CAJ | 학술논문

目的：探讨右美托咪定联合格拉司琼预防妇科腹腔镜手术术后恶心呕吐的效果。方法60例腹腔镜手术患者随机分成诱导组(Ⅰ组)、术毕组(EOS组)和格拉司琼组(G组)各20例。Ⅰ组于诱导前10min静脉泵注右美托咪定，EOS组于手术结束前30min静脉泵注相同剂量右美托咪定，所有患者手术结束前30min均静脉注射格拉司琼3mg。记录术毕至拔气管导管、听从指令时间，麻醉恢复期内患者呼吸抑制、躁动等不良反应发生情况，术后24h内恶心呕吐发生率及严重程度。结果Ⅰ组拔管时间、听从指令时间，术后0~1h、1~2h恶心呕吐评分，在麻醉后恢复室内止吐药给药人次数均小于EOS组和G组。EOS组术后0~1h、1~2h恶心呕吐评分和在麻醉后恢复室内止吐药给药人次数均小于G组(P＜0.05)。EOS组和G组拔管时间、听从指令时间无明显差异(P＞0.05)。术后2~4h、4~12h、12~24h各组间恶心呕吐评分无明显差异(P＞0.05)。所有患者均未见麻醉恢复期内呼吸抑制、躁动等不良反应。结论右美托咪定联合格拉司琼预防妇科腹腔镜手术术后恶心呕吐效果较单用格拉司琼更好，诱导前10min使用为佳。
목적：탐토우미탁미정연합격랍사경예방부과복강경수술술후악심구토적효과。방법60례복강경수술환자수궤분성유도조(Ⅰ조)、술필조(EOS조)화격랍사경조(G조)각20례。Ⅰ조우유도전10min정맥빙주우미탁미정，EOS조우수술결속전30min정맥빙주상동제량우미탁미정，소유환자수술결속전30min균정맥주사격랍사경3mg。기록술필지발기관도관、은종지령시간，마취회복기내환자호흡억제、조동등불량반응발생정황，술후24h내악심구토발생솔급엄중정도。결과Ⅰ조발관시간、은종지령시간，술후0~1h、1~2h악심구토평분，재마취후회복실내지토약급약인차수균소우EOS조화G조。EOS조술후0~1h、1~2h악심구토평분화재마취후회복실내지토약급약인차수균소우G조(P＜0.05)。EOS조화G조발관시간、은종지령시간무명현차이(P＞0.05)。술후2~4h、4~12h、12~24h각조간악심구토평분무명현차이(P＞0.05)。소유환자균미견마취회복기내호흡억제、조동등불량반응。결론우미탁미정연합격랍사경예방부과복강경수술술후악심구토효과교단용격랍사경경호，유도전10min사용위가。
ObjectiveTo investigate the effect of dexmedetomidine combined with granisetron in preventing postoperative nausea and vomiting after gynecological laparoscopic surgery. Methods 60 patients underwent gynecological laparoscopic surgery were randomly divided into the induction group(Ⅰ group, 20 cases), the end of surgery group(EOS group, 20 cases), and the granisetron group(G group, 20 cases). Dexmedetomidine was administered 10 min before induction in theⅠ group patients, or 30 min before the end of surgery in the EOS group patients. All patients received 3 mg of granisetron 30 min before the end of surgery. The time to extubation and response to verbal command, respiratory depression, dysphoria in the postanesthesia intensive care unit, incidence and severity of nausea and vomiting for postoperative 24 h were recorded.ResultsThe time to extubation and response to verbal command, nausea and vomiting scores in postoperative 0~1 h and 1~2 h, antiemetics given in the postanesthesia intensive care unit in theⅠ group were less than those in the EOS group and the G group(P<0.05). Nausea and vomiting scores within postoperative 0~1 h and 1~2 h, antiemetics given in the postanesthesia intensive care unit in the EOS group were less than those in the G group(P<0.05). Time to extubation and response to verbal command between the EOS group and the G group had no signiifcant difference(P>0.05); The nausea and vomiting scores of the three groups within postoperative 2~4 h, 4~12 h, and 12~24 h had no signiifcant difference(P>0.05).ConclusionDexmedetomidine combined with granisetron in preventing postoperative nausea and vomiting after gynecological laparoscopic surgery was more effective than using granisetron lonely, and it’s better by administered 10 min before induction.