腹腔镜经脐双孔治疗小儿腹股沟斜疝的疗效

目的观察采用经脐双孔法腹腔镜治疗小儿腹股沟斜疝的手术效果。 方法回顾分析2018年1~12月北京市通州区妇幼保健院154例经脐双孔法腹腔镜治疗小儿腹股沟斜疝临床资料，评估经脐双孔法腹腔镜治疗腹股沟斜疝临床疗效。 结果所有患儿顺利完成手术，其中单侧腹股沟斜疝71例（46.1%），双侧腹股沟斜疝6例（3.8%），术中发现对侧隐匿疝77例（50%），单侧腹股沟斜疝平均手术时间（32.7±10.1）min，双侧腹股沟斜疝平均手术时间（33.4±10.9）min。术后随访6个月，未发现复发、阴囊血肿、睾丸萎缩及脐疝等相关并发症。 结论经脐双孔法腹腔镜治疗小儿腹股沟斜疝疗效确切，术后瘢痕小，术后并发症低。     

双孔法腹腔镜治疗小儿腹股沟疝89例体会

目的总结双孔法腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的疗效及经验。方法 2010年3月至2012年4月期间我院对89例小儿腹股沟斜疝患儿采用双孔法腹腔镜下疝囊高位结扎术。结果 89例在腹腔镜下完成疝囊高位结扎术,每侧手术时间3～6min,平均4min。13例患儿存在对侧隐性疝,一并行疝囊高位结扎术。术后随访3～12个月,平均10个月,无一例复发,无阴囊红肿及阴囊积气病例。结论双孔法腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝效果满意。     

经脐双孔法腹腔镜手术在小儿外科中的应用

目的探讨经脐双孔法腹腔镜手术在小儿外科中应用的可行性. 方法 2003年1月～2003年12月应用微型腹腔镜对60例小儿腹股沟斜疝(年龄3个月～14岁,平均3.5岁),40例小儿阑尾炎(年龄2.5～14岁,平均6.3岁)行疝囊超高位结扎和阑尾切除术.疝囊超高位结扎术于脐轮左右侧分别置腹腔镜和操作钳,内环口体表投影处进带线的疝环针,体外打结.阑尾切除术在右麦氏点戳孔置操作器械, 术中同时探查有无对侧疝或其它消化道畸形疾病. 结果手术经过顺利,每侧疝和阑尾炎的平均手术时间8.5 min和55.7 min.小儿腹股沟斜疝术后1～2 d出院,阑尾炎术后5～7 d出院.经3～12个月随访,除1例隐性疝术中漏诊术后2个月发生疝外, 未见疝复发; 2例阑尾穿孔术后合并腹腔感染,余患儿术后恢复顺利. 结论经脐双孔法腹腔镜手术操作简易,安全有效,创伤小,并发症少,切口更加美观,值得在小儿外科推广应用.     

经脐双通道腹腔镜手术治疗小儿腹股沟斜疝的体会

目的:探讨经脐单孔双通道腹腔镜手术治疗小儿腹股沟斜疝的应用价值。方法:采用经脐单孔双通道行腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝36例。结果:36例均顺利完成手术,手术时间平均10～15 min,术后平均住院2 d。术后随访1～6个月,均无并发症发生及复发病例。结论:经脐单孔双通道腹腔镜手术治疗小儿腹股沟斜疝安全可行,创伤更小,真正做到腹壁无瘢痕,疝囊结扎更确切,避免了皮下线结异物感,值得推广应用。     

