托烷司琼联合地塞米松预防小儿脑瘫术后曲马多镇痛恶心呕吐的临床观察

目的研究托烷司琼联合地塞米松用于预防小儿脑瘫术后曲马多PCIA镇痛恶心呕吐的临床效果。方法选择60例小儿脑瘫II期手术术后接受曲马多PCIA镇痛的患儿,随机分为三组。镇痛泵中曲马多用量均为15mg/kg。I组病人在手术时静注生理盐水2ml,泵中加入生理盐水至100ml。II组病人手术结束时静注托烷司琼0.1mg/kg,泵中加入托烷司琼0.1mg/kg,并稀释至100ml。III组病人麻醉诱导时静注地塞米松0.2mg/kg,手术结束时静注托烷司琼0.05mg/kg,泵中加入托烷司琼0.1mg/kg,并稀释至100ml。比较各组患儿术后24h恶心呕吐的发生率。结果 II、III组恶心呕吐发生率明显低于I组(P<0.01).II、III组的发生率比较差异无统计学意义(P>0.05)。结论托烷司琼联合地塞米松可有效预防曲马多PCIA镇痛的恶心呕吐,且可提高疗效,减少单一药物的用量。

Clinical Effects of Tropisetron Used in Combination with Dexametlmsone in the Prevention of Postoperative Nausea and Vomiting Due to Tramadol Analgesia in Children with Cerebral Palsy

Objective To investigate the clinical effects of tropisetron used in combination with dexamethasone in the prevention of postop-emtive nausea and vomiting（PONV）due to tramadol analgesia in children with cerebral palsy. Methods Sixty children with cerebral palsy who received tramadol analgesia after secondary operation were randomly divided into 3 groups. Tramadol in an analgesia pump was 15mg/kg in dosage,and was diluted to 100ml with normal saline. 2ml of normal saline was given intravenously st the end of operation in Group I,tropisetron 0. 1mg/kg in Group and dexamethasone 0. 2mg/kg during anesthesia induction and tropisetron 0. 05mg/kg at the end of operation in Group HI. Tropisentron 0. 1mg/kg was added in the pump in the last 2 groups. The incidence rates of PONV 24h after operation were recorded in each group. Results The incidence rates of PONV were clearly lower in Group Ⅱ and Group HI than in Group I（ P 〈0. 01 ） ,and showed no significant difference between Group Ⅱ and Group Ⅲ（ P 〉 0. 05 ）. Conclusions The use of tropisetron in combination with dexa- methasone can effectively prevent PONV due to tramadel analgesia,improve the clinical effects and decrease the dose of a single drug. tramadol analgesia postoperative nausea and vomiting.