摘要
Abstract
Objective To investigate the sex-specific difference in the effects of dexamethasone and tropisetron for the prevention of postoperative nausea and vomiting (PONV) in patients with laparoscopic surgery.Methods The initially enrolled participants were 382 consecutive patients who underwent the laparoscopic surgery (laparoscopic cholecystectomy or laparoscopic appendectomy or laparoscopic hysterectomy and annexectomy) in Tianjin Medical University General Hospital from December 2014 to December 2015.After excluding 22 cases who did not meet the inclusion criteria during and after the surgery,the rest 360 cases were equally divided into male dexamethasone (MD) group,male tropisetron (MT) group,male control (MC) group,female dexamethasone (FD)group,female tropisetron (FT)group,female control (FC)group.Immediately before anesthetic induction,MD and FD groups received intravenous drip of dexamethasone 0.15 mg/kg,MT and FT groups received intravenous drip of tropisetron 5 mg,and MC and FC groups received intravenous drip of 0.9％ sodium chloride solution 5 ml.The incidence and degree of PONV,prevalence of treatment with antiemetic drugs,the first-occurrence time of PONV from the extubation to within 24 h after the surgery were recorded in all the groups.Results Within 24 h after the surgery,MC group had more severe PONV and higher overall incidence of PONV and higher prevalence of treatment with antiemetic drugs than both MD and MT groups (P ＜ 0.01);FC group had more severe PONV and higher overall incidence of PONV and higher prevalence of treatment with antiemetic drugs than FT group (P ＜ 0.01);the degree and overall incidence of PONV and prevalence of treatment with antiemetic drugs did not differ significantly between FD and FC groups (P ＞ 0.01);PONV occurred earlier in MC group than in MD and MT groups (P ＜ 0.05),and it occurred earlier in FC group than in FT group (P ＜ 0.05),but the first-occurrence time of PONV was similar in FD and FC groups (P ＞ 0.05).Conclusion The incidence of PONV can be reduced and the first-occurrence time of PONV can be delayed by intravenous drip of dexamethasone before anesthetic induction in only males with laparoscopic surgery,whereas similar effects like those described above can be achieved by intravenous drip of tropisetron before anesthetic induction in both males and females with laparoscopic surgery.关键词
手术后恶心呕吐/性别/地塞米松/托烷司琼/腹腔镜Key words
Postoperative nausea and vomiting/Gender/Dexamethasone/Tropisetron/Laparoscopes分类
医药卫生
