Lee Myeong Jong, Lee Kyu Chang, Kim Hye Young, Lee Won Sang, Seo Won Jun, Lee Cheol
Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Chungju, Korea.
Department of Anesthesiology and Pain Medicine, Wonkwang University College of Medicine, Iksan, Korea.
Korean J Pain. 2015 Jan;28(1):39-44. doi: 10.3344/kjp.2015.28.1.39. Epub 2015 Jan 2.
Postoperative nausea and vomiting (PONV), postanesthetic shivering and pain are common postoperative patient complaints that can result in adverse physical and psychological outcomes. Some antiemetics are reported to be effective in the management of postoperative pain and shivering, as well as PONV. We evaluated the efficacy of dexamethasone added to ramosetron on PONV, shivering and pain after thyroid surgery.
One hundred and eight patients scheduled for thyroid surgery were randomly allocated to three different groups: the control group (group C, n = 36), the ramosetron group (group R, n = 36), or the ramosetron plus dexamethasone group (group RD, n = 36). The patients were treated intravenously with 1 and 2 ml of 0.9% NaCl (group C); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 0.9% NaCl (group R); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 5 mg/ml dexamethasone (group RD) immediately after anesthesia.
Incidence of nausea and the need for rescue antiemetics, verbal rating scale (VRS) 1 hour pain value, ketorolac consumption, and incidence of shivering were significantly lower in group R and group RD, than in group C (P < 0.05). Moreover, these parameters were significantly lower in group RD than in group R (P < 0.05).
Combination of ramosetron and dexamethasone significantly reduced not only the incidence of nausea and need for rescue antiemetics, but also the VRS 1 hour pain value, ketorolac consumption, and the incidence of shivering compared to ramosetron alone in patients undergoing thyroid surgery.
术后恶心呕吐（PONV）、麻醉后寒战和疼痛是术后患者常见的主诉，可导致不良的生理和心理后果。据报道，一些止吐药在治疗术后疼痛、寒战以及 PONV 方面有效。我们评估了在雷莫司琼中添加地塞米松对甲状腺手术后 PONV、寒战和疼痛的疗效。
108 例计划行甲状腺手术的患者被随机分为三组：对照组（C 组，n = 36）、雷莫司琼组（R 组，n = 36）或雷莫司琼加地塞米松组（RD 组，n = 36）。患者在麻醉后立即静脉注射 1 和 2 ml 的 0.9%氯化钠（C 组）；或 2 ml 的 0.15 mg/ml 雷莫司琼加 1 ml 的 0.9%氯化钠（R 组）；或 2 ml 的 0.15 mg/ml 雷莫司琼加 1 ml 的 5 mg/ml 地塞米松（RD 组）。
R 组和 RD 组的恶心发生率、抢救性止吐药的使用需求、1 小时疼痛的视觉模拟评分（VRS）值、酮咯酸的消耗量以及寒战发生率均显著低于 C 组（P < 0.05）。此外，这些参数在 RD 组显著低于 R 组（P < 0.05）。
与单独使用雷莫司琼相比，雷莫司琼和地塞米松联合使用显著降低了甲状腺手术患者的恶心发生率、抢救性止吐药的使用需求、1 小时疼痛的 VRS 值、酮咯酸的消耗量以及寒战发生率。
