地塞米松对腹腔镜胆囊切除术后止吐和镇痛效果的研究  

EFFECT OF DEXAMETHASONE ON LAPAROSCOPIC CHOLECYSTECTOMY ANTIEMETIC AND ANALGESIC

作　　者：龚仁华[1] 孙登群[1] 钟兴国[1] 田国礼[1] 蔡军[1] 范育林[1] 曹葆强[1] 何新苗[1] 王敬民[1] 

机构地区：[1]安徽武警总队医院,合肥230021

出　　处：《肝胆外科杂志》2010年第2期119-121,共3页Journal of Hepatobiliary Surgery

摘　　要：目的观察地塞米松对腹腔镜胆囊切除术(LC)止吐、镇痛作用的效果。方法120例LC ASAⅠ～Ⅱ级患者,随机分成3组,每组40例。分别在麻醉诱导前静脉注射:安慰剂组、地塞米松5 mg或10 mg组。观察术后3组患者恶心、呕吐症状(PONV)和止痛剂的应用情况。结果120例患者术后麻醉消失后0～24 h PONV发生率:地塞米松5 mg组:恶心症状22例(55%),呕吐症状14例(35%);10 mg组:恶心症状11例(27.5%),呕吐症状5例(12.5%);安慰剂组:恶心症状30例(75%),呕吐症状15例(37.5%)。术后疼痛不能耐受,需要强痛定镇痛患者,地塞米松5 mg组11例(27.5%),10 mg组:5(12.5%)例,安慰剂组14(35%)例。各组分别进行比较后,PONV及疼痛必须应用止痛药物:安慰剂组和地塞米松5 mg组无统计学意义(P>0.05);安慰剂组、地塞米松5 mg和10 mg组比较差异有统计学意义(P<0.05)。结论地塞米松10 mg可以有效的降低LC术后PONV的发生率,减轻疼痛症状。Objective To investigate the effects of dexamethasone on laparoscopic cholecystectomy（LC）surgical analgesic,antiemetic effect.Methods 120 cases of LC patients ASA ⅠⅡ-class patients were randomly divided into three groups,each of 40 cases.Respectively were injected placebo,dexamethasone 5 mg or 10 mg groups before anesthesia.Observed after three groups patients postoperative nausea and vomiting（PONV）symptoms（including nausea,vomiting）,and the application of analgesics.Results 024 h PONV rate after anesthesia occurred：dexamethasone 5 mg group：nausea 22（55%） cases,vomiting 14（35%） cases;10mg group：nausea 11 cases（27.5%）,vomiting 5 cases（12.5%）,placebo group： nausea 30 cases（75%）,vomiting 15 cases（37.5%）.Postoperative needed fortanodyn and could not tolerate pain of treatment in patients with dexamethasone 10 mg group（5 cases,12.5%）was significantly lower than the placebo group（14 cases,35%）and the 5mg group（P〉0.05）.But the 5mg group（11 cases,27.5%）and the placebo group in the application of analgesics had no statistically significant difference（P〈0.05）.Conclusion LC patients with prophylactic use of dexamethasone 10 mg can reduce effectively in PONV and postoperative analgesic applications.

关 键 词：腹腔镜胆囊切除术 地塞米松 呕吐 镇痛作用 

分 类 号：R657.4[医药卫生—外科学]