Lee Jiwon, Park Hee-Pyoung, Jeong Mu-Hui, Kim Hyun-Chang
Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Medical Center, 56 Dalseung-ro, Joong-gu, Daegu, 41931, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University, Seoul, Republic of Korea.
J Anesth. 2017 Dec;31(6):869-877. doi: 10.1007/s00540-017-2411-6. Epub 2017 Oct 4.
Postoperative sore throat (POST) after general anesthesia with endotracheal intubation is a common and undesirable complication. In this study, we evaluated the combined effects of paracetamol and dexamethasone on the prevention of POST in patients after general anesthesia.
A total of 226 patients scheduled for urologic surgery under general anesthesia were randomly assigned to one of two groups. In the DexaPara group (n = 113), dexamethasone (10 mg) and paracetamol (1000 mg) was infused. In the Dexa group (n = 113), dexamethasone (10 mg) alone was given. POST, hoarseness, and dysphagia were monitored. The postoperative wound pain score and perioperative opioid requirements were compared. In addition, complications related to opioids were compared between the groups.
The overall incidence of POST was lower in the DexaPara group than in the Dexa group [42 (37%) vs. 72 (64%), p < 0.001]. The incidence of POST while resting at postoperative 1 and 6 h was lower in the DexaPara group than in the Dexa group (p = 0.008 and p = 0.004, respectively). The incidence of postoperative nausea, vomiting, drowsiness, shivering, and headache was comparable between the groups.
Paracetamol and dexamethasone infusion reduced the incidence of POST without serious complications in patients for urologic surgery under general anesthesia.
气管插管全身麻醉术后咽痛（POST）是一种常见且不良的并发症。在本研究中，我们评估了对乙酰氨基酚和地塞米松联合使用对全身麻醉患者预防POST的效果。
总共226例计划接受全身麻醉下泌尿外科手术的患者被随机分为两组。在对乙酰氨基酚联合地塞米松组（n = 113）中，输注地塞米松（10 mg）和对乙酰氨基酚（1000 mg）。在单纯地塞米松组（n = 113）中，仅给予地塞米松（10 mg）。监测POST、声音嘶哑和吞咽困难情况。比较术后伤口疼痛评分和围手术期阿片类药物需求量。此外，还比较了两组之间与阿片类药物相关的并发症。
对乙酰氨基酚联合地塞米松组的POST总体发生率低于单纯地塞米松组[42例（37%）对72例（64%），p < 0.001]。术后1小时和6小时静息时POST的发生率，对乙酰氨基酚联合地塞米松组低于单纯地塞米松组（分别为p = 0.008和p = 0.004）。两组术后恶心、呕吐、嗜睡、寒战和头痛的发生率相当。
在全身麻醉下接受泌尿外科手术的患者中，输注对乙酰氨基酚和地塞米松可降低POST的发生率，且无严重并发症。