腹腔镜下单孔法治疗小儿腹股沟斜疝的优势探讨

【摘要】 目的 通过比较腹腔镜下单孔法及双孔法治疗小儿腹股沟斜疝的临床应用,探讨腹腔镜下单孔法在治疗小儿腹股沟斜疝中的优势。方法 通过回顾性分析我科自2006年1月至2011年3月收治的80例小儿腹股沟斜疝患儿,分别采用腹腔镜下双孔法及单孔法缝扎腹股沟斜疝单侧疝囊内环治疗,每组各收治40例,年龄在6个月到5岁范围。结果 在缝合正常大小内环口的病例中,腹腔镜下单孔法缝扎单侧内环口操作时间平均为11.8 min(手术用时范围10~13 min),双孔法操作平均时间为12.3 min(手术用时范围11~14 min);而在缝合较大内环口的用时时间上,单孔法手术用时明显较双孔法手术时间短(11.3 min,14.23 min)。术后随访平均6个月(3个月~1年),手术患儿均无腹股沟斜疝复发。结论 相比较腹腔镜下双孔法高位结扎腹股沟疝疝囊,采用腹腔镜下单孔法高位缝扎腹股沟斜疝疝囊,不仅具有美观、创伤小的优势,同时操作时间较短,更适合治疗较大内环口的腹股沟斜疝。     

经脐双通道微型腹腔镜手术治疗儿童腹股沟斜疝

目的探讨经脐双孔通道径路用微型腹腔镜手术治疗小儿腹股沟斜疝的临床效果。方法脐缘左右侧皱褶处分别戮孔置入微型腹腔镜和操作钳,内环口体表投影处剌入带线雪撬针,器械钳配合下超高位缝合关闭疝囊和修补内环。体外打结,线结埋在皮下。结果治疗小儿腹股沟斜疝164例,单侧139例,双侧25例。单侧疝手术时间10～15 min(平均12 min),双侧疝22 min。无阴囊血肿和感染,平均住院时间2.5 d。随访1～12个月,脐缘皱褶内瘢痕线状很难辨出。无疝复发、肠粘连、睾丸萎缩和医源性隐睾。结论经脐双通道行微型腹腔镜手术治疗小儿腹股沟斜疝操作简单,损伤小,疗效确切,术后恢复快,很难辨认出手术戳口瘢痕,更具微创性,美容效果可满足腹壁无疤痕化手术的要求,值得临床推广。     

改良双孔法微型腹腔镜治疗小儿斜疝

目的:探讨改良双孔法微型腹腔镜治疗小儿腹股沟斜疝的应用价值。方法:用改进的腹壁应急缝合针于微型腹腔镜下,用器械钳辅助配合,荷包缝合内环口治疗小儿腹股沟斜疝。结果:治疗小儿斜疝120例,单侧斜疝94例,双侧斜疝26例,隐匿性疝13例。单侧疝手术时间8～15min,平均10min,双侧疝18min,无阴囊水肿、感染、睾丸萎缩、医源性隐睾等并发症发生。术后随访1～15个月,无复发。结论:改良双孔法微型腹腔镜治疗小儿腹股沟斜疝安全、可靠、美观并且操作简便,值得基层医院推广应用。     

经脐0.5cm单孔腹腔镜治疗小儿腹股沟斜疝31例

目的探讨经脐0.5cm单孔腹腔镜治疗小儿腹股沟斜疝的应用价值。方法回顾分析我院2008年12月至2011年6月间采用单孔腹腔镜治疗小儿腹股沟斜疝的临床资料,手术用普通外科缝针荷包缝合内环口。结果治疗小儿斜疝31例,单侧斜疝17例,双侧斜疝14例,其中隐匿性疝4例。单侧疝手术时间平均12min,双侧疝26min,无阴囊水肿、感染、睾丸萎缩、医源性隐睾等并发症发生。术后随访12～24个月,无复发。结论经脐0.5cm单孔腹腔镜治疗小儿腹股沟斜疝安全、可靠、美观并且操作简便,值得基层医院推广应用。     

经脐单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝

目的探讨经脐单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的临床应用价值。方法回顾性分析2010年7月至2012年2月对58例小儿腹股沟斜疝行单孔腹腔镜疝囊高位结扎术的临床资料。结果58例患儿均在单孔腹腔镜下顺利完成手术,一侧手术时间8～12min,平均10min;两侧16～25min,平均20min。手术当日即可下床和进食,次日出院,术后平均住院时间24h。随访2年,无复发病例,脐部小切口处无明显可见瘢痕。结论经脐单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝是一种创伤小、愈合后几乎无可见瘢痕、安全可靠的手术方法,同时可发现和处理对侧隐匿性疝,值得临床推广。     

