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地塞米松对妇科腹腔镜手术患者术后恶心呕吐的影响:一项随机、对照、双盲试验。

The influence of dexamethasone on postoperative nausea and vomiting in patients undergoing gynecologic laparoscopic surgeries: A randomised, controlled, double blind trial.

作者信息

Asadollah Sara, Vahdat Mansoureh, Yazdkhasti Payman, Nikravan Nasrin

机构信息

Tehran University of Medical Sciences Rasool-E-Akram Hospital, Clinic of Obstetrics and Gynecology, Tehran, Iran.

Tehran University of Medical Sciences Rasool-E-Akram Hospital, Clinic of Anesthesiology and Pain, Tehran, Iran.

出版信息

Turk J Obstet Gynecol. 2014 Dec;11(4):219-223. doi: 10.4274/tjod.13471. Epub 2014 Dec 15.

Abstract

OBJECTIVE

Dexamethasone, as a part of multimodal approach, can decrease nausea and vomiting following laparoscopy in high risk patients. We performed this study to find out whether the dexamethasone can improve postoperative nausea and vomiting (PONV) in patients undergoing gynecology laparoscopic surgeries.

MATERIALS AND METHODS

In this double-blind randomized clinical trial, 91 patients who underwent gynecologic laparoscopic surgery in Rasool Akram hospital in Tehran during 2011-2014 were enrolled. Fourty-four patients received 8 mg dexamethasone (study group) and 47 patients received 10 mg metochlopramide (control group) intravenously after intubation. Outcome parameters including age, weight, height, cause of hospitalization, drugs, Last Menstrual Period (LMP), Blood Pressure (BP), Heart Rate (HR), Respiratory Rate (RR) and oxygen saturation, Visual Analogue Scale (VAS) score, nausea and vomiting were entered to SPSS (v.16) and were analyzed.

RESULTS

Eighyt-eight American Society of Anesthesiology (ASA) class 1-2 patients between 25-39 years old were analyzed. There was no difference in vital signs during and post operation (BP, HR, RR and O saturation) between these two groups (p value>0.05). There was no significant difference between VAS score at 4 and 24 hours after the operation (14% vs. 17.8% and 7% vs. 6.7%, respectively, p>0.05). Incidence of PONV in 4 hours was significantly lower in dexamethasone group (11.6% vs. 55.6% p<0.0001), while there was no significant difference in 24 hours (23.3% vs. 22.2%, p>0.05) and also need to anti-emetic drugs wasn't significantly lower in study group (p>0.05).

CONCLUSION

We conclude that dexamethasone can relieve PONV after gynecologic laparoscopic surgery.

摘要

目的

作为多模式方法的一部分,地塞米松可降低高危患者腹腔镜检查后的恶心和呕吐。我们进行这项研究以确定地塞米松是否能改善接受妇科腹腔镜手术患者的术后恶心和呕吐(PONV)。

材料与方法

在这项双盲随机临床试验中,纳入了2011年至2014年期间在德黑兰拉苏勒·阿克拉姆医院接受妇科腹腔镜手术的91例患者。44例患者在插管后静脉注射8毫克地塞米松(研究组),47例患者静脉注射10毫克甲氧氯普胺(对照组)。将包括年龄、体重、身高、住院原因、药物、末次月经(LMP)、血压(BP)、心率(HR)、呼吸频率(RR)和血氧饱和度、视觉模拟量表(VAS)评分、恶心和呕吐等结果参数录入SPSS(v.16)并进行分析。

结果

分析了88例年龄在25至39岁之间的美国麻醉医师协会(ASA)1 - 2级患者。两组患者术中及术后的生命体征(血压、心率、呼吸频率和血氧饱和度)无差异(p值>0.05)。术后4小时和24小时的VAS评分无显著差异(分别为14%对17.8%和7%对6.7%,p>0.05)。地塞米松组4小时时PONV的发生率显著较低(11.6%对55.6%,p<0.0001),而24小时时无显著差异(23.3%对22.2%,p>0.05),并且研究组使用抗呕吐药物的需求也没有显著降低(p>0.05)。

结论

我们得出结论,地塞米松可缓解妇科腹腔镜手术后的PONV。

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