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氟哌啶醇、地塞米松和昂丹司琼联合使用可降低腹腔镜袖状胃切除术后的恶心程度、疼痛强度并减少吗啡用量。

Combination of haloperidol, dexamethasone, and ondansetron reduces nausea and pain intensity and morphine consumption after laparoscopic sleeve gastrectomy.

作者信息

Benevides Márcio Luiz, Oliveira Sérgio de Souza, Aguilar-Nascimento José Eduardo

机构信息

Centro de Ensino e Treinamento da Sociedade Brasileira de Anestesiologia, Cuiabá, MT, Brasil.

出版信息

Braz J Anesthesiol. 2013 Sep-Oct;63(5):404-9. doi: 10.1016/j.bjan.2012.07.011.

Abstract

BACKGROUND AND OBJECTIVE

Postoperative nausea and vomiting (PONV) occur frequently after laparoscopic bariatric surgery. The combination of haloperidol, dexamethasone, and ondansetron may reduce these undesirable events. The aim of this study was to evaluate the intensity of nausea and pain, the number of vomiting episodes, and morphine consumption in postoperative (PO) obese patients undergoing laparoscopic sleeve gastrectomy (LSG).

METHOD

A clinical, randomized, controlled, double-blind study conducted with 90 patients with body mass index ≥ 35 kg.cm-2. Patients were divided into three groups of 30 individuals to receive ondansetron 8 mg (Group O); ondansetron 8 mg and dexamethasone 8 mg (Group OD); and ondansetron 8 mg, dexamethasone 8 mg, and haloperidol 2 mg (Group HDO). We evaluated the intensity of nausea and pain using the verbal numeric scale, cumulative number of vomiting episodes, and morphine consumption in the period of 0-2, 2-12, 12-24, and 24-36 hours postoperatively.

RESULTS

Nausea intensity was lower in Group HDO compared to Group O (p = 0.001), pain intensity was lower in Group HDO compared to Group O (p = 0.046), and morphine consumption was lower in Group HDO compared to Group O (p = 0.037). There was no difference between groups regarding the number of vomiting episodes (p = 0.052).

CONCLUSION

The combination of haloperidol, ondansetron, and dexamethasone reduced nausea and pain intensity and morphine consumption in postoperative obese patients undergoing LSG.

摘要

背景与目的

腹腔镜减肥手术后经常会出现术后恶心呕吐(PONV)。氟哌啶醇、地塞米松和昂丹司琼联合使用可能会减少这些不良事件。本研究的目的是评估接受腹腔镜袖状胃切除术(LSG)的肥胖患者术后恶心和疼痛的强度、呕吐发作次数以及吗啡的消耗量。

方法

对90名体重指数≥35 kg·cm-2的患者进行了一项临床、随机、对照、双盲研究。将患者分为三组,每组30人,分别接受8 mg昂丹司琼(O组);8 mg昂丹司琼和8 mg地塞米松(OD组);以及8 mg昂丹司琼、8 mg地塞米松和2 mg氟哌啶醇(HDO组)。我们使用言语数字量表评估了术后0至2小时、2至12小时、12至24小时和24至36小时期间的恶心和疼痛强度、呕吐发作累积次数以及吗啡消耗量。

结果

与O组相比,HDO组的恶心强度更低(p = 0.001),与O组相比,HDO组的疼痛强度更低(p = 0.046),与O组相比,HDO组的吗啡消耗量更低(p = 0.037)。各组之间呕吐发作次数没有差异(p = 0.052)。

结论

氟哌啶醇、昂丹司琼和地塞米松联合使用可降低接受LSG的肥胖患者术后的恶心和疼痛强度以及吗啡消耗量。

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