Abstract: AIM: To investigate the effect of intercostals neural blockade(INB)combining with intravenous dexamethasone on postoperative pain, nausea and vomiting and rehabilitation after laparoscopic cholecystectomy( LC).METHODS: Seventy-two patients with ASA I-Ⅱ undergoing LC were randomly divided into three groups with twenty-four patients in each group. Group DI received intravenous dexamethasone infusion before induction combining with INB.Group I only received INB.Group C was control group.Propofol and remifentanil consumption were recorded, postoperative pain and fatigue were assessed according to a pain and fatigue severity score using a subjective analog visual scale (VAS)1, 4, 12, and 24 h after the surgery.The incidence of postoperative nausea and vomiting, times to first enterocinesia, flatus and hospital discharge were recorded.RESULTS: Propofol and remifentanil consumption, postoperative pain and fatigue scores 4, 12, 24 h after surgery, the postoperative nausea and vomiting incidences, times to first enterocinesia and flatus, times to hospital discharge were significantly lower in Group DI and I than those in Group C(P <0.05, P < 0.01).Remifentanil consumption, and the pain score when coughing at 1, 4, 12 h after surgery, times to first enterocinesia and flatus were significantly higher in Group I as compared with Group DI(P <0.05, P < 0.01).CONCLUSION: INB is used safely to reduce the postoperative pain and dexamethasone is effective to reduce postoperative nausea and vomiting.Furthermore, INB combining with intravenous dexamethasone reduce postoperative painmore effectively.Meanwhile, it accelerates the postoperative acute rehabilitation.

Key words: intercostals neural blockade, dexamethasone, postoperative pain, nausea and vomiting, laparoscopic cholecystectomy