全麻诱导中地塞米松联合氟哌啶预防腹腔镜胆囊切除术后恶心呕吐.docVIP

全麻诱导中地塞米松联合氟哌啶预防腹腔镜胆囊切除术后恶心呕吐 　【摘要】 　　目的：探讨全麻诱导中地塞米松联合氟哌啶预防腹腔镜胆囊切除术后恶心、呕吐的效果。方法：随机将240例ASAⅠ～Ⅱ腹腔镜胆囊切除术患者分为３组（各80例）。Ⅰ组（对照组）全麻诱导中不用地塞米松、氟哌啶；Ⅱ组全麻诱导中用地塞米松10mg；Ⅲ组全麻诱导中用地塞米松10mg和氟哌啶40μg/kg，观察术后48h患者的恶心、呕吐情况。结果：Ⅰ组患者恶心、呕吐的发生率为72.5%；Ⅱ、Ⅲ组恶心、呕吐的发生率分别为32.5%和7.5%，组间比较差异有统计学意义（P＜0.05）。结论：全麻诱导中用地塞米松联合小剂量氟哌啶能预防腹腔镜胆囊切除术后的恶心、呕吐。 【关键词】 地塞米松　氟哌啶醇　恶心　呕吐　胆囊切除术　腹腔镜 　　The prevention of nausea and vomiting after laparoscopic cholecystectomy with dexamethasone combined with droperidol during induction of general anesthesia 　　【Abstract】Ｏbjective:To explore the effect of prevention for postoperative nausea and vomiting after laparoscopic chyolecystectomy with dexamethasone combined with droperidol during induction of general anesthesia.Methods:Two hundred and forty patients with ASA ⅠⅡ who would undergo laparoscopic cholecystectomy were randomly divided into three groups (80 patients in each group).Group Ⅰ(control group) was not given dexamethasone and droperidol in induction of general anesthesia.Group Ⅱ was given only 10 mg dexamethasone.Group Ⅲ was given 10 mg dexamethasone and 40 ug/kg droperidol.All patients were observed within postoperative 48 hours for nausea and vomiting.Results:The incidence of nausea and vomiting in group Ⅰ,Ⅱ and Ⅲ was respectively 72.5%,32.5% and 7.5%,which had significant differences among groups (Plt;0.05).Conclusions:The nausea and vomiting after laparoscopic cholecystectomy can be prevented maximally with dexamethasone combined with droperidol in small dose during induction of general anesthesia. 　　【Key words】Dexamethasone；Droperidol；Nausea;Vomitinging；Cholecystectomy,laparoscopic 患者在腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后易发生恶心、呕吐［1，2］，全麻诱导中地塞米松对恶心、呕吐有预防作用，联合其他药物是否更加有效有待证实。我们探讨了地塞米松、氟哌啶对LC全麻诱导中防治恶心、呕吐的效果，现报道如下。 　　1 资料与方法 　　1.1 临床资料 　　择期ＬＣ患者240例，ASAⅠ～Ⅱ级，18～70岁，体重35～80kg。随机分成３组，每组80例。Ⅰ组为对照组；Ⅱ组为地塞米松组；Ⅲ组为地塞米松、氟哌啶组。有全身麻醉史，曾服用抗恶心、呕吐药的患者除外。 　　1.2 用药方法和监测指标 　　麻醉诱导中，Ⅰ组依次静注依托咪酯0.3mg/kg、芬太尼4～6μg/kg、维库溴胺0.12mg/kg；Ⅱ组比Ⅰ组另加地塞米松10mg;Ⅲ组比Ⅱ组另加氟哌啶40μg/kg。麻醉维持系间歇静注芬太尼，用维库溴胺