小剂量氟哌利多在预防妇科腹腔镜术后恶心呕吐的效果观察

目的:探讨腹腔镜手术中给予小剂量氟哌利多对术后恶心呕吐(postoperative nausea and vomiting,PONV)的预防效果.方法:选择200例ASA Ⅰ～Ⅱ级择期妇科腹腔镜手术患者,随机分为两组:术中给予氟哌利多组(F组)和对照组(D组).两组患者的麻醉诱导方法、麻醉维持药物及术中输液管理方法均相同,F组术毕前30 min给予氟哌利多1 mg,D组术毕前30 min给予生理盐水1mL.观察术后24h内恶心呕吐的发生情况、氟哌利多不良反应及其他全麻并发症.术中心电图监测有异常者和术后苏醒延迟、呼吸道梗阻、血流动力学不稳定(低血压或高血压)、术中知晓等并发症者剔除本研究.结果:两组患者均未出现锥体外系反应等氟哌利多的不良反应,两组患者PONV发生率F组为12.9％,D组为38.5％,比较两组差异有极显著性(P＜0.01)；PONV程度分级构成比比较两组差异有极显著性(P＜0.01).结论:术中给予小剂量氟哌利多能显著降低PONV发生率,减轻恶心呕吐的程度,是一种安全、有效、经济的预防PONV的措施,值得在基层医院推广应用.

Observation of low-dose droperidol on preventing postoperative nausea and vomiting of laparoscopic gynecologic surgery

Objective：To observe the preventive effect of intraoperative low-dose droperidol during laparoscopic gynecologic surgery on postoperative nausea and vomiting（PONV）,and to discuss its application value in preventing PONV in basic-level hospitals.Methods：200 patients with ASAⅠ~Ⅱ grade elective laparoscopic gynecologic surgery were randomly divided into 2 groups,the group F（droperidol） and D（control）.Two groups had the same method of anesthesia induction,drug for anesthesia maintenance and intraoperative transfusion management methods.The group F was given droperidol 1 mg and the group D was given normal saline 1mL at 30 min before completion of operation respectively.The occurrence of nausea and vomiting,droperidol side-effects and other complications of general anesthesia within 24 h after operation were observed.The cases of ECG abnormalities during intraoperative monitoring and complications of postoperative delayed recovery,respiratory tract obstruction,hemodynamic instability（hypotension or hypertension） and intraoperative awareness were excluded from the study samples.Results：The droperidol side-effects such as extrapyramidal reactions were not found in the two groups.The incidence of PONV was 12.9% in the group F and 38.5% in the group D with significant difference between them（P0.01）.The constituent ratio of severity of PONV also had significant difference between the two groups（P0.01）.Conclusion：Giving low-dose droperidol can significantly reduce both the incidence of PONV and the extent of nausea and vomiting,which is a safe,effective and economical measure to prevent PONV and worth popularization and application in basic-level hospitals.