论文部分内容阅读
目的:观察盐酸雷莫司琼联合地塞米松不同给药方法对预防乳癌术后静脉自控镇痛(PCIA)恶心呕吐(PONV)的疗效观察。方法:选择择期全麻下行乳腺癌改良根治术患者80例,女,随机分为A、B、C、D四组,各20例。麻醉方式为全凭静脉气管插管全麻。A组和B组患者麻醉诱导前给予盐酸雷莫司琼0.3mg静脉注射,术毕PCIA配方A组;舒芬太尼2μg/kg+盐酸雷莫司琼0.3mg;B组:舒芬太尼2μg/kg+盐酸雷莫司琼0.3mg+地塞米松10mg;C组和D组患者术毕给予PCIA,配方为C组:舒芬太尼2μg/kg+盐酸雷莫司琼0.6mg;D组:舒芬太尼2μg/kg+盐酸雷莫司琼0.6mg+地塞米松10mg;PCIA均以0.9%氯化钠注射液配至100m L。观察四组患者术毕4h(T1)、8h(T2)、12h(T3)、24h(T4)的PONV发生率及发生程度及术后24h内盐酸雷莫司琼不良反应的发生率。结果:四组在T1、T3、T4时点的PONV发生率及发生程度差异显著,有统计学差异(P<0.05);四组在T2时点的PONV发生率及发生程度差异无显著,无统计学意义(P>0.05);四组术后24h内盐酸雷莫司琼不良反应的发生率无差异。结论:全麻诱导前给予盐酸雷莫司琼0.3mg静脉注射能有效降低舒芬太尼PCIA所致的近期(4小时内)PONV发生率,降低PONV的发生程度,提高患者舒适度,疗效优于盐酸雷莫司琼单纯PCIA给药;地塞米松10mg对盐酸雷莫司琼预防远期(12小时后)舒芬太尼PCIA的PONV疗效有一定的协同作用。不同给药方式不影响盐酸雷莫司琼不良反应。
Objective: To observe the effect of different administrations of ramosetron hydrochloride and dexamethasone on prevention of postoperative PCIA nausea and vomiting (PONV) in patients with breast cancer. Methods: A total of 80 patients with modified radical mastectomy undergoing general anesthesia were randomly divided into four groups (A, B, C and D), 20 in each. Anesthesia for the whole vein by intravenous intubation anesthesia. Patients in group A and group B were given intravenous injection of ramosetron 0.3 mg before anesthesia induction, and the patients in group A received PCIA formula A, sufentanil 2 μg / kg + ramosetron hydrochloride 0.3 mg, and group B sufentanil 2 μg / kg + ramosetron hydrochloride 0.3mg + dexamethasone 10mg; group C and group D patients were given PCIA surgery, the formula for the C group: sufentanil 2μg / kg + ramosetron hydrochloride 0.6mg; D group: Taiji 2μg / kg + ramosetron hydrochloride 0.6mg + dexamethasone 10mg; PCIA were 0.9% sodium chloride injection to 100m L. The incidence of PONV and the incidence of PONV at 4h (T1), 8h (T2), 12h (T3) and 24h (T4) and the incidence of adverse reactions of ramosetron hydrochloride within 24h after operation were observed in the four groups. Results: There was significant difference in the incidence and occurrence of PONV between the four groups at T1, T3 and T4 (P <0.05). There was no significant difference in the incidence and incidence of PONV between the four groups at T2 Statistical significance (P> 0.05); There was no difference in the incidence of adverse reactions of ramosetron hydrochloride between the four groups within 24h after operation. Conclusion: Intravenous injection of ramosetron 0.3 mg intravenously before general anesthesia can effectively reduce the incidence of PONV induced by sufentanil PCIA in the near future (within 4 hours), reduce the occurrence of PONV, and improve patient comfort and curative effect In racimosine hydrochloride alone PCIA; dexamethasone 10mg ramosetron hydrochloride to prevent long-term (12 hours later) Sufentanil PCIA PONV efficacy has some synergy. Different modes of administration do not affect ramose hydrochloride adverse reactions.