Clinical Investigation Of Methylprednisolone In The Prevention Of Postoperative Nausea And Vomiting After General Anesthesia

Objective:We search for a safe and effective medication forprevention of PONV, by clinical investigation of methylprednisolonein the prevention of postoperative nausea and vomiting aftergeneral anesthesia.Methods:In our study, we chose120patients with ASAphysical statusⅠtoⅡat the age of25to35who were scheduled toreceive gynecological laparoscopic surgery. The patients withcomplication of the following diseases were excluded: severehypertension, heart diseases or cardiac arrhythmias, history oflungs, liver, kidney or gastrointestinal diseases, history of narcoticdrug allergy, history of diabetes, history of smoking and PONV,history of autoimmune disease and glucocorticoids medication.With random number table,120patients were randomly dividedinto4groups (n=30), named by group A-D. In the group A, thepatients received ramosetron0.3mg VI at15minutes before theend of surgery. In the group B, the patients receivedmethylprednisolone40mg VI at15minutes before the end ofsurgery. In the group C, the patients received ramosetron0.3mg VI and methylprednisolone40mg VI at15minutes before the end ofsurgery. In the group D, the patients received methylprednisolone40mg VI before anesthesia induction and ramosetron0.3mg VI at15minutes before the end of surgery.Preoperative vital signs of all patients were recorded, includingblood pressure, blood oxygen saturation and heart rate.Postoperative vital signs above, VAS analogue scale, Ramsaysedation scale, PONV language scale, the dosage of PCIA, theincident of side effect, and the patients’ satisfaction of PONV wererecorded at the following time point: during extubation,in the postanesthesia care unit, postoperative3hour,6hour,9hour,12hour,24hour,48hour.The statistical processes were made by SPSS software v19.0.Measurement data were expressed by x±s and analyzed by T-test,While ratio data were showed by%and analyzed by2-test.When P values less than0.05, the differences of the data werestatistically significant.Results:There are no statistically significant difference in ageand BMI of the patients, the duration of surgery, the intraoperativeinfusion,the difference of vital signs of all groups from the basicvalue, VAS analogue scale, Ramsay sedation scale, and thedosage of PCIA in postoperative48h. In postoperative48h, there are no statistically significant difference in PONV language scale,incidence of side effects and the patients’ satisfaction of PONVbetween group A and B, which indicate the efficacy ofmethylprednisolone is similar with ramosetron. Group C, comparedwith group A and group B, and group D，compared with group Aand group B shows statistically significant differences in PONVlanguage scale, incidence of side effects and the patients’satisfaction of PONV. The differences suggest that the combinationmedication of methylprednisolone and ramosetron is more effectivethan either of both.There are no statistically significant difference inPONV language scale, incidence of side effects and the patients’satisfaction of PONV between group C and D, which indicate theadministration time of methylprednisolone may not affect theefficacy of prevention of PONV.Conclusions:For the prevention of PONV, the medication ofmethylprednisolone alone can be similar to ramosetron, while thecombined medication of methylprednisolone and ramosetron issignificantly superior to either of both respectively. The combinedmedication reduce the incidence and severity of PONV, not affectpostoperative analgesia and sedation, reduce the incidence ofadverse reactions, and improve patient satisfaction.Methylprednisolone is a safe and effective treatment for the prevention of PONV.