地塞米松在子宫术后鞘内超前镇痛中的作用  

The Role of Dexamethasone on Morphine and Fentanyl Combined Intrathecal Preanalgesia Anesthesia after Hysterectomy

作　　者：华伟[1] 赵军[1] 高宝柱[1] 

机构地区：[1]天津市第三中心医院麻醉科,天津300170

出　　处：《中国中西医结合外科杂志》2012年第6期571-573,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察地塞米松预防全子宫切除术后鞘内吗啡复合芬太尼超前镇痛恶心呕吐发生的效果。方法:选择择期全子宫切除术患者40例,随机分为两组,行腰硬联合阻滞,分别给予鞘内吗啡0.5mg、芬太尼15μg(IT1组),鞘内吗啡0.2mg、芬太尼25μg(IT2组),以2%利多卡因间断推注行连续硬膜外阻滞维持麻醉,切皮前静脉注射地塞米松0.1mg/kg。结果:IT1组术后6h、9h PONV发生率较高,组内组间比较有统计学意义(P<0.05)。IT2组3h、6h恶心发生率组间组内比较有统计学意义(P<0.05),呕吐发生率组内组间比较无统计学意义(P>0.05)。结论:静脉注射地塞米松用于全子宫切除术后预防鞘内吗啡复合芬太尼超前镇痛行恶心呕吐的防治效果确切。Abstract：Objective To observe the clinical effect of dexamethasone on preventing postoperative nausea and vomiting（PONY） of morphine-fentanyl combined intrathecal preanalgesia anesthesia. Methods Forty se-lective hysterectomy with combined spinal-epidural anesthesia were randomized into 2 groups： group 1 received morphine 0.5 mg＋fentanyl 15 μg;group Ⅱreceived morphine 0.2 mg＋fentanyl 25 μg. Continuous epidural blockwas performed with 2% lidocaine. Dexamethasone 0.1 mg/kg was infused before incision. Results In IT1 group ,postoperative 6-9 h time period had the highest PONV incidence and level, with significant differences（P 〈 O.05）.In incidence rate and level of nausea dur ing 6,9, 18 h time period were significantly differentbetween two groups（P 〈 0.05）, Conclusion Dexamethasone has a definite effect on preventing postoperative nausea and vomiting of morphine-fentanyl combined intrathecal preanalgesia anesthesia in hysterectomy.

关 键 词：地塞米松 鞘内注射 超前镇痛麻醉 全子宫切除术 术后恶心呕吐 

分 类 号：R971.1[医药卫生—药品]