【摘要】 目的:评价地塞米松对硬膜外吗啡引起恶心呕吐的预防效果。方法:妇科肿瘤择期手术病人120例,随机双盲分为地塞米松(A)组、恩丹西酮(B)组、生理盐水(C)组三组,每组40人。当手术开始时,随机给予地塞米松10 mg或者恩丹西酮8 mg或者生理盐水2 mL。所有病人在手术结束前1 h均接受硬膜外吗啡2 mg,然后以0.125％布比卡因100 mL和吗啡0.12mg/kg维持硬膜外术后止痛48 h,评价镇痛效果、恶心呕吐。结果:A组和B组早期和晚期恶心呕吐发生率低于C组(P<0.05),而A组和B组无差别(P>0.05)。结论:地塞米松和恩丹西酮均能降低硬膜外吗啡引起的恶心呕吐,地塞米松对术后硬膜外吗啡引起的恶心呕吐有预防作用。更多还原

【Abstract】 Objective: To evaluate the prophylactic effect of dexamethasone on postoperative nausea and vomiting associated with epidural morphine. Methods: 120 women (n=40 in each of three groups) undergoing major elective gynecological surgery under epidural anesthesia were enrolled in this randomized, double-blinded, and placebo-controlled study. When the operation started, patients received IV dexamethasone 10 mg, ondansetron 8 mg and saline 2 mL, respectively. All patients received 2 mg epidural morphine bolus one hour before the end of surgery, followed by a continuous epidural infusion containing 0.12 mg/kg morphine in 100 mL bupivacaine 0.125% for postoperative analgesia for 48 hr. Analgesia, nausea and vomiting were evaluated. Results: The incidence of early and late nausea with vomiting in both dexamethasone group and ondansetron group was lower than in the saline (P<0.05). There were no differences between dexamethasone and ondansetron (P>0.05). Conclusions: Both dexamethasone and ondansetron reduced postoperative nausea and vomiting associated with epidural morphine, it suggests that dexamelhasone is a useful treatment in these patients.更多还原