摘要
目的:观察右美托咪定对妇科腹腔镜手术患者术后恶心、呕吐的预防作用。方法:回顾性收集166例择期行妇科腹腔镜手术患者的临床资料,患者均采用相同的麻醉诱导方式,为预防恶心、呕吐发生,手术结束前30 min,A组(44例)静脉推注甲氧氯普胺20 mg,B组(58例)静脉推注雷莫司琼0.3 mg,C组(64例)诱导前静脉推注右美托咪定0.4μg/kg,之后以每小时0.25μg/kg维持至拔管。比较3组患者术后3 h内、3~h、6~h、12~24 h恶心、呕吐的发生情况。结果:3组年龄、麻醉时间、手术时间、舒芬太尼用量、苏醒时间、术中心动过缓发生率比较,差异均无统计学意义(P>0.05)。广义估计方程分析结果显示,不同组间及不同时间段间恶心、呕吐发生率比较,差异均有统计学意义(P>0.05),其中A组发生率最高。术后24 h内,A、B、C组恶心发生率分别为36.4%、15.5%和12.5%,呕吐发生率分别为22.7%、5.2%和7.8%,3组间相比,差异均有统计学意义(P<0.05),其中A组恶心、呕吐发生率均最高,C组低于A组,B、C组间差异无统计学意义(P>0.017)。结论:右美托咪定应用于妇科腹腔镜手术预防恶心、呕吐效果显著,与雷莫司琼预防效果相当,优于甲氧氯普胺。
Aim:To observe the preventive effects of dexmedetomidine on postoperative nausea and vomiting after gynecological laparoscopic surgery.Methods:Retrospectively collected the clinical data of 166 patients with elective gynecological laparoscopic surgery.All the patients accepted the same anesthetic induction.To prevent nausea and vomiting,group A(44 cases)and group B(58 cases)were respectively treated with metoclopramide(20 mg),remosetron(0.3 mg)by intravenous infusion 30 mins before the end of operation;group C(64 cases)accepted venous administration of dexmedetomidine(0.4μg/kg),and then maintained at 0.25μg/kg per hour till extubation.The incidence of nausea and vomiting within 3 h,3~h,6~h and 12~24 h after operation were compared.Results:The age,anesthesia time,operation time,sufentanil usage,recovery time and bradycardia rate among 3 groups had no statistical differences(P>0.05).Generalized estimation equation analysis results showed that the incidence of nausea and vomiting among 3 groups and 4 periods had no statistical differences(P>0.05),and the incidence of nausea and vomiting was the highest in group A.During 24 h after surgery,the incidence of nausea was 36.4%,15.5%,12.5%,the incidence of vomiting was 22.7%,5.2%,7.8%,and there were significant differences(P<0.05);the incidence of nausea and vomiting was the highest in group A,that of group C was lower,and there were no significant difference between group B and C(P>0.017).Conclusion:The effects of dexmedetomidine to prevent nausea and vomiting in gynecological laparoscopic surgery are significant,which are similar to those of remosetron,and better than metoclopramide.
作者
周霞
李宁
孟瑞霞
王培山
ZHOU Xia;LI Ning;MENG Ruixia;WANG Peishan(Department of Anesthesia and Perioperative Medicine,Xinxiang Central Hospital,Xinxiang,Henan 453000)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2021年第3期393-396,共4页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省医学科技攻关计划联合共建项目(2018020936)。
关键词
妇科
腹腔镜
右美托咪定
恶心
呕吐
gynecology
laparoscopy
dexmedetomidine
nausea
vomiting
