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妇科手术中口服加巴喷丁、静脉注射地塞米松及其联合术前使用的比较研究

Comparative study of preoperative use of oral gabapentin, intravenous dexamethasone and their combination in gynaecological procedure.

作者信息

Agrawal Neha, Chatterjee Chandrashekhar, Khandelwal Mamta, Chatterjee Rama, Gupta Madan Mohan

机构信息

Department of Anesthesiology, SMS Medical College, Jaipur, Rajasthan, India.

Department of Radio Diagnosis Clinical Associate DSA, Jaslok Hospital, Mumbai, India.

出版信息

Saudi J Anaesth. 2015 Oct-Dec;9(4):413-7. doi: 10.4103/1658-354X.159466.

Abstract

BACKGROUND

We studied the effects of oral gabapentin and intravenous (I.V.) dexamethasone given together or separately 1 h before the start of surgery on intraoperative hemodynamics Postoperative analgesia and postoperative nausea vomiting (PONV) in patients undergoing gynaecological procedure.

MATERIALS AND METHODS

Patients were randomly divided into three groups: Group 1 (gabapentin, n = 46) received 400 mg gabapentin, Group 2 (dexamethasone, n = 46) received 8 mg dexamethasone and Group 3 (gabapentin plus dexamethasone, n = 46) received both 400 mg gabapentin and 8 mg dexamethasone I.V. 1 h before the start of surgery. Standard induction and maintenance of anesthesia were accomplished. Visual analog scale for pain was recorded for 12 h. Side effects were noted.

RESULTS

Hemodynamics at various time interval (0, 5, 10, 15, 20, 25 and 30 min) of laryngeal mask airway insertion and PONV were found significantly lower in Group 3 than in Group 1 and Group 2 (P < 0.05). The average time to first postoperative analgesic requirement at (visual analogue score >3) was significantly longer in Group 3 (510.00 ± 61.64 min) than in Group 1 (352.83 ± 80.61 min) and in Group 2 (294.78 ± 60.76 min), (P < 0.05).

CONCLUSION

The present study concludes that the combination of oral Gabapentin and I.V. dexamethasone has significantly less hemodynamic changes, better postoperative analgesia and less incidence of PONV than individual administration of each drug.

摘要

背景

我们研究了在妇科手术开始前1小时口服加巴喷丁和静脉注射地塞米松联合或单独给药对术中血流动力学、术后镇痛及术后恶心呕吐(PONV)的影响。

材料与方法

将患者随机分为三组:第1组(加巴喷丁组,n = 46)接受400 mg加巴喷丁;第2组(地塞米松组,n = 46)接受8 mg地塞米松;第3组(加巴喷丁加地塞米松组,n = 46)在手术开始前1小时静脉注射400 mg加巴喷丁和8 mg地塞米松。完成标准的麻醉诱导和维持。记录12小时的疼痛视觉模拟评分。记录副作用。

结果

发现第3组在喉罩置入各时间间隔(0、5、10、15、20、25和30分钟)时的血流动力学及PONV明显低于第1组和第2组(P < 0.05)。第3组首次术后镇痛需求(视觉模拟评分>3)的平均时间(510.00 ± 61.64分钟)明显长于第1组(352.83 ± 80.61分钟)和第2组(294.78 ± 60.76分钟)(P < 0.05)。

结论

本研究得出结论,与单独使用每种药物相比,口服加巴喷丁和静脉注射地塞米松联合使用时血流动力学变化明显较小,术后镇痛效果更好,PONV发生率更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bd/4610086/59f67d6bfbd5/SJA-9-413-g002.jpg

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