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Koomesh

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https://doi.org/10.69107/koomesh-151892

Comparing the Effect of Ondansetron , Dexamethasone and There Combonition in Reducing Postoperative Nausea and Vomiting (PONV) After Hysterectomy, a Single-Blind Randomized Clinical Trial Study

Author(s):
Mohammadreza MoonesanMohammadreza MoonesanMohammadreza Moonesan ORCID1, Sanaz GhenaatiSanaz GhenaatiSanaz Ghenaati ORCID2, Elham SaffariehElham SaffariehElham Saffarieh ORCID3, Majid MirmohammadkhaniMajid MirmohammadkhaniMajid Mirmohammadkhani ORCID4, Babak Hoseinzadeh ZoroofchiBabak Hoseinzadeh Zoroofchi5,*
1Department of Emergency Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
2General Practitioner, Semnan University of Medical Sciences, Semnan, Iran
3Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran
4Department of Epidemiology and Biostatistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
5Department of Anesthesiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
Koomesh:Vol. 26, issue 1; e151892
Published online:Oct 15, 2024
Article type:Research Article
How to Cite:Moonesan M, Ghenaati S, Saffarieh E, Mirmohammadkhani M, Hoseinzadeh Zoroofchi B. Comparing the Effect of Ondansetron , Dexamethasone and There Combonition in Reducing Postoperative Nausea and Vomiting (PONV) After Hysterectomy, a Single-Blind Randomized Clinical Trial Study.koomesh.2024;26(1):e151892.https://doi.org/10.69107/koomesh-151892.

Abstract

Keywords
Hysterectomy
Postoperative complications
Nausea
Vomiting
Dexamethasone

Fulltext

مقدمـه و هـدف: هیسـترکتومی یکـی از اعمـال جراحـی شـایع در زنـان بـوده و دارای عوارضـی همچـون تهـوع و اسـتفراغ پـس از عمـل جراحـی اسـت کـه از شـیوع باالیـی برخـوردار اسـت. داروهـای مختلـف در روشهـای مختلـف بـه منظـور کاهـش ایـن عارضـه مـورد اسـتفاده قــرار گرفتهانــد. در ایــن مطالعــه اثــرات دگزامتــازون و اندانســترون در پیشــگیری از تهــوع و اســتفراغ بعــد از عمــل جراحــی هیســترکتومی مـورد مقایسـه قـرار گرفـت. مــواد و روشهــا: در یــک مطالعــه کارآزمایــی بالینــی تصادفیسازیشــده یــک ســوکور، 76 بیمــار کاندیــد هیســترکتومی مراجعــه کننـده بـه بیمارسـتان امیرالمومنیـن سـمنان در سـال 1396-97 مـورد مطالعـه قـرار گرفتنـد. بیمـاران بـه صـورت تصادفـی بـه 3 گـروه تخصیــص یافتنــد. گــروه اول 16 میلیگــرم دگزامتــازون، گــروه دوم 4 میلیگــرم اندانســترون و گــروه ســوم 4 میلیگــرم اندانســترون بهعـاوه 16 میلیگـرم دگزامتـازون بـه صـورت وریـدی دریافـت نمودنـد. ابـزار جمـعآوری اطالعـات در ایـن مطالعـه شـامل چـک لیسـت بـود. بـروز تهـوع و اسـتفراغ در اتـاق ریـکاوری و در فاصلـه زمانـی 6 و 24 سـاعت بعـد از عمـل ثبـت و مـورد بررسـی قـرار گرفـت. نتایــج: میانگیــن ســنی بیمــاران 7/7 ± 48/21 ســال بــود. میانگیــن فشــار خــون سیســتولیک بیمــاران 18/7 ± ،132/37 میانگیــن فشـارخون دیاسـتولیک 11/7 ± ،84/24 میانگیـن طـول مـدت عمـل جراحـی 38/0 ± 138/16 دقیقـه و میانگیـن طـول مـدت ریـکاوری 11/3 ± 36/45 دقیقـه بـود. در گـروه دریافتکننـده دگزامتـازون بهعـاوه انداسـترون تعـداد دفعـات تهـوع واسـتفراغ و دفعـات نیـاز بـه مسـکن کمتـر از گروههـای دیگـر بـود. در تحلیـل رگرسـیون سـن و فشـار خـون باالتـر بـا افزایـش احتمـال بـروز تهـوع همـراه بـوده و فشـارخون و طـول مـدت بیشـتر جراحـی بـا افزایـش احتمـال بـروز اسـتفراغ و نیـاز بیشـتر بـه داروی مسـکن همـراه بـود. نتیجـه گیـری: تجویـز تـوام دگزامتـازون و اندانسـترون نسـبت بـه تجویـز آنهـا بـه تنهایـی در کاهـش بـروز تهـوع و اسـتفراغ بعـد از عمـل اثـر بهتـری داشـته و نیـاز بـه تجویـز مسـکن را کاهـش میدهـد. توصیـه مـا بـرای کاهـش بـروز عـوارض تهـوع و اسـتفراغ و میـزان نیـاز بـه مسـکن در دوره بعـد از عمـل در جراحیهـای هیسـترکتومی تجویـز تـوام دگزامتـازون و اندانسـترون، بویـژه در سـنین کمتـر و در عملهــای طوالنــی مــدت اســت

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