【摘要】 目的观察三种不同的麻醉方法对妇科腹腔镜手术后恶心呕吐(postoperative nausea and vomiting,PONV)的防治效果。方法择期妇科腹腔镜手术患者75例,随机分为异丙酚组(P组)、异氟醚+盐酸恩丹西酮组(I+O组)和异氟醚组(I组,对照组),每组25例。三组均常规异丙酚静脉复合诱导气管插管,P组患者给予异丙酚持续泵注维持麻醉;I+O组和I组患者给予均以异氟醚吸入维持麻醉;I+O组缝皮时静注8mg盐酸恩丹西酮。术后24h内观察并评估PONV发生率及程度;记录需要止吐治疗的患者例数。结果术后PONV的发生率P组和I+O组低,分别为24.00%和20.00%;I组为56.00%。P组、I+O组分别与I组比较,差异均有统计学意义(χ2分别=5.33和6.87,P均<0.05)。结论异丙酚全静脉麻醉和异氟醚吸入麻醉并预防性静注欧贝均可有效降低妇科腹腔镜手术患者PONV的发生率。更多还原

【Abstract】 Objective To compare the efficacy of three different anesthesia methods in the prevention of postoperative nausea and vomiting (PONV) in gynecologic laparoscopy. Methods Seventy-five patients undergoing elective gynecologic laparoscopy with general anesthesia were divided randomly into three groups: propofol group (group P), isoflurane + ondansetron group (group I+O) and isoflurane group (group I). Anesthesia was induced with propofol and tracheal intubation in all these groups. The anesthesia was maintained with propofol continuous infusion in group P; with isoflurane inhalation in both groups I and I+O. Ondansetron 8mg was given intravenously at the beginning of skin closure in group I+O. The frequency of PONV within the first 24 hours postoperation was evaluated. The number of patients, who received metoclopramide for PONV, was also recorded. Results The incidences of PONV were 20%, 24% and 56% in group I+O, group P, and group I, respectively. The incidences of PONV were significantly lower in the I+O (χ2=6.87, P<0.05) and P groups (χ2=5.33, P<0.05) compared to the I group. Conclusions In gynecologic laparoscopy, propofol anesthesia and isoflurane anesthesia with ondansetron can prevent PONV efficiently.更多还原