经脐双孔法腹腔镜治疗婴幼儿腹股沟嵌顿性斜疝

目的探讨经脐双孔法腹腔镜治疗婴幼儿腹股沟嵌顿性斜疝的临床应用价值。方法2003年4月—2004年4月采用经脐双孔法腹腔镜治疗婴幼儿腹股沟嵌顿性斜疝48例,并与婴幼儿腹股沟嵌顿疝的传统手术在手术时间、肠功能恢复时间、住院天数、术后并发症等方面进行了比较。结果腹腔镜手术组手术过程顺利,未发现嵌顿物坏死,无附加嵌顿内容物切除手术,其平均手术时间为(30±5)min,肠鸣音恢复时间为(7.8±0.3)h,住院时间(4.4±0.3)d,均较传统手术组[平均手术时间(43±6)min,肠鸣音恢复时间(23.3±2.4)h,住院时间(6.7±0.4)d]缩短(P<0.05),术后随访3个月～1年未见疝复发和输精管损伤、膀胱损伤、睾丸萎缩等并发症。结论经脐双孔法腹腔镜治疗婴幼儿腹股沟嵌顿性斜疝是一种安全的微创手术,具有损伤小、恢复快、住院时间短等优点,值得推广应用。     

维生素D受体在糖尿病肾病足细胞损伤及蛋白尿缓解中的作用

目的探讨维生素D受体(VDR)在糖尿病肾病(DKD)足细胞中的表达水平及在足细胞损伤及蛋白尿缓解中的作用。方法(1)本研究纳入了65例诊断患有2型糖尿病(伴或不伴蛋白尿)的患者,并纳入了25例年龄和性别相匹配的健康体检者为对照组。根据白蛋白/肌酐(ACR)的尿排泄比例对2型糖尿病患者进行分组,分别为无蛋白尿(ACR<30 mg/g,n=24)、微量白蛋白尿(ACR 30~300 mg/g,n=18)和临床蛋白尿(ACR>300 mg/g,n=23)。另选择25例经肾活检确诊的DKD患者作为DKD组。正常肾脏组织标本均取自泌尿外科同一时期肾脏肿瘤切除患者10例。将各组检测指标进行对比,同时采用实时定量PCR、ELISA法和免疫组化法检测VDR在各组患者的血液、尿液样本和肾脏组织中的表达情况,以及使用Pearson相关分析分析VDR与尿蛋白的相关性。(2)在2型糖尿病肾病小鼠模型中对上述结果进行验证,将遗传背景均为C57BLKs/J的雄性db/db小鼠及同窝出生的db/m小鼠,随机分为正常对照组(A组)、DKD对照组(B组)、DKD二甲基亚砜处理组(C组)、DKD帕立骨化醇(VDR激动剂)处理组(D组),C、D组连续腹腔注射处理8周,对照组不做任何处理。小鼠10周龄时开始连续干预8周,在小鼠22周龄(开始干预后12周)检测各组小鼠体重、血、尿生化指标对比;Western印迹法检测β⁃catenin、VDR的变化;免疫荧光观察足细胞标志蛋白podocin及足细胞损伤蛋白α⁃SMA的表达变化。结果(1)与正常健康对照组相比,无蛋白尿组、微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿组的糖尿病患者相比,微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05)。(2)与正常健康对照组相比,无蛋白尿糖尿病组和DKD组患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿糖尿病组患者相比,DKD组患者血浆中VDR的mRNA和蛋白水平亦较低(均P<0.05)。(3)免疫组化结果显示,DKD组肾组织中VDR的表达明显少于正常对照组。(4)DKD患者血浆中VDR mRNA相对水平与ACR呈负相关(r=-0.342,P<0.05)。(5)各组尿液上清液中VDR的水平与血浆中的水平呈相反趋势。(6)Western印迹结果显示,B组、C组肾小球足细胞β⁃catenin蛋白表达高于D组(均P<0.05),VDR蛋白的表达低于D组(均P<0.05);免疫荧光结果显示,B组、C组肾小球足细胞podocin的表达低于D组(均P<0.05),α⁃SMA的表达高于D组(均P<0.05)。结论VDR高表达缓解DKD足细胞损伤及蛋白尿。     

