右美托咪定联合格拉司琼预防妇科腹腔镜手术术后恶心呕吐的临床观察  

Dexmedetomidine Combined with Granisetron in Preventing Postoperative Nausea and Vomiting after Gynecological Laparoscopic Surgery

作　　者：刘晓捷[1] 罗富荣[1] 冯宝莹[1] 

机构地区：[1]广东省佛山市中医院麻醉科,528000

出　　处：《中国实用乡村医生杂志》2014年第15期43-45,共3页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨右美托咪定联合格拉司琼预防妇科腹腔镜手术术后恶心呕吐的效果。方法60例腹腔镜手术患者随机分成诱导组（I组）、术毕组（EOS组）和格拉司琼组（G组）各20例。Ⅰ组于诱导前10min静脉泵注右美托咪定，EOS组于手术结束前30min静脉泵注相同剂量右美托咪定，所有患者手术结束前30min均静脉注射格拉司琼3mg。记录术毕至拔气管导管、听从指令时间，麻醉恢复期内患者呼吸抑制、躁动等不良反应发生情况，术后24h内恶心呕吐发生率及严重程度。结果Ⅰ组拔管时间、听从指令时间，术后0-1h、1-2h恶心呕吐评分，在麻醉后恢复室内止吐药给药人次数均小于EOS组和G组。EOS组术后0～1h、-2h恶心呕吐评分和在麻醉后恢复室内止吐药给药人次数均小于G组（P〈0．05）。EOS组和G组拔管时间、听从指令时间无明显差异（P〉0．05）。术后2-4h、4-12h、12-24h各组间恶心呕吐评分无明显差异（P〉0．05）。所有患者均未见麻醉恢复期内呼吸抑制、躁动等不良反应。结论右美托咪定联合格拉司琼预防妇科腹腔镜手术术后恶心呕吐效果较单用格拉司琼更好，诱导前10min使用为佳。Objective To investigate the effect of dexmedetomidine combined with granisetron in preventing postoperative nausea and vomiting after gynecological laparoscopic surgery. Methods 60 patients underwent gynecological laparoscopic surgery were randomly divided into the induction group（ I group, 20 cases）, the end of surgery group（EOS group, 20 cases）, and the granisetron group（G group, 20 cases）. Dexmedetomidine was administered 10 min before induction in the I group patients, or 30 rain before the end of surgery in the EOS group patients. All patients received 3 mg of granisetron 30 min before the end of surgery. The time to extubation and response to verbal command, respiratory depression, dysphoria in the postanesthesia intensive care unit, incidence and severity of nausea and vomiting for postoperative 24 h were recorded. Results The time to extubation and response to verbal command, nausea and vomiting scores in postoperative 0-1 h and 1-2 h, antiemetics given in the postanesthesia intensive care unit in the I group were less than those in the EOS group and the G group（P〈0.05）. Nausea and vomiting scores within postoperative 0~1 h and 1~2 h, antiemetics given in the postanesthesia intensive care unit in the EOS group were less than those in the G group（P〈0.05）. Time to extubation and response to verbal command between the EOS group and the G group had no significant difference（P〉0.05）; The nausea and vomiting scores of the three groups within postoperative 2-4 h, 4~12 h, and 12~24 h had no significant difference（P〉0.05）. Conclusion Dexmedetomidine combined with granisetron in preventing postoperative nausea and vomiting after gynecological laparoscopic surgery was more effective than using granisetron lonely, and it＇s better by administered 10 min before induction.

关 键 词：腹腔镜手术 并发症 恶心 呕吐 预防 右美托咪定 格拉司琼 

分 类 号：R614[医药卫生—麻醉学]