地塞米松在剖腹产术后镇痛中的临床观察  

Clinical observation of dexamethasone administration on the postoperative epidural analgesia

作　　者：阳启茂[1] 谢滨蓉[1] 谢敏[1] 

机构地区：[1]四川省人民医院麻醉科,四川成都610072

出　　处：《淮海医药》2006年第1期7-8,共2页Journal of Huaihai Medicine

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600 m g+布比卡因125 m g+地塞米松10 m g;B组:曲马多600 m g+布比卡因125 m g+氟哌利多5 m g;C组:曲马多600 m g+布比卡因125 m g。每组药液以生理盐水稀释至100 m l配成泵液。以视觉模拟评分法(VA S)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VA S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。Objective To compare the effects of dexamethasone with droperidol on postoperative epidural analgesia for caesarean operation. Methods 120 patients undergoing caesarean operation were randomly divided into 3 groups ：Group A：tramadol 600 mg＋bupivacaine 125 mg＋dexamethasone 10 mg ;Group B：tramadol 600 mg＋bupivacaine 125 mg＋droperidot 5 mg ;Group C：tramadol 600 mg＋ bupivacaine 125 mg. And the solutions for the analgetic pumps of all the groups were diluted with 0. 9% NS to 100 ml. The analgetic effect was measured by VAS,and the side effects at 4,8,12,24 hours after surgery and the times pressing 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 patients receiving postoperative epidural analgesia were safe and effective,and the side effects of dexamethasone administration on nausea,vomiting and itch in the patients receiving postoperative epidural analgesia were safe and effective with less side effects.

关 键 词：剖宫产术 镇痛 硬膜外 地塞米松 氟哌利多 

分 类 号：R719.8[医药卫生—妇产科学] R713.144.2[医药卫生—临床医学]