罗伊适应模式对腹股沟疝无张力疝修补术后恢复情况的影响

目的探讨罗伊适应模式对患者腹股沟疝无张力疝修补术后恢复情况的影响。 方法将2016年1月至2019年5月在秦皇岛市第二医院择期进行无张力修补术治疗的120例腹股沟疝患者，按照随机数字法分为对照组和观察组，每组各60例。对照组采用常规护理治疗，观察组在对照组的基础上采用罗伊适应模式。比较2组患者的术后临床指标、心理状态、围手术期并发症发生情况及满意度。 结果术后观察组患者的首次排气时间、恢复正常饮食时间、离床活动时间和术后住院时间均低于对照组（P<0.05）；术后观察组患者的抑郁自评量表（SDS）和焦虑自评量表（SAS）评分显著低于对照组（P<0.05）；术后2组患者均无切口感染发生，2组患者尿潴留、急性疼痛、认知功能障碍、发热、血肿等发生率相比无统计学差异（P>0.05）；术后观察组患者护理满意度为96.67%，显著高于对照组的83.33%（P<0.05）。 结论在常规护理的基础上，罗伊适应模式用于患者腹股沟疝无张力修补围手术期，能有效改善术后患者的焦虑/抑郁情绪，不增加围手术期并发症，促进术后患者的恢复及提高治疗满意度。     

Long-term follow-up of callotasis lengthening of the capitate after resection of the lunate for the treatment of stage III lunate necrosis

The callotasis lengthening technique was used to gradually lengthen the capitate after resection of the lunate in stage IIIa necrosis in 23 patients. Results of ten patients with a follow-up of at least 5 years showed rapid and sufficient callus formation in every patient regardless of age. The callotasis lengthening modification of the Graner II operation provides all advantages and avoids the major inconvenience of the traditional Graner II operation. There was no increased rate of disturbed fracture healing. Results of the DTPA-gadolinium MRI study did not show any significant impairment of vascularization within the region of the capitate bone. With the “intrinsic bone formation,” contrary to every other intercarpal arthrodesis at the wrist, there is no need for an additional bone graft.     

Comparison of University of Wisconsin and University of Pittsburgh solutions for heart transplantation

The effectiveness of University of Wisconsin (UW) and University of Pittsburgh (UP) solutions for the preservation of rat hearts was compared. Lewis rat hearts were preserved with UW (group A, n=45) or UP (group B, n=45) solution for 0 or 24 h and then transplanted heterotopically into the recipients' abdomen. Ten recipients in each group were observed to obtain 1-week graft survival rates. Tissue water content and tissue content of adenine nucleotides were measured 2 h after transplantation in six grafts from each group. Six hearts preserved for 0 h and seven hearts preserved for 24 h were taken from each group 24 h after grafting for histopathology. The 1-week graft survival rates of groups A24 and B24 were 60% and 10%, respectively. In the 24-h preserved grafts, adenosine triphosphate (ATP) and energy charge [(ATP+adenosine diphosphate/2)/(ATP+adenosine diphosphate+adenosine monophosphate)] of groups A and B were 0.972±0.165 and 0.200±0.123 mg/g wet tissue (P<0.05) and 74.4% and 61.1% (P<0.05), respectively. The tissue water content of group A24 was 71.7%, whereas that of group B24 was 74.1% (P<0.05). Histopathology revealed more severe muscle edema and necrosis and infiltration of polymorphonuclear cells in group B24 than in group A24. We conclude that UW solution is more appropriate for rat heart preservation than UP solution.     

