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昂丹司琼与地塞米松预防腹腔镜胆囊切除术后恶心呕吐的有效性

The Effectiveness of Ondansetron and Dexamethasone in Preventing Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy.

作者信息

Qasemi Farzad, Aini Tahmina, Ali Wahida, Dost Wahidullah, Rasully Mohammad Qaher, Anwari Maiwand, Dost Wahida, Zaheer Rabia, Dost Raisa, Talpur Abdul Subhan

机构信息

General Surgery, Dr. Ruth K. M. Pfau, Civil Hospital, Karachi, PAK.

General Surgery, Jamhuriat Hospital, Kabul, AFG.

出版信息

Cureus. 2023 Apr 11;15(4):e37419. doi: 10.7759/cureus.37419. eCollection 2023 Apr.

Abstract

Background The current research compared the effectiveness of dexamethasone with ondansetron in terms of the frequency of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Methodology A comparative cross-sectional study was conducted in the Department of Surgery, Civil Hospital, Karachi, Pakistan, between June 2021 and March 2022. All patients aged between 18 and 70 years who were scheduled for elective laparoscopic cholecystectomy under general anesthesia were included in the study. All women who were on antiemetics or cortisone before surgery pregnant, and had hepatic, or renal malfunction were excluded. Group A included patients who were administered 8 mg of dexamethasone intravenously, and group B included patients who were prescribed 4 mg of ondansetron intravenously. Observation of patients was done for any symptoms such as vomiting, nausea, or the need for any antiemetic medication after the surgery. The number of episodes of vomiting and nausea was recorded in the proforma along with the duration of stay in the hospital. Results A total of 259 patients were examined during the study - 129 (49.8%) in the dexamethasone group (group A) and 130 (50.2%) in the ondansetron group (group B). The mean age of group A was 42.56 ± 11.9 years, with a mean weight of 61.4 ± 8.5 kg. The mean age of group B was 41.19 ± 10.8 years, with a mean weight of 62.56 ± 6.3 kg. Upon assessing the effectiveness of each drug in preventing nausea and vomiting, postoperatively, it was found that both drugs were equally effective in preventing nausea in the majority of the patients (73.85% vs. 65.89%; = 0.162). However, ondansetron was significantly more effective in preventing vomiting in patients than dexamethasone (91.54% vs. 79.07%; = 0.004). Conclusions This study concluded that the use of either dexamethasone or ondansetron effectively reduces the incidence of postoperative nausea and vomiting. However, ondansetron was significantly more effective in reducing the incidence of vomiting in patients after laparoscopic cholecystectomy than dexamethasone.

摘要

背景 本研究比较了地塞米松与昂丹司琼在腹腔镜胆囊切除术患者术后恶心呕吐发生率方面的有效性。

方法 在巴基斯坦卡拉奇市民医院外科于2021年6月至2022年3月进行了一项比较性横断面研究。所有年龄在18至70岁之间、计划在全身麻醉下进行择期腹腔镜胆囊切除术的患者均纳入本研究。所有术前正在使用止吐药或皮质激素的女性、孕妇以及有肝或肾功能不全的患者均被排除。A组包括静脉注射8毫克地塞米松的患者,B组包括静脉注射4毫克昂丹司琼的患者。术后观察患者是否出现呕吐、恶心等症状或是否需要使用任何止吐药物。在表格中记录呕吐和恶心发作的次数以及住院时间。

结果 在研究期间共检查了259例患者,地塞米松组(A组)129例(49.8%),昂丹司琼组(B组)130例(50.2%)。A组的平均年龄为42.56±11.9岁,平均体重为61.4±8.5千克。B组的平均年龄为41.19±10.8岁,平均体重为62.56±6.3千克。在评估每种药物预防术后恶心和呕吐的有效性时,发现两种药物在大多数患者中预防恶心的效果相当(73.85%对65.89%;P = 0.162)。然而,昂丹司琼在预防患者呕吐方面比地塞米松显著更有效(91.54%对79.07%;P = 0.004)。

结论 本研究得出结论,使用地塞米松或昂丹司琼均可有效降低术后恶心呕吐的发生率。然而,在腹腔镜胆囊切除术后,昂丹司琼在降低患者呕吐发生率方面比地塞米松显著更有效。

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