Department of Hospital Pharmacy, Nagoya University Hospital, Showa-ku, Nagoya, Japan.
J Clin Pharm Ther. 2010 Dec;35(6):679-84. doi: 10.1111/j.1365-2710.2009.01141.x.
Total knee and hip joint replacement has a high risk of postoperative nausea and vomiting (PONV), and steroid cover is used for cases associated with autoimmune diseases. Our aim is to evaluate the antiemetic efficacy of methylprednisolone as steroid cover in patients undergoing the surgery.
A prospective cohort study design was used. Sixty-eight patients, aged between 20 and 80 years, were scheduled for a standardized general anaesthetic technique. Patients who were given methylprednisolone were assigned as the steroid cover group, and those who were not given methylprednisolone formed the non-steroid cover group. PONV were assessment by direct questioning or spontaneous complaints by patients 1 week after surgery. Postoperative pain was evaluated using Visual Analog Scale (VAS) 1 and 3 days after surgery.
The incidence of nausea in the steroid cover group was significantly less than that in the non-steroid cover group (adjusted odds ratio, 0·17, P = 0·021), but there was no significant difference in vomiting between the two groups. Postoperative pain VAS score was not significantly different between groups.
In total knee and hip arthroplasty, methylprednisolone is effective in preventing postoperative nausea; however, higher doses of methylprednisolone may be needed to prevent vomiting.
全膝关节和髋关节置换术有很高的术后恶心和呕吐（PONV）风险，类固醇覆盖用于与自身免疫性疾病相关的病例。我们的目的是评估甲基泼尼松龙作为类固醇覆盖物在接受手术的患者中的止吐效果。
采用前瞻性队列研究设计。68 名年龄在 20 岁至 80 岁之间的患者接受标准化全身麻醉技术。给予甲基泼尼松龙的患者被分配为类固醇覆盖组，未给予甲基泼尼松龙的患者为非类固醇覆盖组。术后 1 周通过直接询问或患者自发抱怨评估 PONV。术后疼痛采用视觉模拟评分（VAS）评估，分别在术后第 1 天和第 3 天。
类固醇覆盖组恶心的发生率明显低于非类固醇覆盖组（调整后的优势比，0.17，P = 0.021），但两组之间的呕吐发生率没有显著差异。两组间术后疼痛 VAS 评分无显著差异。
在全膝关节和髋关节置换术中，甲基泼尼松龙可有效预防术后恶心；然而，可能需要更高剂量的甲基泼尼松龙来预防呕吐。
