Objective:To explore the prophylactic efficiency of dexmedetomidine on postoperative nausea and vomiting (PONV) in highly susceptible patients.Methods:By using randomized and double-blind controlled trial, 100 non-smoking female patients receiving laparoscopic surgery were selected and randomly divided into dexmedetomidine group and control group.The dexmedetomidine group received 0.6 μg/kg dexmedetomidine before induction, and 3 μg/kg dexmedetomidine after surgery.The severity of PONV, the visual analogue scale (VAS)for pain scores, the use of rescued antiemetic and analgesic drugs were assessed for 48 h postoperatively.Results:There were 93 patients completed the study (47 cases in dexmedetomidine group and 46 cases in control group).The number of patients classified as PONV 0 in dexmedetomidine group was significantly more than that in the control group during the time interval 0 to 6 h postoperatively (37 vs 27, P<0.05).The percentage of the usage of antiemetic drugs within 48 hours in dexmedetomidine group was lower than that in control group(25.5% vs 47.8%,P<0.05).During the time intervals 6 to 24 h and 24 to 48 h, the pain scores were significantly lower in dexmedetomidine group compared with control group, 2.9±0.9 vs 3.4±0.7 and 2.7±0.6 vs 3.0±0.7, respectively (P<0.05).Conclusions:Dexmedetomidine used perioperatively might decrease the severity of PONV in early phase postoperatively in highly susceptible patients, and reduce the need for antiemetic drugs and improve the analgesia effects.%目的:探讨右美托咪定对术后恶心呕吐(PONV)高危患者PONV发生的作用.方法:采用随机双盲对照研究法.纳入2015年11月至2016年5月择期行泌尿外科腹腔镜手术、女性且不吸烟的患者100例,随机分为:右美托咪定组和对照组.右美托咪定组患者在诱导前泵注右美托咪定0.6 μg/kg,术后加用右美托咪定3 μg/kg,其他麻醉处理同对照组.评价术后48 h内两组患者PONV严重程度、疼痛VAS评分,记录术后抗呕吐药物和其他镇痛药物使用情况.结果:93例患者完成研究,其中右美托咪定组47例,对照组46例.术后0~6 h,右美托咪定组患者PONV 0级例数较对照组多(37 vs 27,P<0.05).右美托咪定组患者术后48 h内抗恶心呕吐药物使用比例较对照组降低(25.5% vs 47.8%,P<0.05).术后6~24 h、24~48 h,右美托咪定组患者VAS疼痛评分低于同时间段对照组(2.9±0.9 vs 3.4±0.7,2.7±0.6 vs 3.0±0.7,P<0.05).结论:围手术期使用右美托咪定能够降低PONV高危患者术后早期PONV严重程度,减少术后抗恶心呕吐药物使用,并有助于改善术后镇痛效果.
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