Preventive effect of different combinations of antiemetics on nausea and vomiting during gynecologic postoperative analgesia

Abstract

[Objective]To observe the preventive and curative effect of ondansetron combined with dexamethasone,and a small amount of droperidol on nausea and vomiting in patients with controlled epidural analgesia after gynecological hysterectomy.[Methods]Totally 100 patients underwent abdominal hysterectomy in combined spinal epidural anesthesia,were randomly divided into three groups:20 cases in control group ( Group C) were not given any antiemetics; 40 cases in ondansetron group (Group O)were given 8 mg ondansetron intraoperatively by intravenous injection; 40 cases in ondansetron,dexamethasone and droperidol group ( Group O + D + F) were given 10 mg dexamethasone intraoperatively by intravenous injection,8 mg ondansetron was injected at the end of operation,and patient controlled epidural analgesia ( PCEA )wasused postoperatively.In Group C and Group O,the analgesia formula were ropivacaine mesylate (0.238％) and fentanyl solution(0.004％) 100ml in all; In Group O + D + F,2.5mg droperidol was added to analgesic solution.In 48 hours after the operation,the effects of analgesia and incidences of nausea and vomiting were observed.[Results]There were no significant difference in the analgesic effect VAS scores between the three groups.The incidence of nausea and vomiting in Group O was significantly lower than that in Group C (P＜0.05) within 24 hours postoperatively.The incidence of nausea and vomiting in Group O + D + F was significantly lower than that in Group C (P＜0.01) within 48 hours postoperatively.And the incidence of nausea and vomiting in Group O + D + F was significantly lower than that in Group O (P＜0.01) within 48 hours postoperatively.[Conclusions]Ondansetron alone can reduce the of postoperative nausea and vomiting within 24 hours postoperatively.Combination of ondansetron,dexamethasone and droperidol can effectively reduce the incidence of postoperative nausea and vomiting within 48 hours postoperatively. Key words: Postoperative nausea and vomiting ; Hysterectomy ; Ondansetron ; Dexamrethasone ; Droperidol ;