| 引用本文： |
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徐成,张慧文,周全红,等.地塞米松对俯卧位术后咽喉疼痛的预防性作用[J].同济大学学报（医学版）,2020,41(3):362-367. [点击复制]
- XU Cheng,ZHANG Hui-wen,ZHOU Quan-hong,et al.Preventive effect of dexamethasone on postoperative sore throat in prone position surgery under general anesthesia[J].同济大学学报（医学版）,2020,41(3):362-367. [点击复制]
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| 摘要: |
| 目的探索地塞米松对全身麻醉俯卧位手术术后咽喉疼痛（postoperative sore throat, POST）的预防性作用。方法选择拟行全身麻醉下腰椎手术的患者共计240例，性别不限，年龄18～65岁，ASA分级Ⅰ级或Ⅱ级，随机分为生理盐水组（A组）、地塞米松5 mg组（B组）和地塞米松10 mg组（C组），每组各80例。全身麻醉诱导前15 min分别静脉注射生理盐水，5、10 mg地塞米松，观察术后2、6、24、48 h POST的发生率和严重程度，观察术后声音嘶哑和恶心呕吐的发生率。结果术后2、6、24 h时，B组（静止痛分别为18%、23%和13%；吞咽痛分别为22%、28%和15%）和C组（静止痛分别为12%、15%和8%；吞咽痛分别为15%、18%和10%）POST发生率明显低于A组（静止痛分别为36%、42%和25%；吞咽痛分别为40%、49%和28%），差异有统计学意义（P＜0.001）。术后2、6、24、48 h，B组和C组术后POST疼痛VAS分值明显小于A组（P＜0.05），且相比于B组，C组术后2、6、24 h咽喉吞咽痛疼VAS分值更低（P＜0.05）。术后2、6、24、48 h，B组（29%、24%、21%、12%）和C组（19%、16%、13%、8%）术后声音嘶哑发生率明显低于A组（49%、45%、37%、24%），差异有统计学意义（P＜0.001）。B组（21%）和C组（13%）术后恶心呕吐的发生率明显低于A组（36%），差异有统计学意义（P=0.003）。结论术前预防性静脉注射5 mg或10 mg地塞米松可有效降低全身麻醉俯卧位手术后咽喉疼痛、声音嘶哑和恶心呕吐的发生率，而10 mg地塞米松可更加有效地减轻POST的严重程度。 |
| 关键词: 地塞米松 俯卧位手术 术后咽喉疼痛 恶心呕吐 |
| DOI：10.16118/j.1008-0392.2020.03.017 |
| 投稿时间：2019-12-31 |
| 基金项目: |
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| Preventive effect of dexamethasone on postoperative sore throat in prone position surgery under general anesthesia |
| XU Cheng,ZHANG Hui-wen,ZHOU Quan-hong,LU Jie,NI Wen-zong |
| (Dept. of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China;Dept. of Anesthesiology, General Hospital of Ningxia Medical University，Yinchuan 750011, China) |
| Abstract: |
| ObjectiveTo investigate the prophylactic effect of dexamethasone on postoperative sore throat(POST) caused by prone position under general anesthesia. MethodsA total of 240 patients, aged 18-65 years, ASA grade Ⅰ or Ⅱ, scheduled for lumbar surgery under general anesthesia were randomly divided into normal saline group(group A), dexamethasone 5 mg group(group B) and dexamethasone 10 mg group(group C) with 80 cases in each group. The normal saline(group A), 5 mg dexamethasone(group B) or 10 mg dexamethasone(group C) were injected intravenously 15 minutes before induction of general anesthesia. The incidence of POST at 2 h, 6 h, 24 h and 48 h after surgery was observed; and the incidence of hoarseness, nausea and vomiting after surgery was also observed. ResultsThe incidence of POST in group B at resting was 18%, 23% and 13% on 2 h, 6 h and 24 h after surgery; the incidence of POST at swallow was 22%, 28% and 15%, respectively; the incidence of POST in group C at resting was 12%, 15% and 8% and at swallow was 15%, 18% and 10%, which was significantly lower than that in group A(at resting： 36%, 42% and 25%; at swallow： 40%, 49% and 28%）(P＜0.001). In addition, the VAS scores of POST in groups B and C were significantly lower than those in group A at 2, 6, 24 and 48 h after operation; and the VAS scores at swallow in group C were significantly lower than those in group B on 2, 6 and 24 h after operation(P＜0.05). The incidence of hoarseness in group B was 29%, 24%, 21% and 12% and that in group C was 19%, 16%, 13% and 8%, at 2, 6, 24 and 48 h after surgery; which was significantly lower than that in group A（49%, 45%, 37% and 24%）(P＜0.001). The incidence of nausea and vomiting in group B（21%） and group C（13%） was significantly lower than that in group A（36%） after operation（P=0.003）. ConclusionProphylactic intravenous injection of 5 mg or 10 mg dexamethasone can effectively reduce the incidence of postoperative sore throat, hoarseness, nausea and vomiting caused by prone operation under general anesthesia, and 10 mg dexamethasone can more effectively alleviate the POST. |
| Key words: Dexamethasone prone position surgery postoperative sore throat nausea and vomiting |
