Department of Surgery, Hospital of Baselland, Affiliated with the University of Basel, Liestal, Switzerland.
Department of Surgery, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
Langenbecks Arch Surg. 2019 Sep;404(6):693-701. doi: 10.1007/s00423-019-01799-6. Epub 2019 Jun 26.
Nausea and vomiting are common side effects following thyroid and parathyroid surgery. In a prospective controlled randomized trial, postoperative nausea and vomiting (PONV) and the number of episodes of vomiting were defined as two primary endpoints. We analysed whether the placement of drains after thyroid or parathyroid surgery enhances PONV and/or influences vomiting.
From November 2007 to January 2012, 136 consecutive patients were included for thyroid or parathyroid surgery and were randomly assigned to group A (drain, n = 69) or group B (no drain, n = 67). PONV was assessed with visual analogue scale (VAS; range 0 to 10) measurements. Furthermore, episodes of vomiting as well as analgetic and antiemetic therapies were recorded. Difference in neck circumference was compared pre- and postoperatively.
Patients' characteristics did not differ between group A and B. Postoperative VAS values for pain were 2.4 ± 0.3 (group A) and 2.6 ± 0.2 (group B) (p = 0.62), and for nausea 1.4 ± 0.2 (group A) and 1.1 ± 0.2 (group B) (p = 0.57). The relative occurrences of episodes for postoperative vomiting were equal in both groups 0.3 ± 0.1 (p = 1.0). Antiemetic drugs were administered 37 times (group A) and 18 times (group B) (p = 0.099). The total number of treatments of patients with antiemetic drugs was 23 (33.3%) in group A vs. 13 (19.4%) in group B (p = 0.081). The neck circumference postoperatively was significantly larger in group B (p = 0.0025).
Drains after surgery do not enhance postoperative pain, nausea and vomiting. The placement of drains in thyroid surgery is recommended to avoid relevant fluid collection. Drains however may influence the amount of antiemetic drug requirements.
CLINICALTRIALS.
NCT01679418.
甲状腺和甲状旁腺手术后常出现恶心和呕吐等副作用。在一项前瞻性对照随机试验中，术后恶心和呕吐（PONV）以及呕吐发作次数被定义为两个主要终点。我们分析了甲状腺或甲状旁腺手术后放置引流管是否会增加 PONV 并/或影响呕吐。
2007 年 11 月至 2012 年 1 月，连续 136 例甲状腺或甲状旁腺手术患者被纳入研究，并随机分为 A 组（引流组，n=69）或 B 组（无引流组，n=67）。采用视觉模拟评分（VAS；范围 0 至 10）评估 PONV。此外，还记录了呕吐发作次数以及镇痛和止吐治疗情况。比较了术前和术后颈围的差异。
A 组和 B 组患者的特征无差异。术后疼痛的 VAS 值为 2.4±0.3（A 组）和 2.6±0.2（B 组）（p=0.62），恶心的 VAS 值为 1.4±0.2（A 组）和 1.1±0.2（B 组）（p=0.57）。两组术后呕吐发作的相对发生率相同，分别为 0.3±0.1（p=1.0）。A 组使用止吐药物 37 次，B 组使用 18 次（p=0.099）。A 组接受止吐药物治疗的患者总数为 23 例（33.3%），B 组为 13 例（19.4%）（p=0.081）。B 组术后颈围明显增大（p=0.0025）。
手术后放置引流管不会加重术后疼痛、恶心和呕吐。甲状腺手术中推荐放置引流管以避免相关液体积聚。然而，引流管可能会影响止吐药物的使用量。
CLINICALTRIALS.GOV IDENTIFIER：NCT01679418。
