引用本文:檀文好,黄 庆,陆彬堂.托烷司琼联合地塞米松预防剖宫产术后硬膜外镇痛所致恶心呕吐的临床观察[J].中国临床新医学,2011,4(1):47-49.
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托烷司琼联合地塞米松预防剖宫产术后硬膜外镇痛所致恶心呕吐的临床观察
檀文好,黄 庆,陆彬堂
535000 广西,钦州市第二人民医院麻醉科
摘要:
[摘要] 目的 观察托烷司琼联合地塞米松对剖宫产术后患者硬膜外腔吗啡镇痛所致恶心呕吐的防治效果。方法 随机将320例在腰硬膜外联合麻醉下行剖宫产手术的患者分为四组:分别于手术关腹膜时静脉注射生理盐水5 ml(Ⅰ组)、托烷司琼5 mg(Ⅱ组)、地塞米松10 mg(Ⅲ组)和地塞米松10 mg+托烷司琼5 mg(Ⅳ组)。所有患者在手术后均接受硬膜外吗啡镇痛。观察术后48 h内患者镇痛效果和恶心呕吐发生情况。结果 各组间镇痛效果无明显差异。Ⅰ组恶心呕吐发生率明显高于Ⅱ组和Ⅲ组(P<0.05);Ⅳ组恶心呕吐发生率与Ⅰ组比较,P<0.01,与Ⅱ组和Ⅲ组比较,P<0.05。结论 托烷司琼联合地塞米松比其单独应用更能有效地减少剖宫产术后硬膜外吗啡镇痛所致的恶心呕吐症状,值得临床推广应用。
关键词:  托烷司琼  地塞米松  吗啡  术后镇痛  恶心呕吐
DOI:10.3969/j.issn.1674-3806.2011.01.15
分类号:R 719.8;R 614.4
基金项目:
Clinical observation of tropisetron combined with dexamethasone in the prevention of nausea and vomiting caused by epidural analgesia after cesarean section
TAN Wen-hao,HUANG Qing,LU Bin-tang
Department of Anesthesiology,Qinzhou Second People′s Hospital,Guangxi 535000,China
Abstract:
[Abstract] Objective To observe the effects of tropisetron combined with dexamethasone in the prevention and treatment of nausea and vomiting caused by epidural morphine analgesia after cesarean section.Methods Three hundred and twenty patients undergoing cesarean section under the combined spinal-epidural anesthesia were randomly divided into 4 groups:received intravenous injection of physiological saline 4 ml at closing peritoneum during operation as group Ⅰ,5 mg of tropisetron as group Ⅱ,10 mg of dexamethasone as group Ⅲ and 10 mg dexamethasone plus 5 mg of tropisetron as group Ⅳ.All patients received epidural morphine analgesia after operation. The result of analgesia,nausea and vomiting of patients within 48 hours after operation were observed.Results There was no distinct difference in analgesia results between the groups.The occurring rate of nausea and vomiting in group Ⅰ was obviously higher than that in group Ⅱ and Ⅲ (P<0.05); while compared occurring rate of nausea and vomiting in group Ⅳ with that of group Ⅰ the difference was distinct(P<0.01);with that of group Ⅱ and Ⅲ the difference was distinct (P<0.05).Conclusion Tropisetron combined with dexamethasone can more effectively reduce the incidence nausea and vomiting caused by epidural morphine analgesia after cesarean section than individual use.It is worthy of clinical popularization and application.
Key words:  Tropisetron  Dexamethasone  Morphine  Postoperative analgesia  Nausea and vomiting