地塞米松在剖腹产术后镇痛中的临床观察.docVIP

地塞米松在剖腹产术后镇痛中的临床观察 【关键词】 地塞 【摘 要】 目的 比较地塞米松和氟哌利多对剖腹产术后镇痛的影响。 方法 120例剖腹产患者，随机分为3组行硬膜外术后镇痛，每组40例。A组:曲马多600mg+布比卡因125mg+地塞米松10mg;B组:曲马多600mg+布比卡因125mg+氟哌利多5mg;C组:曲马多600mg+布比卡因125mg。每组药液以生理盐水稀释至100ml配成泵液。以视觉模拟评分法（VAS）评价镇痛效果，并观察其不良反应如恶心、呕吐、瘙痒、嗜睡，记录PCEA按压次数。 结果 3组患者VAS评分、PCEA按压次数差异无显著性，但A组低于B、C组;恶心、呕吐发生率C组高于A、B组;瘙痒发生率A组低于B、C组;嗜睡发生率B组高于A、C组。 结论 地塞米松用于剖腹产术后镇痛预防恶心、呕吐、瘙痒安全有效，且副作用较氟哌利多少，效果最佳。 【关键词】 剖宫产术;镇痛，硬膜外;地塞米松;氟哌利多 Clinical observation of dexamethasone administration on the postoperative epidural analgesia YANG Qi-mao，XIE Bing-rong，XIE Min.（Department of Anesthesiology，Sichuan Provincial Peoples Hospital，Sichuan610072，China） 【Abstract】 Objective To compare the effects of dexamethasone with droperidol on postoperative epidural analgesia for cae-sarean operation.Methods 120patients undergoing caesarean operation were randomly divided into3groups:Group A:tramadol600mg+bupivacaine125mg+dexamethasone10mg;Group B:tramadol600mg+bupivacaine125mg+droperidol5mg;Group C:tramadol600mg+bupivacaine125mg.And the solutions for the analgetic pumps of all the groups were diluted with0.9%NS to100ml.The analgetic effect was measured by VAS，and the side effects at4，8，12，24hours after surgery and the times press-ing PCEA were recorded.Results There were no significant difference in VAS scores and the times pressing PCEA among three groups.But VAS scores and times pressing PCEA of Group A were lower than those of Group B and Group C.The incidence of nausea and vomiting of Group C was more frequent than that of Group A and Group B.The incidence of itch of Group A was less frequent than that of Group B and Group C.And the incidence of somnolence of Group B was more frequent than that of Group A and Group C.Conclusion The prophylactic effects of dexamethasone administration on nausea，vomiting and itch in the pa-tients receiving postoperative epidural analgesia were safe and effective，and the side effects of dexamethasone administration on nausea，vomiting and itch in the patients receiving post