Role of Conventional and Diffusion-Weighted Magnetic Resonance Imaging of Spinal Treatment Protocol for Hydatid Disease

Objective:

To demonstrate the role of magnetic resonance imaging (MRI) in determining the treatment protocol for hydatid disease of the spine.

Design:

Case report; literature review.

Findings:

Diffusion-weighted MRI can help differentiate complicated infected hydatidosis from abscesses, epidermoid cysts from arachnoid cysts, and benign from malignant vertebral compression fractures. It is also helpful in differentiating between abscesses and necrotic tumors.

Conclusion:

Diffusion-weighted MRI can help differentiate between infections requiring immediate surgery and those that can be treated medically with antihelmintic treatment.     

不同尿钙水平的Gitelman综合征患者临床特点比较

目的观察不同尿钙水平Gitelman综合征(GS)患者的临床特点,探讨尿钙在GS疾病临床分型中的价值。方法收集2016—2018年来自中国国家罕见病注册系统(NRSC)、在北京协和医院行SLC12A3基因检测诊断为GS患者的临床资料,分析其尿钙特点,比较不同尿钙水平患者的临床和实验室检查指标。氢氯噻嗪试验按照标准操作流程进行,测定患者基线和用药后3 h内氯离子排泄分数改变量的最大值(ΔFECl)。结果共有83例GS患者被纳入研究,其中低尿钙患者53例(63.86%)。低尿钙组尿钙/肌酐比明显低于非低尿钙组[(0.085±0.058)mmol/mmol比(0.471±0.284)mmol/mmol,t=7.349,P<0.001]。两组患者在年龄、性别、估算肾小球滤过率、血压、血尿电解质水平、代谢性碱中毒方面差异均无统计学意义。低尿钙组患者乏力(χ2=4.595,P=0.032)及多尿(χ2=5.778,P=0.016)发生比例低于非低尿钙组,两组患者在其他临床症状方面差异无统计学意义。低尿钙和非低尿钙组各有16例患者行氢氯噻嗪试验,中位ΔFECl结果分别为0.539%(0.430%,1.283%)和0.829%(0.119%,1.298%),均提示对氢氯噻嗪无反应,组间差异无统计学意义(U=130.000,P=0.956)。结论GS患者中低尿钙比例为63.86%,尿钙水平与疾病临床表型、NCC功能损伤严重程度之间均无明确相关性。     

Safety and tolerability of single intravenous doses of sugammadex administered simultaneously with rocuronium or vecuronium in healthy volunteers

BACKGROUND: Sugammadex rapidly reverses rocuronium- and vecuronium-induced neuromuscular block. To investigate the effect of combination of sugammadex and rocuronium or vecuronium on QT interval, it would be preferable to avoid the interference of anaesthesia. Therefore, this pilot study was performed to investigate the safety, tolerability, and plasma pharmacokinetics of single i.v. doses of sugammadex administered simultaneously with rocuronium or vecuronium to anaesthetized and non-anaesthetized healthy volunteers. METHODS: In this phase I study, 12 subjects were anaesthetized with propofol/remifentanil and received sugammadex 16, 20, or 32 mg kg(-1) combined with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1); four subjects were not anaesthetized and received sugammadex 32 mg kg(-1) with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) (n=2 per treatment). Neuromuscular function was assessed by TOF-Watch SX monitoring in anaesthetized subjects and by clinical tests in non-anaesthetized volunteers. Sugammadex, rocuronium, and vecuronium plasma concentrations were measured at several time points. RESULTS: No serious adverse events (AEs) were reported. Fourteen subjects reported 23 AEs after study drug administration. Episodes of mild headache, tiredness, cold feeling (application site), dry mouth, oral discomfort, nausea, increased aspartate aminotransferase and gamma-glutamyltransferase levels, and moderate injection site irritation were considered as possibly related to the study drug. The ECG and vital signs showed no clinically relevant changes. Rocuronium/vecuronium plasma concentrations declined faster than those of sugammadex. CONCLUSIONS: Single-dose administration of sugammadex 16, 20, or 32 mg kg(-1) in combination with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) was well tolerated with no clinical evidence of residual neuromuscular block, confirming that these combinations can safely be administered simultaneously to non-anaesthetized subjects. Rocuronium and vecuronium plasma concentrations decreased faster than those of sugammadex, reducing the theoretical risk of neuromuscular block developing over time.     

