The Clinical Observation Of Ramosetron Combined With Dexamethasone For Prevention Of Postoperative Nausea And Vomiting

With the development of medical science and the progress ofsociety, demand of the patients in the course of medical treatment is notonly to cure the disease, but also to complete treatment in comfortableenvironment as far as possible.Comfortable environment includes twoaspects, one is the medical environment clean and tidy, the other is tomake the side effects of various drugs to the minimum. The doctor alsoshould be the humanistic care to patients, make patients overcome thedemons to actively cooperate with the treatment.Postoperative nauseaand vomiting (PONV) as a complication after anesthesia, has causedgreat impact on the patient’s physiological and psychological. At present,for the prevention of PONV mainly adopts methods of serotoninreceptor blockers. At both inland and abroad have reported thatdexamethasone also inhibited PONV good effect, so if dexamethasonecombined with ramosetron receptor blocker will play what kind of effect?The experiment on dexamethasone and ramosetron were observed on theprevention of PONV effect.Objective: to subtotal thyroidectomy patients as the research object,observation of ramosetron, dexamethasone, and ramosetron plusdexamethasone in the prevention of the effects of PONV, discuss thereasonable prevention PONV scheme.Method: Choose underwent subtotal thyroidectomy in120cases ofpatients with ASAI-II, the aga of20-60, body weight40-80kg.The120 patients were randomly divided into four groups. D (dexamethasone)group at the beginning of operation of intravenous injection ofdexamethasone8mg. R (ramosetron) group in operation before the endof the hour intravenous ramosetron0.3mg. DR (dexamethasone+ramosetron) group. C (control) group, antiemetic drugs do not giveduring operation process. Patients and monitoring of blood pressure,ECG, blood oxygen saturation, open vein access. Anesthesia for half anhour before injection of penehyclidine hydrochloride1mg, anesthesiawas induced with intravenous induction,0.05mk/kg of midazolam,rocuronium0.3mk/kg,and propofol1-2mk/kg, sufentanil0.5μk/kgfollowed by intravenous, when patients lost consciousness for manualrespiration,3minutes after endotracheal intubation, connected to aventilator for mechanical ventilation. The set tidal volume (VT) of8-10ml/kg, respiratory ratio (IE) for1:2, respiratory rate (RR) of12-18times/min. Gas monitoring PETCO2remained in35-40mmHg, MACremained in the1.3-1.5. D, R, DR C group were treated with sevofluranefor maintenance of anesthesia,Drug rationally in the operationprocess,Stop at the end of the operation of sevoflurane, stay awakepatients can be called, breathing air fingertip blood saturationmaintained tracheal extubation were recorded in95%above, theoccurrence of PONV, patients satisfaction and the incidence of adversereactions.Results: In the120patients of the experiment,there is no significantage, height, weight and difference in medical history. The two two compared is found, D group and C group, R group andC group, DR group and D, R, C group, there was significant difference,P was less than0.05, there was statistical significance.The patients satisfaction survey found that the test group washigher than the control group. DR group and R group、D group werecompared, significant difference was found,there was statisticalsignificance. The satisfaction of R group was higher than D group, thedifference was statistically significant.Conclusion:1．Dexamethasone does the function of preventive PONV2Ramosetron prevention PONV effect is superior todexamethasone3．Ramosetron combine with dexamethasone is better in theprevention of PONV than used alone，and make the patientsmore satisfied...