地塞米松减少手术后硬膜外吗啡镇痛引起的恶心呕吐

目的　观察静脉注射地塞米松 (Dex)对减少手术后与硬膜外吗啡镇痛有关的恶心呕吐发生率的作用。方法　随机双盲选择 87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镇痛。Dex组病人 (n =41)在手术后静注Dex 8mg ,对照组病人 (n=46 )则给予等量生理盐水。结果　在手术后 2 4小时内 ,Dex组病人手术后总的恶心呕吐发生率为2 6 8% ,明显低于对照组病人的 43 5 % (P <0 0 1)。两组病人之间手术后皮肤瘙痒的发生率无明显差异 ,Dex也不影响手术后硬膜外吗啡的镇痛作用。结论　预防性静脉注射Dex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

Dexamethasone decreases the postoperative nausea and vomiting related to epidural morphine analgesia

Objective To observe the effect of dexamethasone (Dex) iv on the decrease of epidural morphine related postoperative nausea and vomiting.Methods 87 female patients requiring epidural anesthesia for abdominal surgeries were enrolled in a randomized double blinded study.All patients received epidural morphine for analgesia after the surgery.At the end of the surgery,the patients in Dex group( n= 41) received Dex 8 mg iv,whereas the patients in control group( n= 46) received saline.Results The total incidence of postoperative nausea and vomiting (PONV) was 26 8% in Dex group,which was significantly lower than that (43 5%) in control group ( P< 0 01) during 24 hours after surgery.There was no significant difference in the incidence of pruritus between the two groups.Dexamethasone did not affect the analgesic effect of morphine.Conclusion Prophylactic dexamethasone may be a valuable method to reduce PONV related to epidural morphine analgesia.