A comparison of dexamethasone, ondansetron, and dexamethasone plus ondansetron as prophylactic antiemetic and antipruritic therapy in patients receiving intrathecal morphine for major orthopedic surgery

被引:40
作者
Szarvas, S
Chellapuri, RS
Harmon, DC
Owens, J
Murphy, D
Shorten, GD
机构
[1] Cork Univ Hosp, Dept Anesthesia & Intens Care Med, Cork, Ireland
[2] Natl Univ Ireland Univ Coll Cork, Cork, Ireland
[3] Bon Secours Hosp, Dept Anesthesia, Cork, Ireland
关键词
D O I
10.1213/01.ANE.0000066310.49139.2A
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
In a prospective, double-blinded, randomized trial, we evaluated the efficacy of IV (a) dexamethasone 8 mg, (b) ondansetron 8 mg, and (c) dexamethasone 8 mg plus ondansetron 4 mg for the prevention of postoperative nausea, vomiting (PONV), and pruritus in 130 (ASA physical status I to III) patients undergoing elective major orthopedic surgery after spinal anesthesia with hyperbaric 0.5% bupivacaine and intrathecal morphine. After spinal anesthesia, patients were randomized to one of three groups. Failure of PONV prophylaxis in the 24-h postoperative period occurred more frequently in patients who received dexamethasone alone (29 of 40; 73%) compared with those who received either ondansetron alone (23 of 47; 49%) (P = 0.02) or dexamethasone plus ondansetron together (19 of 43; 44%)(P = 0.01). There was no difference in the incidence of failure of prophylaxis of pruritus (70%, 72%, and 70% in dexamethasone 8 mg, ondansetron 8 mg, and dexamethasone 8 mg plus ondansetron 4 mg, respectively) (P > 0.1) in the 24-h postoperative period. We conclude that the administration of dexamethasone 8 mg with ondansetron 4 mg has no added benefit compared with ondansetron 8 mg alone in the prophylaxis of PONV and pruritus.
引用
收藏
页码:259 / 263
页数:5
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