Dorna Kheirabadi, MD, is with the Anesthesiology and Critical Care Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Amir Shafa is with the Department of Anesthesiology, Anesthesiology and Critical Care Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Anahita Hirmanpour is with the Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Fatemeh Zareh, MD, is with the School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Pain Palliat Care Pharmacother. 2020 Jun;34(2):63-68. doi: 10.1080/15360288.2019.1706691. Epub 2020 Jan 10.
This study aimed to compare the prophylactic effects of intravenous (IV) dexamethasone and lidocaine on hemodynamic condition, respiratory complications, pain control, and vomit incidence following cleft palate repair surgery. This double-blind randomized controlled trial was carried out on 87 children assigned to three groups. Prior to anesthesia, subjects in groups D and L received 0.2 and 1 mg/kg IV dexamethasone and lidocaine, respectively. Moreover, group C received placebo in a similar condition. The outcome variables were recorded prior to the surgery and then every 15 minutes during the surgical and recovery time. Mean heart rate (HR), mean arterial blood pressure (MABP), and mean end-tidal carbon dioxide (ETCO2) during the surgical time were not significantly different between dexamethasone and lidocaine groups. Dexamethasone significantly improved the level of blood oxygen saturation (SPO2) during the recovery time. Nevertheless, MABP in recovery time did not significantly decrease in the dexamethasone group. There were no significant differences in respiratory complications, pain score, and vomiting incidence between lidocaine and dexamethasone groups. Premedication with both IV dexamethasone and lidocaine provided similar stable hemodynamic and respiratory conditions during the surgical time. However, the use of dexamethasone developed more desirable effects on HR and SPO2 than administration of lidocaine during the recovery time. Both drugs significantly lessened postoperative pain compared to the placebo group at this time.
本研究旨在比较静脉（IV）地塞米松和利多卡因对腭裂修复手术后血流动力学状况、呼吸并发症、疼痛控制和呕吐发生率的预防作用。这是一项双盲随机对照试验，共纳入 87 名患儿，分为三组。在麻醉前，D 组和 L 组患儿分别接受 0.2 和 1mg/kg IV 地塞米松和利多卡因，而 C 组在类似条件下接受安慰剂。在手术前和手术及恢复期间的每 15 分钟记录结果变量。手术期间的平均心率（HR）、平均动脉血压（MABP）和平均呼气末二氧化碳（ETCO2）在地塞米松和利多卡因组之间无显著差异。地塞米松组在恢复期间显著提高了血氧饱和度（SPO2）水平。然而，地塞米松组在恢复期间的 MABP 没有显著下降。在呼吸并发症、疼痛评分和呕吐发生率方面，利多卡因组和地塞米松组之间无显著差异。在手术期间，静脉给予地塞米松和利多卡因均可提供相似的稳定血流动力学和呼吸状况。然而，与利多卡因相比，地塞米松在恢复期间对 HR 和 SPO2 有更好的影响。与安慰剂组相比，两种药物在这一时间点均显著减轻了术后疼痛。
