The Prophylactic Effect Of Methylprednisolone Combined With Tropisetron On Postoperative Nausea And Vomiting After Gynecological Laparoscopy

Objective: gynecological laparoscopy has a high risk of postoperative nausea and vomiting(PONV).Our aim is evaluate the effects of tropisetron and tropisetron combined methylprednisolone in prevention of postoperative nausea and vomiting in0-6h and 6-72 h after surgery.Methods: 294 patients were scheduled in this double blind,prospective study.Patients were divided into two groups,receiving 5mg tropisetron(group T,n=130);5mg tropisetron and 40 mg methylprednisolone(group T+M,n=127)according to exclusion criteria.PONV were assessment by direct questioning or spontaneous complaints by patients in 0-6h and 6-72 h after surgery.Furthermore,we evaluate the incidence of PONV in 0-6h and 6-72 h after surgery according to Apfel risk score of patients.Visual Analog Scale(VAS)and Ramsay score were recorded as postoperative pain and sedation evaluation.Results: The incidence of acute PONV was significantly lower in group T+M,compared with group T(p<0.05).The incidence of postoperative vomiting(POV)was significantly lower in group T+M in comparison with group T(p<0.01).The incidence of acute postoperative nausea(PON)was significantly lower in group T+M patients with Apfel score III,compared with those in group T(p<0.01).The incidence of acute POV was lower in group T+M in comparison with group T(p<0.05).The incidence of delayed POV is lower in group T+M in comparison with group T.Conclusion: Tropisetron combined with methylprednisolone showed a greater efficacy in the prevention of PONV in 0-6h after surgery and POV in 6-72 h after surgery compared to tropisetron in patients after gynecological laparoscopy.