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吗啡术后镇痛并发恶心呕吐的发生率约为20%~50%。为提高镇痛质量,本组将硬膜外注入吗啡镇痛的130例患者,采用不同的药物或方法,进行预防恶心呕吐的临床效果观察。所有患者硬膜外麻醉成功后,均辅用盐酸异丙嗪0.5mg/kg,甲氧氯普胺10mg和地塞米松10mg静滴。于术毕前30min经硬膜外导管精确注入吗啡2~3mg。130例分三组,Ⅰ组30例,为对照组,不再用药;Ⅱ组30例,静滴氟哌啶5mg;Ⅲ组70例,静脉追加首剂量异丙嗪。结果表明恶心呕吐的发生率Ⅰ组为30%,Ⅱ组降至20%,Ⅲ组仅为4.3%,远低于Ⅰ、Ⅱ组(P<0.01;P<0.05)。作者认为,异丙嗪追加性用药对预防术后恶心呕吐有很好的效果。
Morphine postoperative analgesia with nausea and vomiting incidence of about 20% to 50%. In order to improve the quality of analgesia, the group of 130 patients with epidural morphine analgesia were injected with different drugs or methods to observe the clinical effect of preventing nausea and vomiting. All patients with epidural anesthesia were supplemented with promethazine hydrochloride 0.5mg / kg, metoclopramide 10mg and dexamethasone 10mg intravenous infusion. 30min before surgery by epidural catheter accurately injected morphine 2 ~ 3mg. 130 cases divided into three groups, Ⅰ group of 30 cases, as the control group, no longer medication; Ⅱ group of 30 patients, intravenous drip-drones 5mg; Ⅲ group of 70 patients, the first additional dose of intravenous promethazine. The results showed that the incidence of nausea and vomiting was 30% in group Ⅰ, 20% in group Ⅱ, and 4.3% in group Ⅲ, much lower than those in group Ⅰ and Ⅱ (P <0.01; P <0.05). The authors believe that promethazine additional medication to prevent postoperative nausea and vomiting have a good effect.