Magnetic resonance imaging for the evaluation of rejection of a kindney allograft in the rat

Orthotopic DA (RT1^a) into Lewis (RT1¹) rat kidney allografts and control Lewis-into-Lewis grafts were assessed by magnetic resonance imaging (MRI) and perfusion measurement after intravenous injection of a superparamagnetic contrast agent. MRI anatomical scores (range 1–6) and perfusion rates were compared with graft histology (rank of rejection score 1–6). Not only acute rejection, but also chronic events were monitored after acute rejection was prevented by daily cyclosporine (Sandimmune) treatment during the first 2 weeks after transplantation. In acute allograft rejection (n=11), MRI scores reached the maximum value of 6 and perfusion rates were severely reduced within 5 days after transplantation; histology showed severe acute rejection (histologic score 5–6). In the chronic phase (100–130 days after transplantation), allografts (n=5) manifested rejection (in histology cellular rejection and vessel changes), accompanied by MRI scores of around 2–3 and reduced perfusion rates. Both in the acute and chronic phases, the MRI anatomical score correlated significantly with the histological score (Spearman rank correlation coefficient r _s 0.89, n=30, P<0.01), and perfusion rates correlated significantly with the MRI score or histological score (r _s values between-0.60 and -0.87, n=23, P<0.01). It is concluded that MRI represents an interesting tool for assessing the anatomical and hemodynamical status of a kidney allograft in the acute and chronic phases after transplantation.     

Fibrinogen-thrombin collagen patch reinforcement of highrisk colonic anastomoses in rats

AIM To evaluate the effectiveness of human fibrinogenthrombin collagen patch(TachoSil~?) in the reinforcement of high-risk colon anastomoses.METHODS A quasi-experimental study was conducted in Wistar rats(n = 56) that all underwent high-risk anastomoses(anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group(24 rats) and treatment group(24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil~? (a piece of Tacho Sil? was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes. RESULTS Overall survival was 71.4% and 57.14% in the TachoSil~? group and control group, respectively(P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage(P 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups(P = 0.066).CONCLUSION In our study, the use of TachoSil~? was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil~? has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.     

Cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting

Background. This study compares the cost-effectiveness of threecombinations of antiemetics in the prevention of postoperativenausea and vomiting (PONV). Methods. We conducted a prospective, double-blind study. NinetyASA I–II females, 18–65 yr, undergoing general anaesthesiafor major gynaecological surgery, with standardized postoperativeanalgesia (intrathecal 0.2 mg plus i.v. PCA morphine), wererandomly assigned to receive: ondansetron 4 mg plus droperidol1.25 mg after induction and droperidol 1.25 mg 12 h later (Group1); dexamethasone 8 mg plus droperidol 1.25 mg after inductionand droperidol 1.25 mg 12 h later (Group 2); ondansetron 4 mgplus dexamethasone 8 mg after induction and placebo 12 h later(Group 3). A decision analysis tree was used to divide eachgroup into nine mutually exclusive subgroups, depending on theincidence of PONV, need for rescue therapy, side effects andtheir treatment. Direct cost and probabilities were calculatedfor each subgroup, then a cost-effectiveness analysis was conductedfrom the hospital point of view. Results. Groups 1 and 3 were more effective (80 and 70%) thanGroup 2 (40%, P=0.004) in preventing PONV but also more expensive.Compared with Group 2, the incremental cost per extra patientwithout PONV was €6.99 (95% CI, –1.26 to 36.57) forGroup 1 and €13.55 (95% CI, 0.89–132.90) for Group3. Conclusion. Ondansetron+droperidol is cheaper and at least aseffective as ondansetron+ dexamethasone, and it is more effectivethan dexamethasone+droperidol with a reasonable extra cost. Br J Anaesth 2003; 91: 589–92