     

Intravenous ondansetron for the control of opioid-induced nausea and vomiting. International S3AA3013 Study Group.

This randomized, double-masked, placebo-controlled, multicenter trial was conducted in 9 countries to assess the safety and efficacy of 2 doses of intravenous ondansetron (8 and 16 mg) for the control of opioid-induced nausea and vomiting. A total of 2574 nonsurgical patients who presented with pain requiring treatment with an opioid analgesic agent participated in this trial. The most common presenting painful condition was back or neck pain, reported by approximately one third of patients. A total of 520 patients (317 females, 203 males) developed nausea or vomiting after opioid administration and were randomly assigned to receive a single dose of 1 of 3 study treatments: placebo (n = 94), ondansetron 8 mg (n = 215), or ondansetron 16 mg (n = 211). Ondansetron 8 and 16 mg led to complete control of emesis in 134 of 215 patients (62.3%) and 145 of 211 patients (68.7%), respectively. Results with both doses were significantly better than those seen with placebo (43 of 94 patients [45.7%]). Complete control of nausea was achieved in 6.8% of placebo patients, 14.8% of ondansetron 8-mg-treated patients, and 19.4% of ondansetron 16-mg treated patients; only ondansetron 16 mg was significantly better than placebo (P = 0.007). Significantly more patients who received ondansetron 8 mg than patients who received placebo were satisfied/very satisfied with their antiemetic treatment, as assessed by 4 patient-satisfaction questions. Significantly more patients who received ondansetron 16 mg compared with placebo were satisfied/very satisfied on 2 of 4 satisfaction questions. In conclusion, based on the observed incidence of opioid-induced nausea and vomiting in this study, it may be more appropriate to treat symptoms on occurrence rather than administering antiemetic agents prophylactically. The results of this study demonstrate that intravenous ondansetron in doses of 8 or 16 mg is an effective antiemetic agent for the control of opioid-induced nausea and vomiting in nonsurgical patients requiring opioid analgesia for pain.     

不同时间应用地塞米松对预防腹腔镜术后恶心呕吐的比较

目的：比较不同时间应用地塞米松对预防术后恶心呕吐的影响。方法：120例腹腔镜胆囊切除术患者,随机分为3组,各40例。1组麻醉诱导前给予地塞米松10 mg,2组于手术后给予地塞米松10 mg,3组为对照组。观察三组术后恶心呕吐情况。结果：1、2组术后恶心呕吐数量均显著低于3组,同时1组亦明显低于2组。结论：不同时间应用地塞米松对预防术后恶心呕吐有影响,麻醉前应用效果优于手术后。     

昂丹司琼对全麻腹腔镜胆囊切除术患者术后恶心呕吐的影响及护理

目的 研究术中静脉注射昂丹司琼对腹腔镜胆囊切除术患者术后恶心呕吐(PONV)的影响及护理.方法 择期行全麻腹腔镜胆囊切除术患者90例,将患者随机分为3组各30例:小剂量昂丹司琼组(O1组),切皮前静脉注射4 mg昂丹司琼;大剂量昂丹司琼组(O2组),切皮前静脉注射8 mg昂丹司琼;对照组(C组),切皮前静脉注射生理盐水.所有注射液体均稀释为4 ml.观察术后24 h发生恶心呕吐的例数及程度.结果 与C组比较,O1组与O2组发生PONV的例数减少且程度减轻,P＜0.05;O1组与O2组之间比较差异无统计学意义,P＞0.05.结论 术中静脉注射昂丹司琼可以减少腹腔镜胆囊切除术后患者的恶心呕吐.