Effects Of Different Doses Of Diphenhydramine Injection On Perianaesthesia Sedation,nausea And Vomiting In Patients Undergoing Laparoscopic Cholecystectomy

Objective:To investigate the effects of different doses of diphenhyramine injection combined with propofol and remifentanil on perianaesthesia sedation,nausea and vomiting in patients undergoing laparoscopic cholecystectomy.Methods:Eighty-one patients（ASAⅠorⅡ,aged 18 to 65,BMI 18.5 to30 kg/m²）scheduled for laparoscopic cholecystectomy were randomly divided into three groups on average（n=27）:Diphenhydramine 20mg group（group D₁）,Diphenhydramine 40mg group（group D₂）and Normal saline group（group C）.All patients in the three groups were given the following drugs at 30min and 15min before surgery.Group D₁ received 20mg diphenhydramine intramuscular injection 30 minutes before surgery and 1ml normal saline intramuscular injection 15 minutes before surgery.Group D₂ received 20mg diphenhydramine intramuscular injection 30min and 15min before surgery.Group C was intramuscular injected with 1ml normal saline 30min and 15min before surgery.Intraoperative and postoperative vital signs,total amount of propofol,intraoperative times of ephedrine use,postoperative pain VAS,RASS score,postoperative times of vomiting and use of remedial drugs,hot and dry sweating and other adverse reactions were recorded.Results:1.Compared with group C,groups D₁ and D₂ had less vomiting and fewer times of metoclopramide application within 4 hours after operation,and their heart rate was more stable after operation（P<0.05）.2.Compared with group C,the dosage of propofol in group D₂ decreased,the VAS score of pain within 1 hour after surgery decreased,the RASS score during and after extubation decreased（P<0.05）.3.There were no significant differences in extubation time,blood oxygen saturation and recovery room residence time among the three groups（P>0.05）.Conclusions:For patients undergoing laparoscopic cholecystectomy,preoperative intramuscular injection of 40mg diphenhydramine injection can significantly reduce intraoperative propofol dosage,reduce patients’agitation during extubation,and effectively relieve postoperative nausea and vomiting.