地塞米松联合氟哌利多预防术后硬膜外吗啡镇痛所致恶心呕吐

目的观察地塞米松联合氟哌利多预防术后硬膜外吗啡镇痛所致恶心呕吐的效果。方法200例连续硬膜外阻滞下手术患者随机分为4组,每组50例:对照组在手术结束时静脉注射生理盐水2ml;地塞米松组在手术结束时静脉注射地塞米松10mg(2ml);氟哌利多组在镇痛药液中加入氟哌利多5mg;联合组在手术结束时静脉注射氟哌利多2.5mg(1ml)和地塞米松5mg(1ml)。术毕所有患者均行硬膜外镇痛。观察术后24h内患者镇痛效果和恶心呕吐发生率。结果对照组恶心呕吐率(22.4%),明显高于氟哌利多组(10%)、地塞米松组(12%)和联合组(10.2%),P<0.05;处理组三组组间比较恶心呕吐率无明显差异,P>0.05。结论地塞米松与氟哌利多单独或联合应用都能有效减少术后硬膜外吗啡镇痛所致恶心呕吐。

Effect of preventive dexamethasone combined with droperidol on postoperative nausea and vomiting induced by epidural morphine analgesia

Objective To investigate the influence of dexamethasone combined with droperidol on postoperative nausea and vomiting(PONV)during epidural analgesia with morphine. Methods 200 patients undergoing elective operation were randomly divided into 4 groups, 50 cases in each group. Control group received normal saline (NS)2ml; dexamethasone group received 10 mg(2ml) dexamethasone; droperidol group added droperidol 5 mg to epidural analgesia solution; dexamethasone combined with droperidol group received dexamethasone 5mg (1ml)and droperidol 2.5mg(1ml) at the end of operation. All patients received epidural analgesia with morphine. Pain rating, nausea and vomiting episodes were recorded for 24 h after operation. Results The incidence of nausea and vomiting in control group(22.4%)was higher than that in droperidol group(10%), dexamethasone group (12%) and dexamethasone combined with droperidol group (10.2%), (P<0.05). There were no differences in nausea and vomiting among other preventive groups, (P>0.05). Conclusions Dexamethasone and droperidol given alone or combination can decrease the incidence of nausea and vomiting during epidural analgesia with morphine,A combination of the two antiemetics reduces half of the dose without causing side effects ,such as extrapyramidal response.