Isik Berrin, Cekmen Nedim, Arslan Mustafa, Ozsoylar Ozgur, Kordan Aysegul Z, Akcabay Mehmet
Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Bsevler, Ankara, Turkey.
Saudi Med J. 2006 May;27(5):646-51.
To compare the antiemetic efficacy of ondansetron and dexamethasone in adults undergoing middle ear surgery.
This clinical research took place in the Faculty of Medicine, Gazi University, Turkey between January to December 2004. The study included 60 cases, classified by the American Society of Anesthesiology physical status group I-II, who underwent middle ear surgery. We carried out anesthesia induction with 5 mg x kg(-1) sodium thiopental and performed muscle relaxation with 0.5 mg x kg(-1) atracurium to be followed by orotracheal intubation. Anesthesia was maintained at 5 L x min(-1) gas flows with 2-3% sevoflurane inhalation in 70/30% O(2)/N(2)O. We randomly distributed the cases into 2 groups, and the first group (Group O) was administered with 4 mg ondansetron intravenously (IV) at the stage of surgical skin closure and the second group (Group D) with 5 mg dexamethasone IV immediately after anesthesia induction. In the first 24 hours postoperatively, nausea vomiting score (NVS) and nausea, vomiting frequency, Metamizole-Na and non-steroidal anti-inflammatory drug use, the need for additional antiemetics and cost as well as the number of cases with nausea, vomiting and the need for extra antiemetics during 0-4, 4-12 and 12-24 hours were recorded, and their distribution to groups was evaluated.
The NVS was 0 (0-0) in group O compared with 1 (0-3) in group D (p=0.003). The use of additional antiemetics was found to be significantly lower in group O (1 +/- 0.6) compared with group D (3.70 +/- 1.02) (p=0.028). In comparing the cost, group O (9.8 dollars) was found to have a significantly higher cost compared with group D (1.1 dollars) (p<0.0001).
Ondansetron had a more significant effect on nausea and vomiting in the early period, however, no difference was found after 4 hours of administration. Furthermore, dexamethasone was found to cost less compared with ondansetron.
比较昂丹司琼和地塞米松在接受中耳手术的成年患者中的止吐效果。
这项临床研究于2004年1月至12月在土耳其加齐大学医学院进行。该研究纳入了60例美国麻醉医师协会身体状况分级为I-II级且接受中耳手术的患者。我们用5mg/kg的硫喷妥钠进行麻醉诱导，并用0.5mg/kg的阿曲库铵进行肌肉松弛，随后进行经口气管插管。麻醉维持采用70/30%的O₂/N₂O混合气体，以5L/min的气流，吸入2%-3%的七氟醚。我们将患者随机分为两组，第一组（O组）在手术皮肤缝合阶段静脉注射4mg昂丹司琼，第二组（D组）在麻醉诱导后立即静脉注射5mg地塞米松。记录术后前24小时的恶心呕吐评分（NVS）、恶心和呕吐频率、安乃近和非甾体抗炎药的使用情况、额外使用止吐药的需求和费用，以及0-4小时、4-12小时和12-24小时内恶心、呕吐的病例数和额外使用止吐药的需求，并评估其在两组中的分布情况。
O组的NVS为0（0-0），而D组为1（0-3）（p=0.003）。发现O组额外使用止吐药的情况（1±0.6）明显低于D组（3.70±1.02）（p=0.028）。在比较费用时，发现O组（9.8美元）的费用明显高于D组（1.1美元）（p<0.0001）。
昂丹司琼在早期对恶心和呕吐有更显著的效果，但给药4小时后未发现差异。此外，发现地塞米松的费用比昂丹司琼低。
