Rothenberg D M, McCarthy R J, Peng C C, Normoyle D A
Department of Anesthesiology, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Acta Anaesthesiol Scand. 1998 Jul;42(6):637-42. doi: 10.1111/j.1399-6576.1998.tb05294.x.
The purpose of this randomized, double-blinded study was to compare the incidence and severity of postoperative nausea and vomiting (PONV) after dexamethasone versus droperidol following gynecologic laparoscopy, a group at high risk for developing PONV.
Ninety-five patients who underwent a propofol-based general anesthetic received either dexamethasone 0.17 mg/kg i.v., or droperidol 0.02 mg/kg i.v., just prior to abdominal incision. Nausea, retching, vomiting, degree of sedation, and discharge times were assessed in the Post Anesthesia Care Unit (PACU), and the Ambulatory Care Unit (ACU). Following hospital discharge (24 h), the patients were contacted by telephone to assess any further complications.
PONV in the PACU (14.6% vs. 14.9%) and ACU (8.3% vs. 14.9%) was as common after dexamethasone as after droperidol. PONV following hospital discharge was, however, less common after dexamethasone than after droperidol (4.2% vs. 17.0%, P = 0.041). Postoperatively, no complications of therapy were detected.
We conclude that PONV is similar with dexamethasone and droperidol, but dexamethasone may have a longer duration of action in patients undergoing gynecologic laparoscopy.
本随机双盲研究的目的是比较地塞米松与氟哌利多用于妇科腹腔镜手术后恶心呕吐（PONV）的发生率及严重程度，该类手术患者发生PONV的风险较高。
95例接受丙泊酚全身麻醉的患者在腹部切口前分别静脉注射0.17mg/kg地塞米松或0.02mg/kg氟哌利多。在麻醉后护理单元（PACU）和门诊护理单元（ACU）评估恶心、干呕、呕吐、镇静程度及出院时间。出院（24小时）后，通过电话联系患者评估有无其他并发症。
地塞米松组与氟哌利多组在PACU（14.6%对14.9%）和ACU（8.3%对14.9%）发生PONV的情况相似。然而，出院后地塞米松组发生PONV的情况少于氟哌利多组（4.2%对17.0%，P = 0.041）。术后未发现治疗相关并发症。
我们得出结论，地塞米松和氟哌利多在预防PONV方面效果相似，但地塞米松对接受妇科腹腔镜手术的患者可能具有更长的作用时间。
