Wang J J, Ho S T, Wong C S, Tzeng J I, Liu H S, Ger L P
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Can J Anaesth. 2001 Feb;48(2):185-90. doi: 10.1007/BF03019733.
To determine the minimum effective dose of dexamethasone in preventing nausea and vomiting associated with epidural morphine for post-Cesarean analgesia.
One hundred and eighty parturients (n=45 in each of four groups) requiring epidural morphine for post-Cesarean analgesia were enrolled in this randomized, double-blinded, placebo-controlled study. At the end of surgery, parturients received either dexamethasone, at doses of 10 mg, 5 mg, 2.5 mg, or saline i.v.. Three milligrams epidural morphine were given to all parturients for postoperative analgesia. The incidence of PONV and side effects were estimated for 24 hr after delivery by blinded, trained nurse anesthetists.
Parturients who received dexamethasone, either 10 mg or 5 mg were different from those who received saline alone in the following parameters: the total incidence of nausea and vomiting, incidence of > 4 vomiting episodes, number the of parturients requiring rescue antiemetics, and the total number of parturients with no vomiting and/or no antiemetic medication (P < 0.05 to P < 0.01). The differences between dexamethasone 10 mg and 5 mg were not significant. Dexamethasone 2.5 mg was partially effective.
Dexamethasone, 5 mg i.v., is suggested as the minimum effective dose in preventing nausea and vomiting associated with epidural morphine for post-Cesarean analgesia.
确定地塞米松预防剖宫产术后硬膜外吗啡镇痛相关恶心呕吐的最小有效剂量。
本随机、双盲、安慰剂对照研究纳入了180例需要硬膜外吗啡进行剖宫产术后镇痛的产妇（四组，每组n = 45）。手术结束时，产妇静脉注射地塞米松（剂量分别为10 mg、5 mg、2.5 mg）或生理盐水。所有产妇均给予3 mg硬膜外吗啡用于术后镇痛。由经过培训的盲法护士麻醉师评估产后24小时内恶心呕吐的发生率和副作用。
接受10 mg或5 mg地塞米松的产妇与仅接受生理盐水的产妇在以下参数方面存在差异：恶心呕吐的总发生率、呕吐发作> 4次的发生率、需要抢救性使用止吐药的产妇数量以及未出现呕吐和/或未使用止吐药的产妇总数（P < 0.05至P < 0.01）。1图10 mg和5 mg地塞米松之间的差异不显著。2.5 mg地塞米松部分有效。
建议静脉注射5 mg地塞米松作为预防剖宫产术后硬膜外吗啡镇痛相关恶心呕吐的最小有效剂量。
